ArticleTobacco control2019
Pictorial health warnings and wear-out effects: evidence from a web experiment in 10 European countries.
Article in Tobacco control, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of graphic health warnings on tobacco products: a systematic review on perceived harm and quit intentions.BMC public health · 2021Pooled it
- Awareness and Perceptions on Health Warning Labels on Cigarette Packs among Smokers: A Cross-Sectional Study.BioMed research international · 2020Trial
- Trends in noticing and responses to cigarette and heated tobacco product warnings among Koreans who use tobacco: findings from the 2020-2023 ITC Korea Surveys.Tobacco control · 2026Article
- Chronic disease and smoking cessation intention: associations with oral health status, behaviors, and care in Korea.Frontiers in public health · 2026Article
- Evolution of tobacco pack health warning labels in India- a timely consensus.BMC public health · 2025Article
- Managing Fear Responses: A Qualitative Analysis of Pictorial Warning Labels Five Years Post-Plain Packaging.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- The Role of e-Cigarette Packaging as a Health Communications Tool: A Focus Group Study With Adolescents and Adults in England and Scotland.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- The impact of the introduction of tobacco product plain packaging on consumer responses in Ireland: a real-world policy evaluation stratified by socioeconomic groups.European journal of public health · 2024Article
- Perceived message effectiveness of cigar warning themes among adults in the United States.Preventive medicine reports · 2023Article
- The association between viewing cigarette health warning labels and intention to quit smoking among Chinese adult smokers: support for including health outcome content and culturally specific messages.BMC public health · 2023Article
- The Effects of Pictorial Health Warning Label on Waterpipe (Low- and High-Frequency) Smokers' Experiences, Toxicant Exposures, and Puffing Behavior.International journal of behavioral medicine · 2023Article
- UK women smokers' experiences of an age-progression smoking cessation intervention: Thematic analysis of accounts.PEC innovation · 2022Article
- Cross-sectional online survey of the impact of new tobacco health warnings in Colombia.BMJ open · 2022Article
- Emotional Impact of Graphic Health Warnings on Tobacco Packaging: Analysis of Their Content.Europe's journal of psychology · 2022Article
- Laws and regulations governing rotation of health warning labels on cigarette packs in the Region of the Americas.Revista panamericana de salud publica = Pan American journal of public health · 2022Article
- Tool to assess appeal-aversion response to graphic warning labels on cigarette packs among US smokers.Tobacco control · 2021Article
- Real-world exposure to graphic warning labels on cigarette packages in US smokers: The CASA randomized trial protocol.Contemporary clinical trials · 2020Article
- Impact of smoking on the income level of Chinese urban residents: a two-wave follow-up of the China Family Panel Study.BMJ open · 2020Article
- Do graphic health warning labels on cigarette packages deter purchases at point-of-sale? An experiment with adult smokers.Health education research · 2019Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis paper examines whether there are possible wear-out effects associated with repeated exposure to pictorial health warnings on tobacco products. Wear-out effects can be
methodsThis study used data from two surveys carried out in 10 European countries. Participants (n=12 600) were exposed in a random order to a series of health warnings and assessed the salience of the warnings as well as their effects on smoking intentions. Using these data and country variations in health warning legislation, we tested whether warning pictures are subject to general and/or specific wear-out effects.
resultsResponses were stronger to combined text+picture warnings than to text-only warnings. This effect was lower for smokers living in countries where combined warnings were already in place at the time of the data collection, compared with smokers residing in countries where text-only warnings were in use. This result, observed for combined warnings with new pictures, is in line with the presence of general wear-out effects. Combined warnings with an unknown pictorial content were more effective than those including pictorial warnings already in use, suggesting that specific wear-out effects are also at play.
conclusionsThese findings strengthen the evidence that pictorial health warnings are an effective tool for tobacco control policies and suggest that, even in the presence of a general wear-out effect among smokers, periodically introducing new pictures helps to maintain warning effectiveness over time.
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