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Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults

OBJECTIVE: The Framework Convention on Tobacco Control recommends health warning labels (HWLs) include an attribution source. Little is known regarding the perceived credibility and effectiveness of different message sources. This study examined perceptions of four HWL attribution sources among adul...

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Autores principales: Czaplicki, Lauren, Hardesty, Jeffrey, Crespi, Elizabeth, Yang, Tingzhong, Kennedy, Ryan David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109087/
https://www.ncbi.nlm.nih.gov/pubmed/35568497
http://dx.doi.org/10.1136/bmjopen-2021-058946
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author Czaplicki, Lauren
Hardesty, Jeffrey
Crespi, Elizabeth
Yang, Tingzhong
Kennedy, Ryan David
author_facet Czaplicki, Lauren
Hardesty, Jeffrey
Crespi, Elizabeth
Yang, Tingzhong
Kennedy, Ryan David
author_sort Czaplicki, Lauren
collection PubMed
description OBJECTIVE: The Framework Convention on Tobacco Control recommends health warning labels (HWLs) include an attribution source. Little is known regarding the perceived credibility and effectiveness of different message sources. This study examined perceptions of four HWL attribution sources among adults in China – the world’s largest consumer of cigarettes. DESIGN: Cross-sectional experimental survey design. PARTICIPANTS: Data were collected in 2017 from a convenience sample of 1999 adults across four cities in China; 80% of the sample were current smokers. MAIN OUTCOME MEASURES: Participants viewed four versions of the same HWL, each with a different attribution source: the China Center for Disease Control (ref. group); the regulatory arm of China’s domestic tobacco company (STMA); Liyuan Peng, China’s first lady; and the WHO. Respondents indicated which HWL was the most: (1) credible, (2) effective at making people quit and (3) effective at preventing youth initiation. RESULTS: Multinomial logistic regression models estimated adjusted relative risk ratios (aRRRs) of the three outcomes. Controlling for demographics and smoking status, HWLs attributed to STMA and Liyuan Peng, respectively, were perceived as significantly less credible (aRRR=0.81, p<0.001; aRRR=0.31, p<0.001), less effective at making people quit (aRRR=0.46, p<0.001; aRRR=0.24, p<0.001) and less effective at preventing young smoking (aRRR=0.52, p<0.001; aRRR=0.39, p<0.001) than the China CDC HWL. There were no significant differences in perceived effectiveness of between the WHO and China CDC HWLs. Participants viewed the WHO HWL as significantly more credible (aRRR=1.21, p<0.001) than the China CDC HWL. CONCLUSION: Results suggest the unique role of health organisations in conveying smoking-related messages that appear credible and effective at motivating others to quit smoking or never start smoking in China. Findings can inform global recommendations regarding HWL attribution sources.
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spelling pubmed-91090872022-05-27 Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults Czaplicki, Lauren Hardesty, Jeffrey Crespi, Elizabeth Yang, Tingzhong Kennedy, Ryan David BMJ Open Global Health OBJECTIVE: The Framework Convention on Tobacco Control recommends health warning labels (HWLs) include an attribution source. Little is known regarding the perceived credibility and effectiveness of different message sources. This study examined perceptions of four HWL attribution sources among adults in China – the world’s largest consumer of cigarettes. DESIGN: Cross-sectional experimental survey design. PARTICIPANTS: Data were collected in 2017 from a convenience sample of 1999 adults across four cities in China; 80% of the sample were current smokers. MAIN OUTCOME MEASURES: Participants viewed four versions of the same HWL, each with a different attribution source: the China Center for Disease Control (ref. group); the regulatory arm of China’s domestic tobacco company (STMA); Liyuan Peng, China’s first lady; and the WHO. Respondents indicated which HWL was the most: (1) credible, (2) effective at making people quit and (3) effective at preventing youth initiation. RESULTS: Multinomial logistic regression models estimated adjusted relative risk ratios (aRRRs) of the three outcomes. Controlling for demographics and smoking status, HWLs attributed to STMA and Liyuan Peng, respectively, were perceived as significantly less credible (aRRR=0.81, p<0.001; aRRR=0.31, p<0.001), less effective at making people quit (aRRR=0.46, p<0.001; aRRR=0.24, p<0.001) and less effective at preventing young smoking (aRRR=0.52, p<0.001; aRRR=0.39, p<0.001) than the China CDC HWL. There were no significant differences in perceived effectiveness of between the WHO and China CDC HWLs. Participants viewed the WHO HWL as significantly more credible (aRRR=1.21, p<0.001) than the China CDC HWL. CONCLUSION: Results suggest the unique role of health organisations in conveying smoking-related messages that appear credible and effective at motivating others to quit smoking or never start smoking in China. Findings can inform global recommendations regarding HWL attribution sources. BMJ Publishing Group 2022-05-13 /pmc/articles/PMC9109087/ /pubmed/35568497 http://dx.doi.org/10.1136/bmjopen-2021-058946 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Global Health
Czaplicki, Lauren
Hardesty, Jeffrey
Crespi, Elizabeth
Yang, Tingzhong
Kennedy, Ryan David
Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title_full Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title_fullStr Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title_full_unstemmed Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title_short Identifying credible attribution sources for cigarette health warning labels in China: results from a cross-sectional survey of Chinese adults
title_sort identifying credible attribution sources for cigarette health warning labels in china: results from a cross-sectional survey of chinese adults
topic Global Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109087/
https://www.ncbi.nlm.nih.gov/pubmed/35568497
http://dx.doi.org/10.1136/bmjopen-2021-058946
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