Cited by 435Smoking Behavior and CessationGlobal Public Health Policies and EpidemiologyBehavioral Health and Interventions

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Text and Graphic Warnings on Cigarette Packages

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Hammond, David, Fong, Geoffrey T., Borland, Ron, Cummings, K. Michael, McNeill, Ann, Driezen, Pete·2007·American Journal of Preventive Medicine

DOI 10.1016/j.amepre.2006.11.011PMC PMC1868456

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Abstract

Background Health warnings on cigarette packages provide smokers with universal access to information on the risks of smoking. However, warnings vary considerably among countries, ranging from graphic depictions of disease on Canadian packages to obscure text warnings in the United States. The current study examined the effectiveness of health warnings on cigarette packages in four countries.Methods Quasi-experimental design. Telephone surveys were conducted with representative cohorts of adult smokers (n=14,975): Canada (n=3687), United States (n=4273), UK (n=3634), and Australia (n=3381). Surveys were conducted between 2002 and 2005, before and at three time points following implementation of new package warnings in the UK.Results At Wave 1, Canadian smokers reported the highest levels of awareness and impact for health warnings among the four countries, followed by Australian smokers. Following the implementation of new UK warnings at Wave 2, UK smokers reported greater levels of awareness and impact, although Canadian smokers continued to report higher levels of impact after adjusting for the implementation date. U.S. smokers reported the lowest levels of effectiveness for almost every measure recorded at each survey wave.Conclusions Large, comprehensive warnings on cigarette packages are more likely to be noticed and rated as effective by smokers. Changes in health warnings are also associated with increased effectiveness. Health warnings on U.S. packages, which were last updated in 1984, were associated with the least effectiveness.

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INDIVIDUALIZED VERSUS POPULATION‐BASED APPROACHES TO TOBACCO CONTROL – A FALSE DICHOTOMY
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Self-citation

Authors: Hammond, D., Fong, G. T., Borland, R., Cummings, K. M., McNeill, A., & Driezen, P.
Affiliations: University of Waterloo (CA)
Cancer Council Victoria (AU)
Roswell Park Comprehensive Cancer Center (US)
University of Nottingham (GB)
Corresponding author: Hammond, David
ORCID: Hammond, David
Fong, Geoffrey T.
Borland, Ron
Cummings, K. Michael
McNeill, Ann
Driezen, Pete
Venue: American Journal of Preventive Medicine
Publisher: Elsevier BV
Published: 2007-03
Volume: 32
Issue: 3
Pages: 202-209
ISSN: 0749-3797 (ISSN-L)
DOI: 10.1016/j.amepre.2006.11.011
PMC: PMC1868456
OpenAlex: W2152630311
Cited by: 434
References: 22
Citations by year: 2026: 1 · 2025: 12 · 2024: 9 · 2023: 8 · 2022: 14 · 2021: 15 · 2020: 19 · 2019: 48 · 2018: 33 · 2017: 31 · 2016: 30 · 2015: 32 · 2014: 26 · 2013: 24 · 2012: 34
FWCI: 16.92
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (P50CA111236, R01CA100362)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords: graphic health warnings, warning effectiveness, cross-national comparison, tobacco control, United States, United Kingdom, Canada, Australia
MeSH terms: Smoking Prevention, Adult, Australia, Canada, Consumer Product Safety, Female, United Kingdom, Health Promotion, Humans, International Cooperation, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Product Labeling, Smoking, United States

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