The Effect of Cigarette Packaging and Illness Sensitivity on Attention to Graphic Health Warnings: A Controlled Study.

BACKGROUND The social and healthcare costs of smoking are immense. To reduce these costs, several tobacco control policies have been introduced (e.g., graphic health warnings (GHWs) on cigarette packs). Previous research has found plain packaging (a homogenized form of packaging), in comparison to branded packaging, effectively increases attention to GHWs using UK packaging prototypes. Past studies have also found that illness sensitivity (IS) protects against health-impairing behaviours. Building on this evidence, the goal of the current study was to assess the effect of packaging type (plain versus branded), IS level, and their interaction on attention to GHWs on cigarette packages using proposed Canadian prototypes. METHOD We assessed the dwell time and fixations on the GHW component of 40 cigarette pack stimuli (20 branded; 20 plain). Stimuli were presented in random order to 50 smokers (60.8% male; mean age= 33.1; 92.2% daily smokers) using the EyeLink 1000 system. Participants were divided into low IS (n= 25) and high IS (n= 25) groups based on scores on the Illness Sensitivity Index. RESULTS Overall, plain packaging relative to branded packaging increased fixations (but not dwell time) on GHWs. Moreover, low IS (but not high IS) smokers showed more fixations to GHWs on plain versus branded packages. CONCLUSIONS These findings demonstrate that plain packaging is a promising intervention for daily smokers, particularly those low in IS, and contributes evidence in support of impending implementation of plain packaging in Canada.