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. 2014 Oct;104(10):e11-30.
doi: 10.2105/AJPH.2014.302129. Epub 2014 Aug 14.

Systematic review of the effect of pictorial warnings on cigarette packages in smoking behavior

Joel Monárrez-Espino  1 , Bojing Liu, Felix Greiner, Sven Bremberg, Rosaria Galanti
Affiliations

Systematic review of the effect of pictorial warnings on cigarette packages in smoking behavior

Joel Monárrez-Espino et al. Am J Public Health. 2014 Oct.

Erratum in

  • Am J Public Health. 2015 Feb;105(2):e5

Abstract

We used a structured approach to assess whether active smokers presented with pictorial warnings on cigarette packages (PWCP) had a higher probability of quitting, reducing, and attempting to quit smoking than did unexposed smokers. We identified 21 articles from among nearly 2500 published between 1993 and 2013, prioritizing coverage over relevance or quality because we expected to find only a few studies with behavioral outcomes. We found very large heterogeneity across studies, poor or very poor methodological quality, and generally null or conflicting findings for any explored outcome. The evidence for or against the use of PWCP is insufficient, suggesting that any effect of PWCP on behavior would be modest. Determining the single impact of PWCP on behavior requires studies with strong methodological designs and longer follow-up periods.

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Figures

FIGURE 1—
FIGURE 1—
Search strategy to identify articles for the systematic review assessing the effect of PWCP on smoking behavior: 1993–2013. Note. PWCP = pictorial warnings on cigarette packages.
See this image and copyright information in PMC

Comment in

  • Pictorial cigarette pack warnings have important effects.
    Noar SM, Hall MG, Brewer NT. Noar SM, et al. Am J Public Health. 2015 Mar;105(3):e1. doi: 10.2105/AJPH.2014.302510. Epub 2015 Jan 20. Am J Public Health. 2015. PMID: 25602876 Free PMC article. No abstract available.
  • Monárrez-Espino and Galanti respond.
    Monárrez-Espino J, Galanti R. Monárrez-Espino J, et al. Am J Public Health. 2015 Mar;105(3):e2. doi: 10.2105/AJPH.2014.302527. Am J Public Health. 2015. PMID: 25665025 Free PMC article. No abstract available.

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