PMID- 34511408
OWN - NLM
STAT- MEDLINE
DCOM- 20230424
LR  - 20230425
IS  - 1468-3318 (Electronic)
IS  - 0964-4563 (Print)
IS  - 0964-4563 (Linking)
VI  - 32
IP  - 3
DP  - 2023 May
TI  - Role of affective reactivity induced by cigarette packaging including graphic 
      warning labels: the CASA Study.
PG  - 315-322
LID - 10.1136/tobaccocontrol-2021-056650 [doi]
AB  - OBJECTIVE: To identify whether three types of cigarette pack designs, including 
      three versions of graphic warning label (GWL) plain packs, one GWL absent and 
      branding absent pack (blank) and the smoker's own GWL absent and branding present 
      pack (US), elicit different valence, type and levels of affect. DESIGN: US daily 
      smokers (n=324) were asked to handle each of the five pack types and 'think 
      aloud' their reactions. To avoid a muted familiarity response, exposure to their 
      own US pack followed exposure to at least one GWL plain pack. Reactions were 
      scored on a reactivity scale (-3 to +3) and the text was coded for speech 
      polarity (-1 to +1) and emotive word frequency. RESULTS: Reactivity scores had 
      excellent inter-rater reliability (agreement >/=86%; intraclass correlation 
      coefficient >/=0.89) and were correlated with speech polarity (r=0.21-0.37, 
      p<0.001). When considering their US pack, approximately two-thirds of smokers had 
      a low (31.5%) to medium (34.6%) positive response (reactivity=1.29; 
      polarity=0.14) with expressed feelings of joy and trust. Blank packaging prompted 
      a largely (65.4%) neutral response (reactivity=0.03; polarity=0.00). The 
      gangrenous foot GWL provoked mostly medium (46.9%) to high (48.1%) negative 
      responses (reactivity=-2.44; polarity=-0.20), followed by neonatal baby 
      (reactivity=-1.85; polarity=-0.10) and throat cancer (reactivity=-1.76; 
      polarity=-0.08) warnings. GWLs varied in their elicitation of disgust, anger, 
      fear and sadness. CONCLUSION: Initial reactions to GWL packs, a blank pack, and 
      smokers' current US pack reflected negative, neutral, and positive affect, 
      respectively. Different versions of the GWL pack elicited different levels and 
      types of immediate negative affect.
CI  - (c) Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Stone, Matthew
AU  - Stone M
AUID- ORCID: 0000-0002-1152-0621
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA m3stone@health.ucsd.edu.
AD  - School of Public Health, San Diego State University, San Diego, California, USA.
FAU - Strong, David
AU  - Strong D
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
AD  - Cancer Control Program, University of California San Diego Moores Cancer Center, 
      La Jolla, California, USA.
FAU - Dimofte, Claudiu
AU  - Dimofte C
AD  - Marketing Department, San Diego State University, San Diego, California, USA.
FAU - Brighton, Elizabeth
AU  - Brighton E
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Oratowski, Jesica
AU  - Oratowski J
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Yang, Tingyi
AU  - Yang T
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Alkuzweny, Manar
AU  - Alkuzweny M
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Asslani, Atean
AU  - Asslani A
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Velasco, Katherine
AU  - Velasco K
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Skipworth, Michael
AU  - Skipworth M
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
FAU - Crespo, Noe C
AU  - Crespo NC
AD  - School of Public Health, San Diego State University, San Diego, California, USA.
FAU - Hurst, Samantha
AU  - Hurst S
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
AD  - Cancer Control Program, University of California San Diego Moores Cancer Center, 
      La Jolla, California, USA.
FAU - Leas, Eric C
AU  - Leas EC
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
AD  - Cancer Control Program, University of California San Diego Moores Cancer Center, 
      La Jolla, California, USA.
FAU - Pulvers, Kim
AU  - Pulvers K
AUID- ORCID: 0000-0002-0282-1975
AD  - Department of Psychology, California State University San Marcos, San Marcos, 
      California, USA.
FAU - Pierce, John P
AU  - Pierce JP
AUID- ORCID: 0000-0002-0075-7471
AD  - Herbert Wertheim School of Public Health and Human Longevity Science, University 
      of California San Diego, La Jolla, California, USA.
AD  - Cancer Control Program, University of California San Diego Moores Cancer Center, 
      La Jolla, California, USA.
LA  - eng
GR  - R01 CA190347/CA/NCI NIH HHS/United States
GR  - R01 DA033296/DA/NIDA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20210912
PL  - England
TA  - Tob Control
JT  - Tobacco control
JID - 9209612
SB  - IM
MH  - Infant, Newborn
MH  - Humans
MH  - *Tobacco Products/adverse effects
MH  - Product Labeling
MH  - Reproducibility of Results
MH  - Product Packaging
MH  - Drug Packaging
MH  - Smoking Prevention
PMC - PMC8917242
MID - NIHMS1736349
OTO - NOTNLM
OT  - packaging and labelling
OT  - prevention
OT  - public policy
COIS- Competing interests: None declared.
EDAT- 2021/09/14 06:00
MHDA- 2023/04/24 06:42
PMCR- 2024/05/01
CRDT- 2021/09/13 06:28
PHST- 2021/03/11 00:00 [received]
PHST- 2021/08/24 00:00 [accepted]
PHST- 2024/05/01 00:00 [pmc-release]
PHST- 2023/04/24 06:42 [medline]
PHST- 2021/09/14 06:00 [pubmed]
PHST- 2021/09/13 06:28 [entrez]
AID - tobaccocontrol-2021-056650 [pii]
AID - 10.1136/tobaccocontrol-2021-056650 [doi]
PST - ppublish
SO  - Tob Control. 2023 May;32(3):315-322. doi: 10.1136/tobaccocontrol-2021-056650. 
      Epub 2021 Sep 12.