ArticleSocial science & medicine (1982)2018
Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US.
Article in Social science & medicine (1982), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis 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
48 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of health warning labels on selection and consumption of food and alcohol products: systematic review with meta-analysis.Health psychology review · 2021Pooled it
- Examining Spontaneous Cognitive and Emotional Reactions to Messages About Very Low Nicotine Cigarettes (VLNCs).Health education & behavior : the official publication of the Society for Public Health Education · 2026Trial
- Little Cigar and Cigarillo Graphic Health Warnings and Quitting Behaviors: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Tobacco package health warnings about product manipulations: an experimental study among Australian adults who smoke.Health promotion international · 2025Trial
- Relative Efficacy of Cigarillo Warning Statements in Text and Pictorial Formats: An Experimental Study Among a Sample of US Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Differential Responses to Cigarette Package Labeling Alternatives Among Adults Who Smoke: Results From a Randomized Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- 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
- Responses to pictorial versus text-only cigarillo warnings among a nationally representative sample of US young adults.Tobacco control · 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
- Trial
- Higher negative emotions in response to cigarette pictorial warning labels predict higher quit intentions among smokers.Tobacco control · 2020Trial
- "I Quit": Testing the Added Value and Sequencing Effects of an Efficacy-focused Message among Cigarette Warning Labels.Journal of health communication · 2020Trial
- Acceptability and understanding of front-of-pack nutritional labels: an experimental study in Mexican consumers.BMC public health · 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
- Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment.International journal of environmental research and public health · 2018Trial
- Contingent Effects of E-Cigarette Warning Label Messages on Cognitive Elaboration and Fear Among U.S. Youth Ages 14-17 by Vaping Experience and Peer Vaping Behavior.Health communication · 2025Article
- Indonesian Adolescents' Perceptions of Front-of-Package Labels on Packaged Food and Drinks.Current developments in nutrition · 2025Article
- Conversations about cigarette health warning labels and smoking cessation attempts in Mexico.Salud publica de Mexico · 2024Article
- Self-reported attention and responses to cigarette package labels at the end of a two-week randomized trial of cigarette package labeling configurations.Tobacco induced diseases · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundCigarette pack health warning labels can elicit negative emotions among smokers, yet little is known about how these negative emotions influence behavior change.
objectiveGuided by psychological theories emphasizing the role of emotions on risk concern and behavior change, we investigated whether smokers who reported stronger negative emotional responses when viewing warnings reported stronger responses to warnings in daily life and were more likely to try to quit at follow-up.
methodsWe analyzed data from 5439 adult smokers from Australia, Canada, Mexico, and the US, who were surveyed every four months from September 2012 to September 2014. Participants were shown warnings already implemented on packs in their country and reported negative emotional responses (i.e., fear, disgust, worry), which were averaged (range = 1 to 9). Country-stratified logistic and linear generalized estimating equations were used to analyze the effect of negative emotional responses on self-reported responses to warnings in daily life (i.e., attention, risk concern, avoidance of warnings, forgoing planned cigarettes) and quit attempts at follow-up. Models were adjusted for socio-demographic and smoking-related characteristics, survey wave, and the number of prior surveys answered.
resultsSmokers who reported stronger negative emotions were more likely to make quit attempts at follow-up (Adjusted ORs ranged from 1.09 [95% CI 1.04 to 1.14] to 1.17 [95% CI 1.12 to 1.23]; p < .001) than those who reported lower negative emotions. This relationship was mediated through attention to warnings and behavioral responses to warnings. There was no significant interaction of negative emotions with self-efficacy or nicotine dependence.
conclusionNegative emotions elicited by warnings encourage behavior change, promoting attention to warnings and behavioral responses that positively predict quit attempts.
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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.