Pictorial Warning Labels & Memory for Relative & Absolute Cigarette Health-risk Information Over Time in Adult Smokers

Pictorial cigarette warning labels (PWLs) are thought to increase risk knowledge, but experimental research has not examined PWLs' longer term effects on memory for health risks. In this study, adult smokers are repeatedly exposed to text-only vs. low arousal graphic vs. high arousal graphic warning labels paired with numeric risk information. This study will allow the investigators to assess the extent to which reactions to warnings remain consistent over time and influence smoking risk perceptions and quit intentions. The investigators will also assess the impact of graphic images on memory for smoking risk information presented in absolute (a smoker's lifetime risk of getting a smoking related disease) versus relative (a smoker's risk of getting a smoking related disease, compared to the risk of non-smokers) formats.

Study Overview

• Status: Completed
• Conditions: Smoking Cessation; Smoking, Cigarette
• Intervention / Treatment: Behavioral: text-only PWL; Behavioral: absolute risk; Behavioral: relative risk; Behavioral: low arousal graphic PWL; Behavioral: high arousal graphic PWL

• Study Type: Interventional
• Enrollment (Actual): 3213
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Columbus, Ohio, United States, 43210
      • the Ohio State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years to 64 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• have smoked 100+ lifetime cigarettes
• currently smoke "every day" or "some days."

Exclusion Criteria:

• have not ever smoked a cigarette

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Text-only PWL, absolute risk; Exposure to FDA-mandated warning labels, without a graphic image, accompanied by risk information about smoker's risk of a smoking-related disease	Behavioral: text-only PWL; control condition (no image); Behavioral: absolute risk; Percentage risk information for smoking-related diseases for smokers
Experimental: Text-only PWL, relative risk; Exposure to FDA-mandated warning labels, without a graphic image, accompanied by risk information about smoker's risk and non-smoker's risk of a smoking-related disease	Behavioral: text-only PWL; control condition (no image); Behavioral: relative risk; Percentage risk information for smoking-related diseases for smokers and non-smokers
Experimental: Low arousal graphic PWL, absolute risk; Exposure to FDA-mandated warning labels, paired with a low arousal graphic image, accompanied by risk information about smoker's risk of a smoking-related disease	Behavioral: absolute risk; Percentage risk information for smoking-related diseases for smokers; Behavioral: low arousal graphic PWL; pictorial warning
Experimental: Low arousal graphic PWL, relative risk; Exposure to FDA-mandated warning labels, paired with a low arousal graphic image, accompanied by risk information about smoker's risk and non-smoker's risk of a smoking-related disease	Behavioral: relative risk; Percentage risk information for smoking-related diseases for smokers and non-smokers; Behavioral: low arousal graphic PWL; pictorial warning
Experimental: High arousal graphic PWL, absolute risk; Exposure to FDA-mandated warning labels, paired with a high arousal graphic image, accompanied by risk information about smoker's risk of a smoking-related disease	Behavioral: absolute risk; Percentage risk information for smoking-related diseases for smokers; Behavioral: high arousal graphic PWL; pictorial warning
Experimental: High arousal graphic PWL, relative risk; Exposure to FDA-mandated warning labels, paired with a high arousal graphic image, accompanied by risk information about smoker's risk and non-smoker's risk of a smoking-related disease	Behavioral: relative risk; Percentage risk information for smoking-related diseases for smokers and non-smokers; Behavioral: high arousal graphic PWL; pictorial warning

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
numeric risk recognition	Participants answered one multiple choice question about the numeric risk for smokers for each label (e.g., ____% of smokers die before age 85). For each question, there were four decoy responses.	measured immediately following last exposure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
numeric risk recognition	Participants answered one multiple choice question about the numeric risk for smokers for each label (e.g., ____% of smokers die before age 85). For each question, there were four decoy responses.	measured after 6-week delay
relative risk recognition	Participants answered one multiple choice question about the numeric risk for smokers vs. nonsmokers for each health risk (e.g., a smoker is ____ as likely to die from heart disease as a nonsmoker). For each question, there were three decoy responses (e.g., for heart disease, response options were: "about as likely," "1.75 times," "4.1 times," "10.4 times").	measured immediately following last exposure
relative risk recognition	Participants answered one multiple choice question about the numeric risk for smokers vs. nonsmokers for each health risk (e.g., a smoker is ____ as likely to die from heart disease as a nonsmoker). For each question, there were three decoy responses (e.g., for heart disease, response options were: "about as likely," "1.75 times," "4.1 times," "10.4 times").	measured after 6-week delay
smoking risk perceptions	Participants completed several scale items about how much risk they perceived smoking posed to them (e.g., "If a person smokes at your age, how likely are they to get a life-threatening illness from smoking someday ?" [1=very unlikely; 5=extremely likely])	measured immediately following last exposure
smoking risk perceptions	Participants completed several scale items about how much risk they perceived smoking posed to them (e.g., "If a person smokes at your age, how likely are they to get a life-threatening illness from smoking someday ?" [1=very unlikely; 5=extremely likely])	measured after 6-week delay
quit intentions (for next 30 days)	Participants intentions to quit smoking; self-reported likelihood of smoking "within the next 30 days" (-3 = very unlikely, 3 = very likely)	measured immediately following last exposure
quit intentions (for next 30 days)	Participants intentions to quit smoking; self-reported likelihood of smoking "within the next 30 days" (-3 = very unlikely, 3 = very likely)	measured after 6-week delay
quit intentions (for next year)	Participants intentions to quit smoking; self-reported likelihood of smoking "within next year" (-3 = very unlikely, 3 = very likely)	measured immediately following last exposure
quit intentions (for next year)	Participants intentions to quit smoking; self-reported likelihood of smoking "within next year" (-3 = very unlikely, 3 = very likely)	measured after 6-week delay
risk recognition	Participants were given a list of 9 warnings and asked to select which ones they'd been previously exposed to	measured immediately following last exposure
risk recognition	Participants were given a list of 9 warnings and asked to select which ones they'd been previously exposed to	measured after 6-week delay
feelings about smoking	Participants completed several scale items about their feelings towards smoking (e.g., "How good or bad do you feel about smoking?" -2=very bad; +2=very good; "How much do you feel confused about the harms vs. benefits of smoking?" 0=not at all confused; 4=very confused)	measured immediately following last exposure
feelings about smoking	Participants completed several scale items about their feelings towards smoking (e.g., "How good or bad do you feel about smoking?" -2=very bad; +2=very good; "How much do you feel confused about the harms vs. benefits of smoking?" 0=not at all confused; 4=very confused)	measured after 6-week delay

Collaborators and Investigators

• Sponsor: Ohio State University
• Collaborators: University of Pennsylvania

Study record dates

Study Major Dates

• Study Start (Actual): July 10, 2017
• Primary Completion (Actual): October 3, 2017
• Study Completion (Actual): October 3, 2017

Study Registration Dates

• First Submitted: April 9, 2018
• First Submitted That Met QC Criteria: April 13, 2018
• First Posted (Actual): April 17, 2018

Study Record Updates

• Last Update Posted (Actual): April 17, 2018
• Last Update Submitted That Met QC Criteria: April 13, 2018
• Last Verified: April 1, 2018

More Information

Terms related to this study

• Keywords: memory; emotion; pictorial warning labels; risk knowledge; risk perceptions; quit intentions
• Other Study ID Numbers: P50CA180908A2a-A; P50CA180908 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No