Grant Number:	4R01CA167067-06 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:	2016

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.




Strategies to enhance the effects of pictorial warnings for cigarettes: results from a discrete choice experiment.
Authors: Thrasher J.F. , Islam F. , Arillo-Santillán E. , Rodriguez-Bolaños R. , Saenz de Miera Juarez B. , Hardin J.W. , Barrientos-Gutierrez I. .
Source: Addiction (abingdon, England), 2021-10-25 00:00:00.0; , .
EPub date: 2021-10-25 00:00:00.0.
PMID: 34697845
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Cessation Conversations and Quit Attempts: Differences by Ethnicity and Language Preference.
Authors: Lambert V.C. , Davis R.E. , Popova L. , Thrasher J.F. .
Source: American Journal Of Health Behavior, 2020-07-01 00:00:00.0; 44(4), p. 473-487.
PMID: 32553028
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Are the Same Health Warnings Effective Across Different Countries? An Experimental Study in Seven Countries.
Authors: Hammond D. , Reid J.L. , Driezen P. , Thrasher J.F. , Gupta P.C. , Nargis N. , Li Q. , Yuan J. , Boudreau C. , Fong G.T. , et al. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2019-06-21 00:00:00.0; 21(7), p. 887-895.
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The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US.
Authors: Berg C.J. , Fong G.T. , Thrasher J.F. , Cohen J.E. , Maziak W. , Lando H. , Drope J. , Mejia R. , Barnoya J. , Nakkash R. , et al. .
Source: Addictive Behaviors, 2018 Dec; 87, p. 162-168.
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Which type of tobacco product warning imagery is more effective and sustainable over time? A longitudinal assessment of smokers in Canada, Australia and Mexico.
Authors: Anshari D. , Yong H.H. , Borland R. , Hammond D. , Swayampakala K. , Thrasher J. .
Source: Bmj Open, 2018-07-13 00:00:00.0; 8(7), p. e021983.
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Over-Time Impacts of Pictorial Health Warning Labels and their Differences across Smoker Subgroups: Results from Adult Smokers in Canada and Australia.
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Strengthening Policy-Relevant Tobacco Research Capacity in Low- and Middle-Income Countries: Challenges, Opportunities and Lessons Learned.
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Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2018-06-05 00:00:00.0; , .
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Assessing Smoking Cessation Messages with a Discrete Choice Experiment.
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Source: Tobacco Regulatory Science, 2018 Mar; 4(2), p. 73-87.
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Advancing Tobacco Product Warning Labels Research Methods and Theory: A Summary of a Grantee Meeting Held by the US National Cancer Institute.
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Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2018-02-10 00:00:00.0; , .
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Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment.
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Source: International Journal Of Environmental Research And Public Health, 2018-02-06 00:00:00.0; 15(2), .
EPub date: 2018-02-06 00:00:00.0.
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Does Adding Information on Toxic Constituents to Cigarette Pack Warnings Increase Smokers' Perceptions About the Health Risks of Smoking? A Longitudinal Study in Australia, Canada, Mexico, and the United States.
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EPub date: 2017-12-13 00:00:00.0.
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Disparagement of health warning labels on cigarette packages and cessation attempts: results from four countries.
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Source: Health Education Research, 2017-12-01 00:00:00.0; 32(6), p. 524-536.
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Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US.
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Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment.
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Images in cigarette warning labels: how should they warn?
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