Cigarette Warning Label Policy Alternatives and Smoking-Related Health Disparities
Cigarette Warning Label Policy Alternatives and Smoking-Related Health Disparities
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DOI：
10.1016/j.amepre.2012.08.025
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发表时间：
2012-12-01
影响因子：
5.5
通讯作者：
Cummings, K. Michael
中科院分区：
文献类型：
--
作者：
Thrasher, James F.;Carpenter, Matthew J.;Cummings, K. Michael
背景：有人建议在美国香烟包装上印制健康警告图片，但它们对遭受烟草相关健康差异的人群的潜在影响尚不清楚。目的：评价图片健康警示标签，包括健康素养和种族对其影响的适度性。方法：2011年7月至2012年1月，将981名成年吸烟者随机分为对照（纯文字标签组，207人）和实验组（图片标签组，774人）进行现场实验。实验条件根据健康主题和图像类型系统地改变健康警示标签刺激。线性混合效应（LME）模型估计了健康警告标签特征和参与者特征对标签评级的影响。数据分析时间为2012年1月至2012年4月。结果：与纯文字警告标签相比，图片警告标签被评为更具有个人相关性（5.7 vs 6.8, p < 0.001）和有效性（5.4 vs 6.8, p < 0.001），并且更可信，但仅在健康素养较低的参与者中（7.6 vs 8.2, p < 0.001）。在实验条件下，与人类痛苦图像和象征性图像相比，带有图形图像的健康警告标签在可信度、个人相关性和有效性方面具有显著更高的评级。重要的相互作用表明，带有图形图像的标签在种族群体和健康素养水平之间的评分差异很小，而其他图像产生更大的群体差异。结论：图形健康警示标签对成年吸烟者具有最显著的短期影响，包括过去难以接触到的人群。[J]中华预防医学杂志，2012;43(6):590-600
Background: Pictorial health warning labels on cigarette packaging have been proposed for the U.S., but their potential influences among populations that suffer tobacco-related health disparities are unknown.Purpose: To evaluate pictorial health warning labels, including moderation of their influences by health literacy and race.Methods: From July 2011 to January 2012, field experiments were conducted with 981 adult smokers who were randomized to control (i.e., text-only labels, n = 207) and experimental conditions (i.e., pictorial labels, n = 774). The experimental condition systematically varied health warning label stimuli by health topic and image type. Linear mixed effects (LME) models estimated the influence of health warning label characteristics and participant characteristics on label ratings. Data were analyzed from January 2012 to April 2012.Results: Compared to text-only warning labels, pictorial warning labels were rated as more personally relevant (5.7 vs 6.8, p < 0.001) and effective (5.4 vs 6.8, p < 0.001), and as more credible, but only among participants with low health literacy (7.6 vs 8.2, p < 0.001). Within the experimental condition, pictorial health warning labels with graphic imagery had significantly higher ratings of credibility, personal relevance, and effectiveness than imagery of human suffering and symbolic imagery. Significant interactions indicated that labels with graphic imagery produced minimal differences in ratings across racial groups and levels of health literacy, whereas other imagery produced greater group differences.Conclusions: Pictorial health warning labels with graphic images have the most-pronounced short-term impacts on adult smokers, including smokers from groups that have in the past been hard to reach. (Am J Prev Med 2012;43(6):590-600) (C) 2012 American Journal of Preventive Medicine