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Karger Publishers, European Addiction Research, 1(21), p. 47-52, 2014

DOI: 10.1159/000366019

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Effectiveness of Text versus Pictorial Health Warning Labels and Predictors of Support for Plain Packaging of Tobacco Products within the European Union

Journal article published in 2014 by Israel T. Agaku ORCID, Filippos T. Filippidis, Constantine I. Vardavas ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

<b><i>Background:</i></b> Tobacco product warning labels are a key health communication medium with plain packaging noted as the next step in the evolution of tobacco packaging. We assessed the self-reported impact of text versus pictorial health warnings and the determinants of support for plain packaging of tobacco products in the European Union (EU). <b><i>Methods:</i></b> The Special Eurobarometer 385 survey was analyzed for 26,566 adults from 27 EU countries in 2012. The self-reported impact of warning labels (text or pictorial) and determinants of EU-wide support for plain packaging were assessed using multivariate logistic regression. <b><i>Results:</i></b> Current smokers in countries where cigarette pictorial warnings were implemented had higher odds of reporting that health warning labels had any effect on their smoking behavior (making a quit attempt or reducing number of cigarettes smoked per day) compared to respondents in countries with text-only warning labels (adjusted odds ratio, aOR = 1.31; 95% confidence interval, 95% CI: 1.10-1.56). Population support for plain packaging of tobacco packs was higher in countries where cigarette pictorial warnings already existed (aOR = 1.17; 95% CI: 1.07-1.28). <b><i>Conclusions:</i></b> These findings indicate that the implementation of pictorial warnings at an EU level may have a positive behavioral impact among smokers and pave the way for population support for plain packaging in the EU.