Skip to main content
Grant Details

Grant Number: 1R01CA167067-01A1 Interpret this number
Primary Investigator: Thrasher, James
Organization: University Of South Carolina At Columbia
Project Title: Building Evidence for Effective and Sustainable Cigarette Warning Label Policy
Fiscal Year: 2012
Back to top


DESCRIPTION (provided by applicant): The US Food and Drug Administration (FDA) now has regulatory authority over tobacco, including the selection and changing of pictorial and textual content for health warning labels (HWLs) on cigarette packaging. In September 2012, the US is scheduled to implement nine different text messages and images on HWLs that will cover 50% of the front and back of cigarette packs. After the first round of pictorial HWLs is implemented, its effects will "wear out" over time. The FDA is charged with changing the content of HWLs if they have evidence that changing them will "...promote greater public understanding of the risks associated with the use of tobacco products.'' The proposed study will address methodological shortfalls of previous studies to provide researchers and US regulators with state-of-the-art scientific evidence on the effects of key pictorial HWL policy characteristics on smokers' understanding of smoking-related risks and on smoking cessation. The results will inform legal challenges to implementation of current US policy, and they will provide the basis for decision-making about future pictorial HWL policy in the US and around the world. We propose to conduct studies of adult smokers in the US and in three comparable countries that will all implement new pictorial HWLs in 2012, but with policies that differ from one another in important ways: 1. the US will implement its 1st round of pictorial HWLs, using short and simple risk messages; 2. Mexico will rotate new HWLs at the highest frequency in the world (i.e., two new HWLs every three months); 2. Canada will implement its 2nd round of pictorial HWLs, which include comprehensive risk and quit messages; 4. Australia will implement its 2nd round of pictorial HWLs, while also implementing the innovative policy of prohibiting brand colors and logos from cigarette packages in order to enhance the efficacy of HWLs. This project will capitalize on the unprecedented opportunity to systematically examine the real world effects over time of different pictorial HWL policies that US regulators should consider for future policy development. The proposed project will pursue the following specific aims: Specific Aim 1: We will use a quasi-experimental design with panels of adult smokers in four countries (Canada, Australia, Mexico, United States) to determine which pictorial HWL characteristics most effectively promote understanding of smoking-related risks and increase cessation behavior. 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 characteristics that are novel relative to existing HWLs, in order to determine the cognitive and affective impact of these manipulations. Meeting these aims will produce the scientific evidence that US regulators need on the real world impacts of different pictorial HWL policy options. Results will be disseminated to researchers and decision-makers, including the FDA, which can revise US HWLs to improve consumer understanding of smoking-related harms. PUBLIC HEALTH RELEVANCE: In 2012, the United States (US), Mexico, Canada, and Australia will all implement new pictorial health warning labels (HWLs) on cigarette packaging in order to address smoking, which remains the leading cause of preventable death in the US. The proposed study will take advantage of the extraordinary opportunity to examine the effects of new pictorial HWLs in countries that are comparable to the US but with pictorial HWL policies that contrast in important ways with US policy. Our innovative study will address methodological problems with previous research in order to provide US regulators with the scientific knowledge that they need to develop a HWL policy that most effectively builds and sustains consumer understanding of smoking-related risks.

Back to top


Detecting Smoking Events Using Accelerometer Data Collected Via Smartwatch Technology: Validation Study.
Authors: Cole C.A. , Anshari D. , Lambert V. , Thrasher J.F. , Valafar H. .
Source: Jmir Mhealth And Uhealth, 2017-12-13 00:00:00.0; 5(12), p. e189.
EPub date: 2017-12-13 00:00:00.0.
PMID: 29237580
Related Citations

Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US.
Authors: Cho Y.J. , Thrasher J.F. , Yong H.H. , Szklo A.S. , O'Connor R.J. , Bansal-Travers M. , Hammond D. , Fong G.T. , Hardin J. , Borland R. .
Source: Social Science & Medicine (1982), 2017-10-12 00:00:00.0; , .
EPub date: 2017-10-12 00:00:00.0.
PMID: 29096946
Related Citations

Evaluating The Perceived Effectiveness Of Pregnancy-related Cigarette Package Health Warning Labels Among Different Gender/age Groups
Authors: Kollath-Cattano C. , Osman A. , Thrasher J.F. .
Source: Addictive Behaviors, 2017 Mar; 66, p. 33-40.
PMID: 27871043
Related Citations

Influences of Self-Efficacy, Response Efficacy, and Reactance on Responses to Cigarette Health Warnings: A Longitudinal Study of Adult Smokers in Australia and Canada.
Authors: Thrasher J.F. , Swayampakala K. , Borland R. , Nagelhout G. , Yong H.H. , Hammond D. , Bansal-Travers M. , Thompson M. , Hardin J. .
Source: Health Communication, 2016 Dec; 31(12), p. 1517-26.
PMID: 27135826
Related Citations

Neural Response To Pictorial Health Warning Labels Can Predict Smoking Behavioral Change
Authors: Riddle P.J. , Newman-Norlund R.D. , Baer J. , Thrasher J.F. .
Source: Social Cognitive And Affective Neuroscience, 2016 Nov; 11(11), p. 1802-1811.
PMID: 27405615
Related Citations

Interpersonal communication about pictorial health warnings on cigarette packages: Policy-related influences and relationships with smoking cessation attempts.
Authors: Thrasher J.F. , Abad-Vivero E.N. , Huang L. , O'Connor R.J. , Hammond D. , Bansal-Travers M. , Yong H.H. , Borland R. , Markovsky B. , Hardin J. .
Source: Social Science & Medicine (1982), 2016 Sep; 164, p. 141-9.
PMID: 26092600
Related Citations

Cigarette package inserts can promote efficacy beliefs and sustained smoking cessation attempts: A longitudinal assessment of an innovative policy in Canada.
Authors: Thrasher J.F. , Swayampakala K. , Cummings K.M. , Hammond D. , Anshari D. , Krugman D.M. , Hardin J.W. .
Source: Preventive Medicine, 2016 Jul; 88, p. 59-65.
PMID: 26970037
Related Citations

Cigarette brands with flavour capsules in the filter: trends in use and brand perceptions among smokers in the USA, Mexico and Australia, 2012-2014.
Authors: Thrasher J.F. , Abad-Vivero E.N. , Moodie C. , O'Connor R.J. , Hammond D. , Cummings K.M. , Yong H.H. , Salloum R.G. , Czoli C. , Reynales-Shigematsu L.M. .
Source: Tobacco Control, 2016 May; 25(3), p. 275-83.
PMID: 25918129
Related Citations

Predictive and External Validity of a Pre-Market Study to Determine the Most Effective Pictorial Health Warning Label Content for Cigarette Packages.
Authors: Huang L.L. , Thrasher J.F. , Reid J.L. , Hammond D. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2016 May; 18(5), p. 1376-81.
PMID: 26377516
Related Citations

Depressive symptoms and responses to cigarette pack warning labels among Mexican smokers.
Authors: Osman A. , Thrasher J.F. , Cayir E. , Hardin J.W. , Perez-Hernandez R. , Froeliger B. .
Source: Health Psychology : Official Journal Of The Division Of Health Psychology, American Psychological Association, 2016 May; 35(5), p. 442-53.
PMID: 26867043
Related Citations

Was the media campaign that supported Australia's new pictorial cigarette warning labels and plain packaging policy associated with more attention to and talking about warning labels?
Authors: Nagelhout G.E. , Osman A. , Yong H.H. , Huang L.L. , Borland R. , Thrasher J.F. .
Source: Addictive Behaviors, 2015 Oct; 49, p. 64-7.
PMID: 26050643
Related Citations

The U.S. National Tips From Former Smokers Antismoking Campaign: Promoting Awareness of Smoking-Related Risks, Cessation Resources, and Cessation Behaviors.
Authors: Huang L.L. , Thrasher J.F. , Abad E.N. , Cummings K.M. , Bansal-Travers M. , Brown A. , Nagelhout G.E. .
Source: Health Education & Behavior : The Official Publication Of The Society For Public Health Education, 2015 Aug; 42(4), p. 480-6.
PMID: 25588934
Related Citations

The Use of Cigarette Package Inserts to Supplement Pictorial Health Warnings: An Evaluation of the Canadian Policy.
Authors: Thrasher J.F. , Osman A. , Abad-Vivero E.N. , Hammond D. , Bansal-Travers M. , Cummings K.M. , Hardin J.W. , Moodie C. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2015 Jul; 17(7), p. 870-5.
PMID: 25480931
Related Citations

Promoting cessation resources through cigarette package warning labels: a longitudinal survey with adult smokers in Canada, Australia and Mexico.
Authors: Thrasher J.F. , Osman A. , Moodie C. , Hammond D. , Bansal-Travers M. , Cummings K.M. , Borland R. , Yong H.H. , Hardin J. .
Source: Tobacco Control, 2015 Mar; 24(e1), p. e23-31.
PMID: 25052860
Related Citations

Pictorial health warning label content and smokers' understanding of smoking-related risks-a cross-country comparison.
Authors: Swayampakala K. , Thrasher J.F. , Hammond D. , Yong H.H. , Bansal-Travers M. , Krugman D. , Brown A. , Borland R. , Hardin J. .
Source: Health Education Research, 2015 Feb; 30(1), p. 35-45.
PMID: 24848554
Related Citations

Mediational pathways of the impact of cigarette warning labels on quit attempts.
Authors: Yong H.H. , Borland R. , Thrasher J.F. , Thompson M.E. , Nagelhout G.E. , Fong G.T. , Hammond D. , Cummings K.M. .
Source: Health Psychology : Official Journal Of The Division Of Health Psychology, American Psychological Association, 2014 Nov; 33(11), p. 1410-20.
PMID: 24977309
Related Citations

Adult smokers' responses to "corrective statements" regarding tobacco industry deception.
Authors: Kollath-Cattano C.L. , Abad-Vivero E.N. , Thrasher J.F. , Bansal-Travers M. , O'Connor R.J. , Krugman D.M. , Berg C.J. , Hardin J.W. .
Source: American Journal Of Preventive Medicine, 2014 Jul; 47(1), p. 26-36.
PMID: 24746372
Related Citations

Examining the relationship between psychosocial and behavioral proxies for future consumption behavior: self-reported impact and bidding behavior in an experimental auction study on cigarette labeling.
Authors: Rousu M.C. , Thrasher J.F. .
Source: Health Education Research, 2014 Apr; 29(2), p. 183-94.
PMID: 24399267
Related Citations

Cigarette warning label policy alternatives and smoking-related health disparities.
Authors: Thrasher J.F. , Carpenter M.J. , Andrews J.O. , Gray K.M. , Alberg A.J. , Navarro A. , Friedman D.B. , Cummings K.M. .
Source: American Journal Of Preventive Medicine, 2012 Dec; 43(6), p. 590-600.
PMID: 23159254
Related Citations

Back to Top