![]() Yet, one of the most effective manipulation strategies employed by the industry was the introduction of ‘light’ cigarettes, which are not less addictive or lethal, but were packaged and marketed to imply ‘less harm.’ After FDA prohibited these misleading labels in 2010, many tobacco companies, guided by Philip Morris (manufacturer of Marlboro), shifted focus to use a cigarette pack color-coding scheme to imply that ‘light’ flavored cigarettes would be sold in gold packs while the ‘full flavor’ cigarettes would continue to be sold in red packs. Industry research found that Marlboro Ultra-Light cigarettes are perceived to have a “harsher” drag when placed in red packs while cigarettes from blue packs were considered “too mild”. Tobacco industry documents show that “the sensory experience of smoking a cigarette can be manipulated simply by changing the design elements of the pack, such as color, fonts and logos.”. ![]() Cigarette packaging designs can affect smokers’ beliefs about brands, downplay the harms of smoking, and ultimately influence use behavior. With increasing regulations on cigarettes, packaging has been referred by tobacco companies as the “final communication vehicle”. While graphic warnings appear to increase smoking-related health perceptions, strong empirical data is needed to better understand changes in risk beliefs in response to graphic warning labels, particularly upon initial exposure. Recent US trials have shown that graphic warnings decreased smokers’ positive perceptions of their cigarettes, and increase quitting-related cognitions, quit attempts and cessation after 4-weeks, but not 3-months. These warnings aim to communicate smoking health risk information in a manner that helps the public understand the negative health consequences of use. After failed implementation of a 2011 graphic warning rule, the Food and Drug Administration (FDA) recently finalized a new set of warnings to go into effect on Octo. Yet, the US is one of the remaining countries without a graphic labeling requirement. ![]() While rates of combustible cigarette use in the United States (US) continue to decline smoking still accounts for nearly half-a-million deaths annually Graphic warning labels on cigarette packs depicting the health hazards of smoking have seen widespread global adoption (> 120 countries) and have effectively reduced tobacco use in other countries. Regulatory agencies could consider supporting policy changes with information campaigns to maximize public knowledge. Pack color modification may increase uncertainty about several key cigarette risk beliefs, though graphic warnings may attenuate these effects. text) warning condition had reduced odds of reporting their study cigarettes as ‘safer’ than regular cigarettes (OR range = 0.22–0.32). Across all pack color periods, those in the graphic (vs. While smokers largely held correct risk beliefs at baseline (Mean = 6.02, SE = 0.17, Range:0–8), the cumulative number of incorrect or uncertain cigarette risk beliefs increased from baseline in all pack color manipulations in the text (IRR range = 1.70–2.16) and graphic (IRR range = 1.31–1.70) warning conditions. ![]() However, use increased in all conditions (2.59–3.59 cigarettes per day) relative to baseline. Warning type and package color did not impact cigarette consumption or subjective ratings. Mixed-effects models examined between- and within-subject differences on risk beliefs, product perceptions, and smoking behavior. Participants were blinded to the fact that all packs contained their usual cigarettes. Within each warning label condition, participants completed three within-subjects pack color manipulations (red, gold, plain), each lasting 15 days. Participants smoked their usual cigarettes during baseline (5-days) and were randomized to receive cigarette packs with a warning label manipulation (graphic vs. MethodsĪdult, daily, Marlboro non-menthol smokers (Red or Gold ) completed a mixed factorial randomized trial. Plain packaging and graphic warning labels are two regulatory strategies that may impact cigarette risk beliefs and reduce consumption, but data are needed to better understand how smokers respond to such regulations.
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