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Public attitudes toward larger cigarette pack warnings: Results from a nationally representative U.S. sample

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  • Sarah D Kowitt
  • Seth M Noar
  • Leah M Ranney
  • Adam O Goldstein

Abstract

A large body of evidence supports the effectiveness of larger health warnings on cigarette packages. However, there is limited research examining attitudes toward such warning labels, which has potential implications for implementation of larger warning labels. The purpose of the current study was to examine attitudes toward larger warning sizes on cigarette packages and examine variables associated with more favorable attitudes. In a nationally representative survey of U.S. adults (N = 5,014), participants were randomized to different warning size conditions, assessing attitude toward “a health warning that covered (25, 50, 75) % of a cigarette pack.” SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights. Across experimental groups, nearly three-quarters (72%) of adults had attitudes supportive of larger warning labels on cigarette packs. Among the full sample and smokers only (N = 1,511), most adults had favorable attitudes toward labels that covered 25% (78.2% and 75.2%, respectively), 50% (70% and 58.4%, respectively), and 75% (67.9% and 61%, respectively) of a cigarette pack. Young adults, females, racial/ethnic minorities, and non-smokers were more likely to have favorable attitudes toward larger warning sizes. Among smokers only, females and those with higher quit intentions held more favorable attitudes toward larger warning sizes. Widespread support exists for larger warning labels on cigarette packages among U.S. adults, including among smokers. Our findings support the implementation of larger health warnings on cigarette packs in the U.S. as required by the 2009 Tobacco Control Act.

Suggested Citation

  • Sarah D Kowitt & Seth M Noar & Leah M Ranney & Adam O Goldstein, 2017. "Public attitudes toward larger cigarette pack warnings: Results from a nationally representative U.S. sample," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-14, March.
  • Handle: RePEc:plo:pone00:0171496
    DOI: 10.1371/journal.pone.0171496
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    References listed on IDEAS

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    1. Noar, Seth M. & Francis, Diane B. & Bridges, Christy & Sontag, Jennah M. & Ribisl, Kurt M. & Brewer, Noel T., 2016. "The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies," Social Science & Medicine, Elsevier, vol. 164(C), pages 118-129.
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    3. Rose, S.W. & Emery, S.L. & Ennett, S. & Reyes, H.L.M. & Scott, J.C. & Ribisl, K.M., 2015. "Public support for family smoking prevention and tobacco control act point-of-sale provisions: Results of a national study," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 60-67.
    4. Heiser, P.F. & Begay, M.E., 1997. "The campaign to raise the tobacco tax in Massachusetts," American Journal of Public Health, American Public Health Association, vol. 87(6), pages 968-973.
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