Investigating the Impact of the 2012 Canadian Graphic Health Warning Label Revisions: Findings from the ITC Canada Survey
Notice bibliographique
Résumé
Background: Approximately 100 Canadians die every day from smoking-related illnesses. Health warnings labels (HWLs) on cigarette packages are a highly cost-effective strategy to inform the public on the health risks of smoking and to motivate smokers to quit. Warnings that display graphic images have been shown to be particularly effective in increasing quit intentions and cessation-related behaviours. Canada became the first country to implement graphic HWLs on cigarette packages in June 2001. The Canadian graphic HWLs were revised in 2012. \nObjectives: This is the first longitudinal study to evaluate the impact of the 2012 Canadian graphic HWL revisions on: 1) Key indicators of warning label effectiveness (warning salience, and cognitive and behavioural HWL responses); 2) Affective reactions evoked by warnings; 3) Beliefs about smoking-related health statements displayed on warnings; 4) Rates of reading interior efficacy messages; 5) Levels of quit-efficacy and perceived difficulty to quit smoking; and 6) Quit intentions and cessation-related behaviours. Moderation of the impact by socioeconomic status (SES) was explored for each outcome. Mediation of the effect of HWLs on smokers’ quit intentions and quit attempts through cognitive and affective reactions was also tested through a series of mediation models. \nMethods: Data for this study were taken from Waves 1 to 9 (conducted between 2002 and 2014) of the ITC Canada Survey, a nationally representative longitudinal survey of smokers aged 18 years and older (n=5929). Using generalized estimating equations and segmented regression models, the overall secular trends of cognitive and behavioural outcomes were investigated to assess the impact of the 2012 graphic HWL revisions. Structural equationmodeling was used to test mediation of HWL impact on quit intentions through cognitive and affective reactions. \nResults: Following the 2012 Canadian graphic HWL revisions, significantly more smokers reported to notice warnings “often” or “very often”, think “a lot” about health risks of smoking and about quitting due to warnings, and avoid warnings. The HWL revisions also increased affective reactions evoked by warnings and warning believability (which were positively associated with quit intentions and quit attempts). Adding health messages to warnings significantly increased rates of correct beliefs about these health facts, and the removal of health information was shown to decrease positively trending rates in correct beliefs, and even reduce them. Although few smokers (15%) reported to read the interior efficacy messages in 2013, those who did had significantly higher levels of quit-efficacy, quit intentions, and were more likely to call the toll-free quit line. Quit-efficacy decreased and perceived difficulty to quit smoking increased following the 2012 HWL revisions, but these measures were not associated with quit attempts. Rates of calling the quit line more than doubled after the revisions (which included the addition of the toll-free quit line number on cigarette packages). Quit intentions and cessation- related behaviours did not significantly change, with the exception of rates of sustained smoking cessation, which significantly increased. Affective reactions evoked by the graphic HWLs significantly mediated the impact of HWLs on smokers’ intentions to quit, but only after the warnings were revised in 2012. SES was not found to moderate the impact of the HWL revisions on any cognitive or behavioural outcome measures. \nConclusions: The 2012 HWL revisions were successful in reducing and even reversing the effects of wear-out, which were shown to be progressively diminishing the effectiveness of the Canadian graphic HWLs between 2002 and 2011. Affective reactions evoked by the graphic HWLs were significantly and positively associated with increased cessation-related cognitions and behaviours, supporting the implementation of emotionally evocative warnings. The impact of the 2012 graphic HWL revisions was just as strong among smokers with a low income and education as it was among smokers with a high income and education.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,016 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,007 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».