Evaluation of cigarette package inserts for enhanced communication with smokers

项目总结： 烟草产品标签是一项重要的公共卫生政策，世界上大多数国家都要求 香烟包装外部的健康警告标签(HWL)。一种标签选项是香烟包装插入- 香烟包装内的小印制传单。一个多世纪以来，卷烟制造商一直使用插入物来 每次吸烟者打开新烟盒时，都要向他们传达促销信息。但是，插入物仍保留 在公共卫生交流中未得到充分利用。加拿大是世界上唯一同时拥有HWL和HWL的国家 在帮助吸烟者的有效性方面，我们最近的研究发现了非常有希望的结果 不干了。美国食品和药物管理局目前正在为美国的香烟开发新的标签，以及 迫切需要研究来支持其决策。 我们提出的研究是基于有关行为益处的“功效”信息的重要性 改变和建立改变行为的信心，这是加拿大插页上使用的消息类型。 插入物上的功效信息可能在伴随着显示以下内容的大型图形化HWL时最有效 吸烟的危害。我们的目标是评估带有功效信息的插入物是否有助于戒烟： 目的1：我们将通过一项在成人中进行的实验来评估带有功效信息的插入物的影响 美国的吸烟者。在研究1中，320名吸烟者将被分成四个标签组中的一个：1.不插入或 图片式HWL；2.仅插页；3.仅图片式HWL；4.插页和图片式HWL。吸烟者将被给予14- 每天供应他们喜欢的香烟品牌，并根据他们的组别贴上标签。参与者将 在每天结束时回答一份简短的调查，每天回答另外四次。我们将研究吸烟者是否在 每组人都经历了与戒烟相关的不同心理反应或行为。 目标2：我们将通过以下两组成年人来评估加拿大插入标签政策的影响 2020年，在加拿大将新的吸烟剂和HWL放在烟盒上之前和之后，将对吸烟者进行调查。学习 参与者将在新政策实施前后接受为期14天的调查(如研究1所示)。 在研究2b中，我们将在两年内每4个月调查1500名吸烟者，涵盖之前的时期(3次调查) 并在(4次调查)新政策之后。研究2a和2b的时间和问题将使我们能够比较 他们的结果，这将帮助我们得出关于标签是否促进戒烟的更有力的结论。 这项拟议的研究将提供迄今为止关于包装插入的最强有力的研究。的优势所在 研究1中的实验得到了在更自然的环境中对插入效果的评估的补充 研究2a和2b。比较所有三项研究的结果将有助于确定插入和HWL 工作，包括它们对戒烟的影响。研究结果将对美国和美国的政策制定都有帮助 国际上也是如此。我们还将提高对产品标签的理解，产品标签的低成本和能力 与许多人反复交流，对促进健康的消费行为具有巨大的潜力。

PROJECT SUMMARY: Tobacco product labeling is a critical public health policy, and most countries around the world require health warning labels (HWLs) on cigarette pack exteriors. One labeling option is cigarette package inserts – small printed leaflets inside of cigarette packs. For over a century, cigarette manufacturers have used inserts to reach smokers with promotional messages every time they open a new pack. However, inserts remain underused for public health communication. Canada is the only country in the world that has both HWLs and inserts, for which our recent research finds very promising results on their effectiveness for helping smokers quit. The US Food and Drug Administration currently is developing new labels for cigarettes in the US, and research is urgently needed to support its decision making. Our proposed study is based on the importance of “efficacy” messages about the benefits of behavior change and that build confidence to change behavior, which is the type of message used on Canadian inserts. Efficacy messages on inserts may be most effective when accompanied by large pictorial HWLs that show harms from smoking. We aim to evaluate whether inserts with efficacy messages promote smoking cessation: AIM 1: We will evaluate the impact of inserts with efficacy messages using an experiment among adult smokers in the US. In Study 1, 320 smokers will be put into one of four labeling groups: 1. no inserts or pictorial HWLs; 2. inserts only; 3. pictorial HWLs only; 4. inserts & pictorial HWLs. Smokers will be given a 14- day supply of their preferred cigarette brand with packs labeled according to their group. Participants will answer a brief survey at the end of each day and four other times each day. We will study whether smokers in each group experience different psychological responses or behaviors associated with smoking cessation. AIM 2: We will evaluate the impact of an `inserts' labeling policy in Canada by following two groups of adult smokers who will be surveyed before and after Canada puts new inserts and HWLs on packs in 2020. Study 2a participants will answer surveys for 14 days (as in Study 1) both before and after the new policy is in place. In Study 2b we will survey 1500 smokers every 4 months over 2 years, covering the period before (3 surveys) and after (4 surveys) the new policy. The timing and questions for Studies 2a and 2b will allow us to compare their results, which will help us reach stronger conclusions about whether labels promote smoking cessation. The proposed study will provide the strongest research on package inserts to date. The strengths of the experiment in Study 1 are complemented by the evaluation of insert effects in more natural contexts for Studies 2a and 2b. Comparison of results across all three studies will help determine how inserts and HWLs work, including their effects on smoking cessation. The results will be useful for policy making both in the US and internationally. We will also improve understanding of product labeling, whose low cost and ability to repeatedly communicate with many people holds great potential for promoting healthy consumer behaviors.