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

• Published in: Health psychology Vol. 33; no. 11; p. 1410
• Main Authors: Yong, Hua-Hie, Borland, Ron, Thrasher, James F, Thompson, Mary E, Nagelhout, Gera E, Fong, Geoffrey T, Hammond, David, Cummings, K Michael
• Format: Journal Article
• Language: English
• Published: United States 01.11.2014
• Subjects: Adolescent; Adult; Australia; Canada; Cohort Studies; Data Collection; Female; Humans; Intention; Male; Middle Aged; Product Labeling; Smoking - psychology; Smoking Cessation - psychology; Tobacco Products - adverse effects; United Kingdom; United States; Young Adult
• ISSN: 1930-7810
• DOI: 10.1037/hea0000056

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. 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). 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. 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.