ArticleHealth psychology : official journal of the Division of Health Psychology, American Psychological Association2014
Mediational pathways of the impact of cigarette warning labels on quit attempts.
Article in Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
88 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies.Social science & medicine (1982) · 2016Pooled it
- Pictorial cigarette pack warnings: a meta-analysis of experimental studies.Tobacco control · 2016Pooled it
- Perceived Effectiveness of Cigar Warnings Among Young People in the U.S.American journal of preventive medicine · 2026Trial
- Combining Inserts With Warning Labels on Cigarette Packs to Promote Smoking Cessation: A 2-Week Randomized Trial.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2024Trial
- A mixed-method study of perceptions of cigarette pack inserts among adult smokers from New York and South Carolina exposed as part of a randomized controlled trial.Health education research · 2023Trial
- A Pilot Randomised Trial Investigating the Effects of Including Efficacy Messaging on Tobacco Warning Labels.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Trial
- The Impact of The Real Cost Vaping and Smoking Ads across Tobacco Products.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Trial
- Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2022Trial
- Cognitive and emotional responses to pictorial warning labels and their association with quitting measures after continued exposure.Addictive behaviors · 2022Trial
- Designing Effective Testimonial Pictorial Warning Labels for Tobacco Products.Health communication · 2019Trial
- Understanding Why Pictorial Cigarette Pack Warnings Increase Quit Attempts.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2019Trial
- Cigarette pack messages about toxic chemicals: a randomised clinical trial.Tobacco control · 2019Trial
- Why smokers avoid cigarette pack risk messages: Two randomized clinical trials in the United States.Social science & medicine (1982) · 2018Trial
- The role of negative affect and message credibility in perceived effectiveness of smokeless tobacco health warning labels in Navi Mumbai, India and Dhaka, Bangladesh: A moderated-mediation analysis.Addictive behaviors · 2017Trial
- Potential Effectiveness of Pictorial Warning Labels That Feature the Images and Personal Details of Real People.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2017Trial
- Reactance to Health Warnings Scale: Development and Validation.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2016Trial
- Effect of Pictorial Cigarette Pack Warnings on Changes in Smoking Behavior: A Randomized Clinical Trial.JAMA internal medicine · 2016Trial
- Exposure to graphic warning labels on cigarette packages: Effects on implicit and explicit attitudes towards smoking among young adults.Psychology & health · 2016Trial
- Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial.PloS one · 2015Trial
- Within-Day Dynamics of Self-Efficacy and Smoking Attitudes: Ecological Momentary Assessment Study of Motivation to Quit and Forgoing Behavior.Journal of medical Internet research · 2026Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveTo test and develop, using structural equation modeling, a robust model of the mediational pathways through which health warning labels exert their influence on smokers' subsequent quitting behavior.
methodData come from the International Tobacco Control Four-Country Survey, a longitudinal cohort study conducted in Australia, Canada, the United Kingdom, and the United States. Waves 5-6 data (n = 4,988) were used to calibrate the hypothesized model of warning label impact on subsequent quit attempts via a set of policy-specific and general psychosocial mediators. The finalized model was validated using Waves 6-7 data (n = 5065).
resultsAs hypothesized, warning label salience was positively associated with thoughts about risks of smoking stimulated by the warnings (β = .58, p < .001), which in turn were positively related to increased worry about negative outcomes of smoking (β = .52, p < .001); increased worry in turn predicted stronger intention to quit (β = .39, p < .001), which was a strong predictor of subsequent quit attempts (β = .39, p < .001). This calibrated model was successfully replicated using Waves 6-7 data.
conclusionHealth warning labels seem to influence future quitting attempts primarily through their ability to stimulate thoughts about the risks of smoking, which in turn help to raise smoking-related health concerns, which lead to stronger intentions to quit, a known key predictor of future quit attempts for smokers. By making warning labels more salient and engaging, they should have a greater chance to change behavior.
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Registered trials
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.