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Randomized Controlled Trial
. 2019 Jan;28(1):74-80.
doi: 10.1136/tobaccocontrol-2017-054112. Epub 2018 Apr 13.

Cigarette pack messages about toxic chemicals: a randomised clinical trial

Noel T Brewer  1   2 , Michelle Jeong  1   2 , Jennifer R Mendel  1 , Marissa G Hall  1   2 , Dongyu Zhang  3 , Humberto Parada Jr  4 , Marcella H Boynton  1   2 , Seth M Noar  2   5 , Sabeeh A Baig  1 , Jennifer C Morgan, Kurt M Ribisl  1   2
Affiliations
Randomized Controlled Trial

Cigarette pack messages about toxic chemicals: a randomised clinical trial

Noel T Brewer et al. Tob Control. 2019 Jan.

Abstract

Background: The USA can require tobacco companies to disclose information about harmful and potentially harmful chemicals in cigarette smoke, but the impact of these messages is uncertain. We sought to assess the effect of placing messages about toxic chemicals on smokers' cigarette packs.

Methods: Participants were 719 adult cigarette smokers from California, USA, recruited from September 2016 through March 2017. We randomly assigned smokers to receive either factual messages about chemicals in cigarette smoke and their health harms (intervention) or messages about not littering cigarette butts (control) on the side of their cigarette packs for 3 weeks. The primary trial outcome was intention to quit smoking.

Results: In intent-to-treat analyses, smokers whose packs had chemical messages did not have higher intentions to quit smoking at the end of the trial than those whose packs had control messages (P=0.56). Compared with control messages, chemical messages led to higher awareness of the chemicals (28% vs 15%, P<0.001) and health harms (60% vs 52%, P=0.02) featured in the messages. In addition, chemical messages led to greater negative affect, thinking about the chemicals in cigarettes and the harms of smoking, conversations about the messages and forgoing a cigarette (all P<0.05).

Discussion: Chemical messages on cigarette packs did not lead to higher intentions to quit among smokers in our trial. However, chemical messages informed smokers of chemicals in cigarettes and harms of smoking, which directly supports their implementation and would be critical to defending the messages against cigarette company legal challenges.

Trial registration number: NCT02785484.

Keywords: carcinogens; packaging and labelling; prevention; public policy; smoking caused disease.

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Conflict of interest statement

Competing interests: None of the authors have received funding from tobacco product manufacturers. NTB and KMR have served as paid expert consultants in litigation against tobacco companies. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Labels placed on smokers’ cigarette packs in intervention arm (A) and control arm (B).
Figure 2
Figure 2
Flow diagram of trial enrollment, randomisation and retention.
See this image and copyright information in PMC

References

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