CoChat
Sign Up
Cited by 71Smoking Behavior and CessationBehavioral Health and InterventionsGlobal Public Health Policies and Epidemiology

Does the effect go up in smoke? A randomized controlled trial of pictorial warnings on cigarette packaging

Schneider, Sven, Gadinger, Michael, Fischer, Andreas·2012·Patient Education and Counseling
DOI 10.1016/j.pec.2011.03.005
Open this paper in CoChat — free account

Abstract

Objective Placing a combination of a written warning and a graphic image on cigarette packaging (so called "pictorial warnings") is one of the WHO Framework Convention on Tobacco Control's most controversial recommendations. Our randomized controlled trial investigated if pictorial warnings lead to significantly higher motivation to quit, as compared to written warnings alone.Methods Four pictorial warnings were selected from the EU Commission's official image catalogue. Study arm 1 (44 adult smokers) viewed only the written warnings while study arm 2 (44 adult smokers) viewed the corresponding pictorial warnings. Self-affirmation was a second randomly manipulated factor, and nicotine dependence a quasi-experimental third factor. The main outcome measured was the motivation to quit, with fear intensity as one of the secondary outcomes.Results Pictorial warnings were associated with a significantly higher motivation to quit. A pictorial warning was also associated with higher fear intensity. The effect of warnings appears to be independent of nicotine dependence and self-affirmation.Conclusions Nationwide implementation of pictorial warnings may be effective in increasing heavy smokers' motivation to quit.Practice implication Due to the fact that perceived vulnerability, response and self-efficacy are not more strongly affected by pictorial warnings this effect may turn out to be short-term.

Integrity signals

Registry

Crossref · 10.1016/j.pec.2011.03.005

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Schneider, S., Gadinger, M., & Fischer, A.
Affiliations
  • Heidelberg University (DE)
  • University of Mannheim (DE)
Corresponding author
Schneider, Sven
ORCID
Schneider, Sven
Venue
Patient Education and Counseling
Publisher
Elsevier BV
Published
2012-01
Volume
86
Issue
1
Pages
77-83
ISSN
0738-3991 (ISSN-L)
DOI
10.1016/j.pec.2011.03.005
OpenAlex
W2039498296
Cited by
71
References
37
Citations by year
2025: 4 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 7 · 2020: 1 · 2019: 5 · 2018: 7 · 2017: 10 · 2016: 6 · 2015: 11 · 2014: 3 · 2013: 9 · 2012: 1
FWCI
3.04
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Patient Education and Counseling (publishedVersion)
  • PubMed (publishedVersion)
Funders
Deutsches Krebsforschungszentrum
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Keywords
graphic health warnings, cigarette packaging, smoking cessation motivation, fear intensity, self-affirmation, nicotine dependence, Framework Convention on Tobacco Control, tobacco control
MeSH terms
Smoking Prevention, Adolescent, Adult, Analysis of Variance, Communication, Fear, Female, Germany, Health Education, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Models, Psychological, Motivation, Product Labeling, Public Health, Surveys and Questionnaires, Smoking, Tobacco Use Disorder, Smoking Cessation, Product Packaging, Social Marketing, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review