Avoidance of tobacco health warnings? An eye-tracking approach
Avoidance of tobacco health warnings? An eye-tracking approach
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DOI：
10.1111/add.15148
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发表时间：
2020-07-02
期刊：
影响因子：
6
通讯作者：
Maynard, Olivia M.
中科院分区：
文献类型：
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作者：
Sillero-Rejon, Carlos;Leonards, Ute;Maynard, Olivia M.
目的在三项眼球跟踪研究中，我们研究了香烟包装的特征如何影响视觉注意力和自我报告的对警告的回避和反应。设计研究1：吸烟状况×警告即时性(短期与长期健康后果)×警告位置(顶部与底部)。研究2：吸烟状况×警告框架(增益框架与丢失框架)×警告格式(纯文本与图片)。研究3：吸烟状况×警告严重程度(吸烟的高度严重后果与中度严重后果)。背景：英国布里斯托尔大学眼球跟踪实验室。研究1：不吸烟者(n=25)、每周吸烟者(n=25)和每日吸烟者(n=25)。研究2：非吸烟者(n=37)，吸烟者(n=37)和不打算戒烟的吸烟者(n=43)。研究3：不吸烟者(n=27)、每周吸烟者(n=26)和每日吸烟者(n=26)。所有研究的测量：视觉注意力，测量的是注视次数与警告与品牌的比率，自我报告预测对警告的回避和反应，研究3，警告对戒烟动机的影响。结果研究1：更大的自我报告回避[平均差异(MD)=1.14；95%可信区间(CI)=0.94，1.35，P<；视觉注意(MD=0.001.89，95%CI=0.0 9，1.6 8，P=0.0 3，ETA(2)(P)=0.0 6)，而对反应性不敏感(MD=0.14，95%CI=-0.0 4，0.32，P=0.12，ETA(2)(P)=0.0 3)。增加了对包装上半部分警告的视觉注意(MD=1.8；95%CI=0.33，3.26，P=0.02，ETA(2)(P)=0.08)。研究2：较高的自我报告回避(MD=0.70；95%CI=0.59，0.80，P<；0.001，Eta(2)(P)=0.61)和对(MD=0.37；95%CI=0.27，0.47，P<；0.001，Eta(2)(P)=0.34)丢失框架警告的反应性，但几乎没有证据表明视觉注意的差异(MD=0.52；95%CI=-0.54，1.58，P=0.30，ETA(2)(P)=0.01。与纯文字警告相比，更大的视觉注意力、回避和对图片警告的反应(ALP<；0.001，Eta(2)(P)>；0.25)。研究3：更多的自我报告回避(MD=0.37；95%CI=0.25，0.48，P<；0.001，Eta(2)(P)=0.33)和对高度严重警告的反应(MD=0.14；95%CI=0.05，0.23，P=0.003，Eta(2)(P)=0.11)，但结果不确定是否有视觉注意的差异(MD=-0.55；95%CI=-1.5，0.41，P=0.24，ETA(2)(P)=0.02。结论主观和客观(眼球跟踪)避免香烟包装上的健康警告的测量结果不同，这表明这两种测量结构不同。视觉回避警告表明对警告的低水平脱离，而自我报告的预测回避反映了对警告的较高水平的接触。
Aims Among three eye-tracking studies, we examined how cigarette pack features affected visual attention and self-reported avoidance of and reactance to warnings. Design Study 1: smoking status x warning immediacy (short-term versus long-term health consequences) x warning location (top versus bottom of pack). Study 2: smoking status x warning framing (gain-framed versus loss-framed) x warning format (text-only versus pictorial). Study 3: smoking status x warning severity (highly severe versus moderately severe consequences of smoking). Setting University of Bristol, UK, eye-tracking laboratory. Participants Study 1: non-smokers (n = 25), weekly smokers (n = 25) and daily smokers (n = 25). Study 2: non-smokers (n = 37), smokers contemplating quitting (n = 37) and smokers not contemplating quitting (n = 43). Study 3: non-smokers (n = 27), weekly smokers (n = 26) and daily smokers (n = 26). Measurements For all studies: visual attention, measured as the ratio of the number of fixations to the warning versus the branding, self-reported predicted avoidance of and reactance to warnings and for study 3, effect of warning on quitting motivation. Findings Study 1: greater self-reported avoidance [mean difference (MD) = 1.14; 95% confidence interval (CI) = 0.94, 1.35,P < 0.001, eta(2)(p) = 0.64] and visual attention (MD = 0.89, 95% CI = 0.09, 1.68,P = 0.03, eta(2)(p) = 0.06) to long-term warnings, but not for reactance (MD = 0.14, 95% CI = -0.04, 0.32,P = 0.12, eta(2)(p) = 0.03). Increased visual attention to warnings on the upper versus lower half of the pack (MD = 1.8; 95% CI = 0.33, 3.26,P = 0.02, eta(2)(p) = 0.08). Study 2: higher self-reported avoidance of (MD = 0.70; 95% CI = 0.59,0.80,P < 0.001, eta(2)(p) = 0.61) and reactance to (MD = 0.37; 95% CI = 0.27, 0.47,P < 0.001, eta(2)(p) = 0.34) loss-framed warnings but little evidence of a difference for visual attention (MD = 0.52; 95% CI = -0.54, 1.58,P = 0.30, eta(2)(p) = 0.01). Greater visual attention, avoidance and reactance to pictorial versus text-only warnings (allPs < 0.001, eta(2)(p) > 0.25). Study 3: greater self-reported avoidance of (MD = 0.37; 95% CI = 0.25, 0.48,P < 0.001, eta(2)(p) = 0.33) and reactance to (MD = 0.14; 95% CI = 0.05, 0.23,P = 0.003, eta(2)(p) = 0.11) highly severe warnings but findings were inconclusive as to whether there was a difference in visual attention (MD = -0.55; 95% CI = -1.5, 0.41,P = 0.24, eta(2)(p) = 0.02). Conclusions Subjective and objective (eye-tracking) measures of avoidance of health warnings on cigarette packs produce different results, suggesting these measure different constructs.Visual avoidance of warnings indicates low-level disengagement with warnings, while self-reported predicted avoidance reflects higher-level engagement with warnings.