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Impact of Tobacco-Related Health Warning Labels across Socioeconomic, Race and Ethnic Groups: Results from a Randomized Web-Based Experiment

Author

Listed:
  • Jennifer Cantrell
  • Donna M Vallone
  • James F Thrasher
  • Rebekah H Nagler
  • Shari P Feirman
  • Larry R Muenz
  • David Y He
  • Kasisomayajula Viswanath

Abstract

Background: The U.S. Family Smoking Prevention and Tobacco Control Act of 2009 requires updating of the existing text-only health warning labels on tobacco packaging with nine new warning statements accompanied by pictorial images. Survey and experimental research in the U.S. and other countries supports the effectiveness of pictorial health warning labels compared with text-only warnings for informing smokers about the risks of smoking and encouraging cessation. Yet very little research has examined differences in reactions to warning labels by race/ethnicity, education or income despite evidence that population subgroups may differ in their ability to process health information. The purpose of the present study was to evaluate the potential impact of pictorial warning labels compared with text-only labels among U.S. adult smokers from diverse racial/ethnic and socioeconomic subgroups. Methods/Findings: Participants were adult smokers recruited from two online research panels (n = 3,371) into a web-based experimental study to view either the new pictorial warnings or text-only warnings. Participants viewed the labels and reported their reactions. Adjusted regression models demonstrated significantly stronger reactions for the pictorial condition for each outcome salience (b = 0.62, p

Suggested Citation

  • Jennifer Cantrell & Donna M Vallone & James F Thrasher & Rebekah H Nagler & Shari P Feirman & Larry R Muenz & David Y He & Kasisomayajula Viswanath, 2013. "Impact of Tobacco-Related Health Warning Labels across Socioeconomic, Race and Ethnic Groups: Results from a Randomized Web-Based Experiment," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-11, January.
    • Handle: RePEc:plo:pone00:0052206
    DOI: 10.1371/journal.pone.0052206
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    References listed on IDEAS

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    2. Kuehnle, Daniel, 2019. "How effective are pictorial warnings on tobacco products? New evidence on smoking behaviour using Australian panel data," Journal of Health Economics, Elsevier, vol. 67(C).
    3. Andreas Vilhelmsson & Per-Olof Östergren, 2018. "Reducing health inequalities with interventions targeting behavioral factors among individuals with low levels of education - A rapid review," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-14, April.
    4. Adnan M. S. Fakir & Tushar Bharati, 2021. "Healthy, nudged, and wise: Experimental evidence on the role of cost reminders in healthy decision-making," Economics Discussion / Working Papers 21-13, The University of Western Australia, Department of Economics.
    5. Hughner, Renée Shaw & Dumitrescu, Claudia, 2024. "The effectiveness of sugar-sweetened beverage warning labels: An examination of consumer reactance and cost of compliance," Journal of Business Research, Elsevier, vol. 182(C).
    6. Ce Shang & Jidong Huang & Kai-Wen Cheng & Yanyun He & Frank J. Chaloupka, 2017. "The Association between Warning Label Requirements and Cigarette Smoking Prevalence by Education-Findings from the Global Adult Tobacco Survey (GATS)," IJERPH, MDPI, vol. 14(1), pages 1-16, January.
    7. Adnan M. S. Fakir & Tushar Bharati, 2022. "Healthy, nudged, and wise: Experimental evidence on the role of information salience in reducing tobacco intake," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1129-1166, June.
    8. Ramanadhan, Shoba & Nagler, Rebekah H. & McCloud, Rachel & Kohler, Racquel & Viswanath, Kasisomayajula, 2017. "Graphic health warnings as activators of social networks: A field experiment among individuals of low socioeconomic position," Social Science & Medicine, Elsevier, vol. 175(C), pages 219-227.
    9. Abigail T Evans & Ellen Peters & Andrew A Strasser & Lydia F Emery & Kaitlin M Sheerin & Daniel Romer, 2015. "Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-23, December.
    10. Jessica L. Reid & Seema Mutti-Packer & Prakash C. Gupta & Qiang Li & Jiang Yuan & Nigar Nargis & A. K. M. Ghulam Hussain & David Hammond, 2017. "Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries," IJERPH, MDPI, vol. 14(8), pages 1-15, August.
    11. Daniel Bennett & Syed Ali Asjad Naqvi & Wolf‐Peter Schmidt, 2015. "Constraints on Compliance and the Impact of Health Information in Rural Pakistan," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1065-1081, September.

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