Longer term impact of cigarette package warnings in Australia compared with the United Kingdom and Canada

Abstract

This study examines the effects of different cigarette package warnings in Australia, Canada and the United Kingdom up to 5 years post-implementation. The data came from the International Tobacco Control Surveys. Measures included salience of warnings, cognitive responses, forgoing cigarettes and avoiding warnings. Although salience of the UK warnings was higher than the Australian and Canadian pictorial warnings, this did not lead to greater levels of cognitive reactions, forgoing or avoiding. There was no difference in ratings between the Australian and UK warnings for cognitive responses and forgoing, but the Canadian warnings were responded to more strongly. Avoidance of the Australian warnings was greater than to UK ones, but less than to the Canadian warnings. The impact of warnings declined over time in all three countries. Declines were comparable between Australia and the United Kingdom on all measures except avoiding, where Australia had a greater rate of decline; and for salience where the decline was slower in Canada. Having two rotating sets of warnings does not appear to reduce wear-out over a single set of warnings. Warning size may be more important than warning type in preventing wear-out, although both probably contribute interactively.

Fig. 1.

Salience of warning labels, aligned. Notes: Weighted data were used. ‘Year1’ means the first survey wave/year after the new warnings were implemented. This applies to other years, all three countries and other response measures. ‘Mean’: ranges from 1 to 5, by averaging the responses to ‘having noticed the warnings’ and ‘having read/looked closed at them’.

Fig. 2.

Cognitive response, aligned. Notes: This question was only asked from Wave 2 of the ITC-4 Survey (in 2003), and it was the third year of pictorial warning implementation in Canada. ‘Mean’: ranges from 1.00 to 3.67, by averaging the responses to ‘the warnings made the respondent think about the risks of smoking’, ‘be more likely to quit’ and ‘be motivated to think about quitting’.

Fig. 3.

Forgoing cigarettes, aligned. Notes: Percentages are the proportion reporting positive responses, i.e. ‘% that had forgone cigarettes at least once over the preceding month’.

Fig. 4.

Avoiding warnings, aligned. Notes: Percentages are the proportion reporting positive responses, i.e. ‘% that used at least one strategy to avoid warning labels’.