Immediate Effects of Plain Packaging Health Warnings on Quitting Intention and Potential Mediators: Results From Two Ecological Momentary Assessment Studies
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AbstractThe purpose of this study is to examine the immediate, everyday impact of health warnings on cigarettepackages on potential smoking cessation mediators and to test for differences in immediate reactions tobranded and plain tobacco packaging during the transition phase when plain packs where first introducedin Australia. Two Ecological Momentary Assessment studies tested whether smokers report higher riskappraisals, self-efficacy, and quitting intentions immediately after seeing a warning compared to randomtimes of the day (Study 1), and whether smoking from plain packs results in higher quitting intention, riskappraisal, and self-efficacy than smoking from branded packs (Study 2). There was no immediateincrease in self-efficacy, risk appraisal, or intention after encountering health warnings, and no differencesin cognitions when using plain compared with branded packs. Moreover, cognitions were notdifferent when warnings were encountered in proximity to smoking compared to nonsmoking events.However, self-efficacy and risk appraisal were significantly associated with quitting intention. Currenthealth warnings do not seem to have an immediate impact on important predictors of quitting intentionand might benefit from including messages that place a stronger focus on increasing smokers confidencethat they can quit. Replication of the results with larger sample and cluster sizes is warranted.