Graphic health warnings on cigarette packs: how long before the effects on adolescents wear out?
Menée en Australie à partir des données de quatre vagues d'enquêtes réalisées sur la période 2005-2011 auprès de 2 560, 1 306, 2 303 puis 2 716 adolescents âgés de 13 à 17 ans, cette étude analyse l'évolution de leurs perceptions vis-à-vis des avertissements sanitaires graphiques imprimés sur les paquets de cigarettes
Introduction : To examine the long-term impact of graphic health warning labels (GHWL) on adolescents’ cognitive processing of warning labels and cigarette pack perceptions. Methods : Cross-sectional school-based surveys of students aged 13 to 17 years residing in urban centers, conducted prior to GHWL introduction (2005) and six-months (2006), two years (2008) and five years (2011) post-GHWL introduction. Students who had seen a cigarette pack in the previous 6 months or in 2006 , who had seen GHWL were included in analyses (2005 n=2560; 2006 n=1306; 2008 n=2303; 2011 n=2716). Smoking stage, reported exposure to cigarette packs, cognitive processing of GHWL and positive and negative perceptions of pack image were assessed. Results : While cognitive processing of GHWL in 2006 and 2008 was greater than 2005 (p<0.01), by 2011 scores had returned to 2005 levels. This pattern of change was consistent across smoking status groups. Pack image perceptions became more negative over time among all students, irrespective of smoking experience. While positive pack image ratings were lower in all subsequent years than 2005, the 2008 rating was higher than 2006 (p<.01). A significant interaction between survey time and smoking status (p<.01) showed that significant increases in positive pack ratings after 2006 only occurred among current and experimental smokers. Conclusions : When novel, graphic health warning labels on cigarette packs increase cognitive processing among adolescents. However this effect diminishes after five years, suggesting more regular message refreshment is needed. Australia’s adoption of plain packaging is intended to undermine positive pack appeal and increase warning salience.