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Health Psychol. 2014 Nov;33(11):1410-20. doi: 10.1037/hea0000056. Epub 2014 Jun 30.

Mediational pathways of the impact of cigarette warning labels on quit attempts.

Author information

1
VicHealth Centre for Tobacco Control, The Cancer Council Victoria.
2
Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina.
3
Department of Statistics and Actuarial Science, University of Waterloo.
4
Department of Health Promotion, Maastricht University.
5
Department of Psychology, University of Waterloo.
6
School of Public Health and Health Systems, University of Waterloo.
7
Hollings Cancer Center, Medical University of South Carolina.

Abstract

OBJECTIVE:

To test and develop, using structural equation modeling, a robust model of the mediational pathways through which health warning labels exert their influence on smokers' subsequent quitting behavior.

METHOD:

Data come from the International Tobacco Control Four-Country Survey, a longitudinal cohort study conducted in Australia, Canada, the United Kingdom, and the United States. Waves 5-6 data (n = 4,988) were used to calibrate the hypothesized model of warning label impact on subsequent quit attempts via a set of policy-specific and general psychosocial mediators. The finalized model was validated using Waves 6-7 data (n = 5065).

RESULTS:

As hypothesized, warning label salience was positively associated with thoughts about risks of smoking stimulated by the warnings (β = .58, p < .001), which in turn were positively related to increased worry about negative outcomes of smoking (β = .52, p < .001); increased worry in turn predicted stronger intention to quit (β = .39, p < .001), which was a strong predictor of subsequent quit attempts (β = .39, p < .001). This calibrated model was successfully replicated using Waves 6-7 data.

CONCLUSION:

Health warning labels seem to influence future quitting attempts primarily through their ability to stimulate thoughts about the risks of smoking, which in turn help to raise smoking-related health concerns, which lead to stronger intentions to quit, a known key predictor of future quit attempts for smokers. By making warning labels more salient and engaging, they should have a greater chance to change behavior.

PMID:
24977309
PMCID:
PMC4600667
DOI:
10.1037/hea0000056
[Indexed for MEDLINE]
Free PMC Article

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