Pictorial Warning Labels and Memory for Cigarette Health-risk Information Over Time

Study Overview
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Brief Summary
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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. This trial tests memory for health risks immediately or after a six-week delay for US-representative adult smokers, US-representative teen smokers/vulnerable smokers, and Appalachian-representative adult smokers. In addition, the trial tests the effects of different warning label components and the consequences of memory for labels on risk perceptions and quit intentions.

Official Title
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Pictorial Warning Labels and Memory for Cigarette Health-risk Information Over Time

Conditions
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Smoking Cessation, Smoking, Cigarette

Intervention / Treatment
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* Behavioral: Text-only PWL
* Behavioral: Low-emot PWL
* Behavioral: High-emot PWL
* Behavioral: Immediate posttest
* Behavioral: delay posttest


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 19-65 years old (adult samples) have smoked 100+ lifetime cigarettes (adult samples) currently smoke every day or some days. (adult samples) 14-18 years old (teen sample) have ever smoked a cigarette (teen sample) Exclusion Criteria: • have not ever smoked a cigarette (all samples)

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Text-only PWL, immediate post<br>Exposure to 9 FDA-mandated warning labels Posttest measures (e.g., memory, risk perceptions, quit intentions) administered immediately following last exposure to warning labels | Behavioral: Text-only PWL<br>* Control condition<br>Behavioral: Immediate posttest<br> <br> |
| Experimental: Text-only PWL, delay posttest<br>Exposure to 9 FDA-mandated warning labels Posttest measures (e.g., memory, risk perceptions, quit intentions) administered 6 weeks after last exposure to warning labels | Behavioral: Text-only PWL<br>* Control condition<br>Behavioral: delay posttest<br> <br> |
| Experimental: Low-emot PWL, immediate posttest<br>Exposure to 9 warning labels paired with image that elicited little emotion Posttest measures (e.g., memory, risk perceptions, quit intentions) administered immediately following last exposure to warning labels | Behavioral: Low-emot PWL<br>* Pictorial warning<br>Behavioral: Immediate posttest<br> <br> |
| Experimental: Low-emot PWL, delay posttest<br>Exposure to 9 warning labels paired with image that elicited little emotion Posttest measures (e.g., memory, risk perceptions, quit intentions) administered 6 weeks after last exposure to warning labels | Behavioral: Low-emot PWL<br>* Pictorial warning<br>Behavioral: delay posttest<br> <br> |
| Experimental: High-emot PWL, immediate posttest<br>Exposure to 9 warning labels paired with image that elicited high emotion Posttest measures (e.g., memory, risk perceptions, quit intentions) administered immediately following last exposure to warning labels | Behavioral: High-emot PWL<br>* Pictorial warning<br>Behavioral: Immediate posttest<br> <br> |
| Experimental: High-emot PWL, delay posttest<br>Exposure to 9 warning labels paired with image that elicited high emotion Posttest measures (e.g., memory, risk perceptions, quit intentions) administered 6 weeks after last exposure to warning labels | Behavioral: High-emot PWL<br>* Pictorial warning<br>Behavioral: delay posttest<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| graphic warning label recall | free recall for risk information presented in labels (9 text boxes, 1 for each label; coded for exact or equivalent words) | immediately following last exposure or after 6-week delay | 
| smoking risk recognition | Participants were subsequently shown twenty-six negative health effects and asked Which of the following health effects were mentioned in the warnings we showed you? and responded Yes, I saw this health effect or No, I did not see this health effect. Fourteen risks were mentioned in the warnings (e.g., cancer, harms children, emphysema); six were risks of smoking not presented in the warnings (e.g., wrinkles, diabetes), and six were not risks of smoking (e.g., acne, thyroid problems). | immediately following last exposure or after 6-week delay | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| smoking risk perceptions | participants completed several scale items about how much risk they perceived smoking posed to them (e.g., Compared to the average nonsmoker your age, gender, and race, how would you rate your chances of: 1) getting a life threatening illness because of smoking, 2) getting lung cancer, and 3) dying at a younger age than average (-3 = Much lower, +3 = Much higher)) | immediately following last exposure or after 6-week delay | 
| quit intentions | participants' intentions to quit smoking | immediately following last exposure or after 6-week delay | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pictorial warning labels, risk knowledge, emotion, memory, risk perceptions, quit intentions