Evaluation of cigarette package inserts for enhanced communication with smokers

项目概要： 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）。一种标签选择是香烟包装插页- 香烟盒内的小印刷传单。世纪以来，香烟制造商一直使用插入物来 吸烟者每次打开新包装时都会收到促销信息。然而， 未充分用于公共卫生传播。加拿大是世界上唯一一个同时拥有HWL和 插入物，我们最近的研究发现它们对帮助吸烟者的有效性非常有希望的结果 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， 迫切需要研究来支持其决策。 我们提出的研究是基于关于行为益处的“功效”信息的重要性 改变和建立信心改变行为，这是加拿大插页上使用的信息类型。 当随附显示以下内容的大型图形HWL时，插页上的疗效信息可能最有效 吸烟的危害。我们的目的是评估带有疗效信息的插页是否能促进戒烟： 目的1：我们将在成年人中进行一项实验，评估带有疗效信息的插入物的影响 吸烟者在美国在研究1中，320名吸烟者将被分为四个标签组之一：1。没有插入物或 图片HWL; 2.仅插入物; 3.仅图形HWL; 4.插页和图形HWL。吸烟者将获得14- 每天供应他们喜欢的香烟品牌，并根据他们的群体标记包装。参与者将 在每天结束时回答一个简短的调查，每天另外四次。我们将研究吸烟者是否在 每一组经历与戒烟相关的不同心理反应或行为。 目的2：我们将通过以下两组成年人来评估加拿大“插入物”标签政策的影响 吸烟者将在2020年加拿大将新的插入物和HWL放在包装上之前和之后接受调查。研究 2a参与者将在新政策实施之前和之后回答14天的调查（如研究1）。 在研究2b中，我们将在2年内每4个月对1500名吸烟者进行调查，涵盖之前的时期（3次调查） （四）新政策出台后。研究2a和2b的时间和问题将使我们能够比较 他们的结果，这将有助于我们得出更有力的结论，标签是否促进戒烟。 拟议的研究将提供迄今为止关于包装说明书的最强有力的研究。的长处 研究1中的实验是通过在更自然的背景下评估插入效应来补充的， 研究2a和2b。所有三项研究的结果比较将有助于确定衬垫和HWL 工作，包括其对戒烟的影响。研究结果将对美国和欧洲的政策制定都有帮助。 和国际上。我们还将提高对产品标签的理解，其成本低， 与许多人反复沟通对促进健康的消费行为具有很大的潜力。

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.