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The Impact of Including Cessation Resource Information on Health Warnings on Standardized Tobacco Packaging on Awareness and Use: A Longitudinal Online Survey in the United Kingdom

Research output: Contribution to journalArticlepeer-review

Crawford Moodie, Catherine Best, Nathan Critchlow, Martine Stead, Ann McNeill, Sara Hitchman

Original languageEnglish
Pages (from-to)1068-1073
Number of pages6
JournalNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
Issue number6
Published24 May 2021

Bibliographical note

Publisher Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

King's Authors


INTRODUCTION: Since May 2017, all cigarettes and roll-your-own (RYO) tobacco in the United Kingdom must be sold in standardized packs with pictorial warnings displaying, for the first time, a stop-smoking website. AIMS AND METHODS: Data come from three waves of a longitudinal online survey with smokers and ex-smokers conducted pre- and post-standardized packaging, with Wave 1 (W1) in April-May 2016, Wave 2 (W2) in September-November 2017, and Wave 3 (W3) in May-July 2019. Only smokers are included in the analysis: W1 (N = 6233), W2 (N = 3629), and W3 (N = 2412). We explored any change in citing warnings on packs as a source of information about a stop-smoking website, and whether citing warnings as a source was associated with use of a stop-smoking website. As the warnings, and therefore the stop-smoking website, are larger on RYO packs than on cigarette packs due to the larger pack size, we explored differences in awareness of a stop-smoking website among exclusive cigarette smokers (W1 = 3142, W2 = 1884, W3 = 1247) and exclusive RYO smokers (W1 = 2046, W2 = 1119, W3 = 814). RESULTS: Among smokers recalling seeing information about a stop-smoking website, citing warnings as a source increased between waves (W1 = 14.0%, W2 = 24.2%, W3 = 25.1%) and was associated with having visited a stop-smoking website (odds ratio = 11.81, 95% confidence interval 8.47-16.46). Citing warnings as a source of a stop-smoking website increased among exclusive RYO smokers at each wave (W1 = 15.5%, W2 = 26.3%, W3 = 32.1%), while for exclusive cigarette smokers it only increased at W2 (W1 = 10.5%, W2 = 22.4%, W3 = 19.9%). CONCLUSIONS: Warnings are an important source of cessation resource information. Making this information more prominent may help sustain awareness. IMPLICATIONS: The findings support the inclusion of a stop-smoking website on warnings as awareness among smokers increased and citing warnings as a source of information about a stop-smoking website was associated with having visited a stop-smoking website. We also explored whether the stop-smoking website on warnings on RYO packs, which is larger than on cigarette packs as a function of the larger size of RYO packs, would have any impact on awareness of this information. That exclusive RYO smokers were more likely than exclusive cigarette smokers to notice a stop-smoking website on warnings suggests that this information should be more prominent.

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