Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers.

AIMS Previous research with adults indicates that plain packaging increases visual attention to health warnings in adult non-smokers and weekly smokers, but not daily smokers. The present research extends this study to adolescents aged 14-19 years. DESIGN Mixed-model experimental design, with smoking status as a between-subjects factor and pack type (branded or plain pack) and eye gaze location (health warning or branding) as within-subjects factors. SETTING Three secondary schools in Bristol, UK. PARTICIPANTS A convenience sample of adolescents comprising never-smokers (n = 26), experimenters (n = 34), weekly smokers (n = 13) and daily smokers (n = 14). MEASUREMENTS Number of eye movements to health warnings and branding on plain and branded packs. FINDINGS Analysis of variance, irrespective of smoking status revealed more eye movements to health warnings than branding on plain packs, but an equal number of eye movements to both regions on branded packs (P = 0.033). This was observed among experimenters (P < 0.001) and weekly smokers (P = 0.047), but not among never-smokers or daily smokers. CONCLUSION Among experimenters and weekly smokers, plain packaging increases visual attention to health warnings and away from branding. Daily smokers, even relatively early in their smoking careers, seem to avoid the health warnings on cigarette packs. Adolescent never-smokers attend the health warnings preferentially on both types of packs, a finding which may reflect their decision not to smoke.

[1]  David Hammond,et al.  Health warning messages on tobacco products: a review , 2011, Tobacco Control.

[2]  R. Baddeley,et al.  Do we look at lights? Using mixture modelling to distinguish between low- and high-level factors in natural image viewing , 2009 .

[3]  Kimmo Koskenniemi,et al.  Expert panel report , 2007 .

[4]  Kathryn Angus,et al.  Plain tobacco packaging: A systematic review , 2012 .

[5]  Selcuk R. Sirin.  Socioeconomic Status and Academic Achievement: A Meta-Analytic Review of Research , 2005 .

[6]  Ute Leonards,et al.  Plain packaging increases visual attention to health warnings on cigarette packs in non-smokers and weekly smokers but not daily smokers. , 2011, Addiction.

[7]  R Doll,et al.  Mortality in relation to smoking: 40 years' observations on male British doctors , 1994, BMJ.

[8]  J. Arnett,et al.  Optimistic bias in adolescent and adult smokers and nonsmokers. , 2000, Addictive behaviors.

[9]  C. Vardavas,et al.  Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels. , 2009, European journal of public health.

[10]  Richard Doll,et al.  Mortality in relation to smoking: 22 years' observations on female British doctors. , 1980, British medical journal.

[11]  K. Cummings,et al.  The cigarette pack as image: new evidence from tobacco industry documents , 2002, Tobacco control.

[12]  Geoffrey T Fong,et al.  Text and graphic warnings on cigarette packages: findings from the international tobacco control four country study. , 2007, American journal of preventive medicine.

[13]  M. Wakefield,et al.  Do graphic health warning labels have an impact on adolescents' smoking-related beliefs and behaviours? , 2008, Addiction.

[14]  Allison Ford,et al.  Young adult smokers' perceptions of plain packaging: a pilot naturalistic study , 2011, Tobacco Control.

[15]  C. Koch,et al.  A saliency-based search mechanism for overt and covert shifts of visual attention , 2000, Vision Research.