ArticleTobacco control2013
Cigarette packet warning labels can prevent relapse: findings from the International Tobacco Control 4-Country policy evaluation cohort study.
Article in Tobacco control, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour.Nature human behaviour · 2024Pooled it
- The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions.BMC public health · 2021Pooled it
- Trial
- Google Trends Analysis of Interest in Smoking Cessation, Treatment Options, and Electronic Nicotine Delivery Systems Following Tax Increase and Introduction of Pictorial Health Warnings in Germany.Tobacco use insights · 2025Article
- The impact of specific health warning messages on Chinese young people's perception of smoking risks and quitting intentions.Tobacco induced diseases · 2024Article
- Cigarette health warning label compliance in Nigeria: A multi-city observational study.Tobacco prevention & cessation · 2023Article
- Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers.PloS one · 2022Article
- Responses to Graphic Warning Labels among Low-income Smokers.American journal of health behavior · 2020Article
- Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey.Addiction (Abingdon, England) · 2019Article
- Graphic Warning Labels Affect Hypothetical Cigarette Purchasing Behavior among Smokers Living with HIV.International journal of environmental research and public health · 2019Article
- Sex Differences in Graphic Warning Label Ratings by Addictions Clients.Tobacco regulatory science · 2019Article
- Public health benefits from pictorial health warnings on US cigarette packs: a SimSmoke simulation.Tobacco control · 2017Article
- Addiction Treatment Clients' Reactions to Graphic Warning Labels on Cigarette Packs.Journal of drug issues · 2017Article
- Effects of Strengthening Cigarette Pack Warnings on Attention and Message Processing: A Systematic ReviewJournalism & mass communication quarterly · 2017Article
- Graphic Warning Labels and the Cost Savings from Reduced Smoking among Pregnant Women.International journal of environmental research and public health · 2017Article
- Associations of Proposed Relative-Risk Warning Labels for Snus With Perceptions and Behavioral Intentions Among Tobacco Users and Nonusers.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2016Article
- The impact of the 2009/2010 enhancement of cigarette health warning labels in Uruguay: longitudinal findings from the International Tobacco Control (ITC) Uruguay Survey.Tobacco control · 2016Article
- FDA cigarette warning labels lower craving and elicit frontoinsular activation in adolescent smokers.Social cognitive and affective neuroscience · 2015Article
- Emotional reaction facilitates the brain and behavioural impact of graphic cigarette warning labels in smokers.Tobacco control · 2015Article
- Pictorial health warning label content and smokers' understanding of smoking-related risks-a cross-country comparison.Health education research · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo investigate the links between health warning labels (WLs) on cigarette packets and relapse among recently quit smokers.
designProspective longitudinal cohort survey.
settingAustralia, Canada, the UK and the USA.
participants1936 recent ex-smokers (44.4% male) from one of the first six waves (2002-2007) of the International Tobacco Control 4-Country policy evaluation survey, who were followed up in the next wave.
main outcome measuresWhether participants had relapsed at follow-up (approximately 1 year later).
resultsIn multivariate analysis, very frequent noticing of WLs among ex-smokers was associated with greater relapse 1 year later (OR: 1.52, 95% CI 1.11 to 2.09, p<0.01), but this effect disappeared after controlling for urges to smoke and self-efficacy (OR: 1.29, 95% CI 0.92 to 1.80, p=0.135). In contrast, reporting that WLs make staying quit 'a lot' more likely (compared with 'not at all' likely) was associated with a lower likelihood of relapse 1 year later (OR: 0.65, 95% CI 0.49 to 0.86, p<0.01) and this effect remained robust across all models tested, increasing in some.
conclusionsThis study provides the first longitudinal evidence that health warnings can help ex-smokers stay quit. Once the authors control for greater exposure to cigarettes, which is understandably predictive of relapse, WL effects are positive. However, it may be that ex-smokers need to actively use the health consequences that WLs highlight to remind them of their reasons for quitting, rather than it being something that happens automatically. Ex-smokers should be encouraged to use pack warnings to counter urges to resume smoking. Novel warnings may be more likely to facilitate this.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.