Evidence map›Paper›PMID 25512431›Full record

ArticleTobacco control2016

The impact of the 2009/2010 enhancement of cigarette health warning labels in Uruguay: longitudinal findings from the International Tobacco Control (ITC) Uruguay Survey.

Shannon Gravely, Geoffrey T Fong, Pete Driezen, Mary McNally, James F Thrasher, Mary E Thompson, Marcelo Boado, Eduardo Bianco, Ron Borland, David Hammond

Abstract read
In one paragraph

Article in Tobacco control, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Examining the Effectiveness of the 2012 Canadian Graphic Warning Label Policy Change by Sex, Income, and Education.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023
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  13. Smoking-Related Stigma: A Public Health Tool or a Damaging Force?Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020
    Article
  14. Article
  15. Graphic Warning Labels Affect Hypothetical Cigarette Purchasing Behavior among Smokers Living with HIV.International journal of environmental research and public health · 2019
    Article
  16. Strengthening Policy-Relevant Tobacco Research Capacity in Low- and Middle-Income Countries: Challenges, Opportunities, and Lessons Learned.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2019
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  17. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shannon GravelyDepartment of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
Geoffrey T FongDepartment of Psychology, University of Waterloo, Waterloo, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
Pete DriezenDepartment of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
Mary McNallyDepartment of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
James F ThrasherArnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Mary E ThompsonDepartment of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.
Marcelo BoadoFacultad de Ciencias Sociales, Universidad de la República, Montevideo, Uruguay.
Eduardo BiancoCentro de Investigación para la Epidemia del Tabaquismo, Montevideo, Uruguay.
Ron BorlandThe Cancer Council Victoria, Melbourne, Victoria, Australia.
David HammondSchool of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Funding

Variation in Cigarettes, Tobacco use Behaviors and Exposures in ITC CountriesP01CA138389 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI THOMPSON, MARY · 2009 to 2013
$13.4M
Project 3: Policy Effects on Cigarette Design, Emissions &BehaviorP50CA111236 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI CUMMINGS, KENNETH MICHAEL · 2004 to 2009
$8.2M
CIHR MOP 115016NCI NIH HHS P01 CA138389NCI NIH HHS P50 CA111236
6 · The paper itself

Abstract

backgroundFramework Convention on Tobacco Control (FCTC) Article 11 Guidelines recommend that health warning labels (HWLs) should occupy at least 50% of the package, but the tobacco industry claims that increasing the size would not lead to further benefits. This article reports the first population study to examine the impact of increasing HWL size above 50%. We tested the hypothesis that the 2009/2010 enhancement of the HWLs in Uruguay would be associated with higher levels of effectiveness.

methodsData were drawn from a cohort of adult smokers (≥18 years) participating in the International Tobacco Control (ITC) Uruguay Survey. The probability sample cohort was representative of adult smokers in five cities. The surveys included key indicators of HWL effectiveness. Data were collected in 2008/09 (prepolicy: wave 2) and 2010/11 (postpolicy: wave 3).

resultsOverall, 1746 smokers participated in the study at wave 2 (n=1379) and wave 3 (n=1411). Following the 2009/2010 HWL changes in Uruguay (from 50% to 80% in size), all indicators of HWL effectiveness increased significantly (noticing HWLs: OR=1.44, p=0.015; reading HWLs: OR=1.42, p=0.002; impact of HWLs on thinking about risks of smoking: OR=1.66, p<0.001; HWLs increasing thinking about quitting: OR=1.76, p<0.001; avoiding looking at the HWLs: OR=2.35, p<0.001; and reports that HWLs stopped smokers from having a cigarette 'many times': OR=3.42, p<0.001).

conclusionsThe 2009/2010 changes to HWLs in Uruguay, including a substantial increment in size, led to increases of key HWL indicators, thus supporting the conclusion that enhancing HWLs beyond minimum guideline recommendations can lead to even higher levels of effectiveness.

Indexed as

Product LabelingSmoking PreventionAdolescentAdultAgedFemaleHumansLongitudinal StudiesMaleMiddle AgedNicotianaTime FactorsUruguayGlobal healthHarm ReductionLow/Middle income countryPackaging and Labelling

Identifiers

PMID25512431
PMCPMC4618260

What OpenQuestion holds

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Registered trials

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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.