Dien Anshari, S.Sos., M.Si., Ph.D.

No Title Description
1 Which Tobacco Product Warning Imagery is Most Effective? A Longitudinal Assessment of Smokers in Australia, Canada, and Mexico Which Tobacco Product Warning Imagery is Most Effective? A Longitudinal Assessment of Smokers in Australia, Canada, and Mexico

BACKGROUND: This study examined temporal changes in smokers’ responses to pictorial health warning (PHW) with different types of imagery (i.e., symbolic representations of risk; personal suffering from smoking; graphic depictions of bodily harm) on cigarette packs under natural conditions of exposure.
METHODS: Adult smokers from online panels in Australia (AU; n=4,006), Canada (CA; n=4,002) and Mexico (MX; n=4,006) were surveyed quarterly after new PHWs were implemented in each country. Participants were shown specific PHWs on packs in their country and asked about: negative emotions (i.e., fear; disgust; worry about smoking risks); PHW believability; attention to the PHW in the prior month; interpersonal communication about the PHW in the prior month; and motivation to quit because of the PHW. Temporal changes and differences by imagery type were analyzed using country-specific generalized estimating equations models.
RESULTS: Across countries, assessment of the main effects of time on PHW responses indicated no changes over time except for increasing attention to PHWs in CA (OR=1.17, p CONCLUSIONS: PHWs with diverse graphic and suffering imagery appear effective in inhibiting wear out for different key pathways of PHW effects.


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2 Do textual styles in cigarette health warning labels matter? Do textual styles in cigarette health warning labels matter?

OBJECTIVES: To determine whether different textual styles (testimonial vs. didactic) on cigarette health warning labels influence responses to the warning labels.
METHODS: A field experiment was conducted with adult smokers (n=584) and 15- to 18-year-old adolescents (n=593) in Indonesia using intercept recruitment strategies. Respondents were randomly assigned to one of two conditions: 1) warning labels with didactic text (i.e., smoking causes lung cancer); or 2) warning labels matched on all characteristics except that they contained testimonial text (i.e., “I am suffering from lung cancer because of smoking”). For each condition, respondents were randomly assigned to evaluate warnings for two out of eight possible health topics, with each topic containing four to six warnings that systematically varied key characteristics (i.e., presence vs. absence of picture; pictorial types: graphic organ damage, personal suffering, symbolic representation of risk). Respondents rated each warning for overall effectiveness, believability, relevance, and negative emotional arousal. Linear mixed effects models regressed ratings on dummy variables for textual conditions, for image types, and the interaction between them, both for the entire population and when estimating models separately for adults and adolescents.
RESULTS: In linear mixed effects models, effectiveness ratings were significantly higher for didactic than testimonial text only among adolescents. When estimating model for entire population, significant interactions were found between condition and age group, and between condition and image type. Similarly, believability ratings were also significantly higher for didactic than testimonial only among adolescents and when considering pictorial images. Negative emotional arousal and relevance ratings were not significantly affected by condition. However, when estimating relevance model for adolescents, significant interaction was found between condition and smoking status.
CONCLUSIONS: Didactic text style appears to influence youth responses to cigarette warning labels. Future research should determine its effects on cessation-related outcomes.


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