Building evidence for effective and sustainable cigarette warning label policy

描述（由申请人提供）：最近的立法为美国食品和药物管理局（FDA）提供了对烟草的监管权力，包括为新的健康警告标签（hwl）选择图像，这些标签将从2012年开始覆盖卷烟包装正面和背面的50%。美国的禁烟政策与研究一致，研究清楚地表明，最有效的禁烟标志是突出的，覆盖烟盒的正面和背面，并包括描述吸烟后果的图像。然而，图像HWLs的“磨损”效应以及促进持续影响的图像HWLs的具体特征尚未得到仔细研究。图示HWL政策的关键特征在不同国家之间的差异允许进行自然实验，以确定其随时间的相对影响。我们建议在四个国家的成年吸烟者中进行准实验和实验研究，这些国家的图示HWL政策在关键维度上有所不同，并涉及在2012年实施新的图示HWL内容和设计：美国将首次推出图像hwl；2. 加拿大将在世界上曝光时间最长（即11年）后首次更改图像hwl；3. 墨西哥将继续以世界上最高的频率（即每三个月一次）轮换新的hwl；和4。澳大利亚将改变其图像hwl，同时实施禁止在卷烟包装上使用品牌图像（即“普通”包装）的创新政策。该项目将利用这一前所未有的机会，系统地研究将在同一年引入新型图形化HWL的四个国家的HWL政策变化的长期影响。具体目标1：我们将使用准实验设计，在这四个国家的成年吸烟者中进行滚动面板，以确定最容易处理的图像HWL特征是否比需要更大认知努力来处理的HWL特征对戒烟相关的认知、影响和行为有更持久的影响。具体目标2：我们将进行一系列的控制

DESCRIPTION (provided by applicant): Recent legislation provides the US Food and Drug Administration (FDA) with regulatory authority over tobacco, including the selection of pictorial imagery for new health warning labels (HWLs) that will cover 50% of the front and back of cigarette packs starting in 2012. US HWL policy is aligned with research that has clearly demonstrated that the most effective HWLs are prominent, cover the front and back of the pack, and include imagery that depicts the consequences of smoking. However, the effects of pictorial HWLs "wear out", and the specific characteristics of pictorial HWLs that promote a sustained impact have not been carefully studied. Between-country variation in key characteristics of pictorial HWL policies allows for a natural experiment to determine their relative impact over time. We propose to conduct quasi-experimental and experimental studies among adult smokers in four countries with pictorial HWL policies that differ along key dimensions and that involve implementation of new pictorial HWL content and design in 2012: 1. The US will introduce pictorial HWLs for the first time; 2. Canada will change pictorial HWLs for the first tim after the longest period of exposure in the world (i.e., 11 years); 3. Mexico will continue rotatin new HWLs at the highest frequency in the world (i.e., every three months); and 4. Australia will change its pictorial HWLs while simultaneously implementing the innovative policy of prohibiting brand imagery on cigarette packs (i.e., "plain" packaging). This project would capitalize on the unprecedented opportunity to systematically examine the over-time effects of changes to HWL policies in four countries that will introduce novel pictorial HWLs in the same year. We will do this by pursuing the following specific aims: Specific Aim 1: We will use a quasi-experimental design with rolling panels of adult smokers in these four countries, in order to determine whether pictorial HWL characteristics that are easiest to process have a more sustained impact on smoking cessation-related cognitions, affect and behaviors than HWL characteristics that require greater cognitive effort to process. Specific Aim 2: We will conduct a series of controlled randomized experiments among adult smokers in the same four countries, systematically varying their exposure to pictorial HWL content and design that is novel relative to existing HWLs, in order to determine the cognitive and affective impact of these manipulations. This project brings together the world's leading experts on tobacco HWL policy to extend the foundation for evidence-based policy development, so that it encompasses the effectiveness and sustainability of different HWL policy options. Results will be disseminated to key decision-makers around the world, including the US FDA and the US Secretary of Health and Human Services, who have the authority to revise HWLs to ensure adequate public understanding of the harms of tobacco use.