Abstract
Background: Pictorial health warnings on tobacco packs stimulate short-term cognitive and emotional responses that can lead to quit attempts. We tested novel product attribute health warnings (PAHWs) that corrected misperceptions about product harmfulness. PAHWs uniquely influenced outcomes assessing knowledge of industry manipulation of cigarettes, industry-centric negative emotional responses and product-specific smoking dissonance. We aimed to examine if these unique short-term responses predicted subsequent quitting-related behaviours.
Method: We analysed follow-up data from a between-subjects online experiment during which participants were randomised to view PAHWs alone (PAHW condition) or with a complementary video (PAHW+Video) during a baseline session and daily for 7 days. In the present study, covariate-adjusted logistic regression models examined associations between short-term responses to the PAHWs measured at 8-day follow-up (predictors) and subsequent quitting-related behaviours measured at 4-week follow-up (outcomes).
Results: Participants with valid data for the 8-day and 4-week follow-up surveys were analysed (N=301). Two short-term responses to the PAHWs-knowledge of industry manipulation of cigarettes and product-specific smoking dissonance-significantly and positively predicted all three quitting-related outcomes: smoke-limiting microbehaviours (eg, foregoing cigarettes), quit attempts and 7-day sustained abstinence. Industry-centric negative emotional responses positively predicted smoke-limiting microbehaviours and 7-day sustained abstinence but not quit attempts.
Conclusion: Short-term responses elicited by PAHWs featuring corrective information about the tobacco industry's manipulation of tobacco products predicted subsequent engagement in smoke-limiting microbehaviours, quit attempts and sustained quit attempts. PAHWs can complement other health warnings featuring the health risks of smoking and may help motivate people who smoke to quit and stay quit.