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328160
Impact of Health Warning Labels on Smoking Prevalence: Findings from GATS and GYTS and Implications for Future FDA Regulatory Actions


Sunday, November 1, 2015

Ce Shang, PhD, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Jidong Huang, PhD, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Frank J. Chaloupka, PhD, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Background: While the Food and Drug Administration (FDA) has authorities to regulate manufacture, distribution, and marketing of tobacco products, including requiring graphic warning labels (GWLs) on cigarette packages, GWLs have not been implemented in the U.S. due to the resulting court's decision that faulted FDA for not providing strong scientific evidence demonstrating the impact of GWLs on smoking prevalence.

 

Objective: This study aims to assess the impact of health warning labels (HWLs) on cigarette smoking prevalence, focusing on requirements related to warning size, style, rotation, and inclusion of pictures and photographs, and to provide evidence of the effectiveness of HWLs for FDA's future regulatory actions related to HWLs.

Methods: WHO' “MPOWER” policy measures were linked to the Global Adult Tobacco Survey (GATS) and Global Youth Tobacco Survey (GYTS) to analyze the impact of HWLs on smoking prevalence. Logistic regressions were conducted to examine the impact of different dimensions of HWLs related policies on smoking prevalence, controlling for other factors.

Findings: Our results show that HWL policies regarding label size, font size and color, and rotation are associated with a lower smoking prevalence. Specifically, an increase in the size of HWL on the principle display areas of cigarette packages is associated with a decrease in smoking prevalence among both adults (p≤0.01) and teens (p≤0.1).

Conclusion: HWL related policies are effective in lowering smoking prevalence. The magnitude of the impact of these policies varies by age group, gender, and policy dimensions.

Learning Areas:

Biostatistics, economics
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Assess the impact of health warning labels (HWLs) on cigarette smoking prevalence, focusing on requirements related to warning size, style, rotation, and inclusion of pictures and photographs, and to provide evidence of the effectiveness of HWLs for FDA's future regulatory actions related to HWLs.

Keyword(s): Tobacco Control, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research focusing on policy impact on tobacco use behaviors has been funded by the FDA, NCI, and others. I have published multiple scientific articles that analyzed policy factors that are associated with the usage of different tobacco products and smoking transitions such as initiation and cessation. Recently, I have been working on analyzing the effects of future or potential FDA regulatory actions on tobacco use behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2063.0: Tobacco policy: domestic and international perspectives