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Effect of Packaging on Smoking Perceptions and Behavior: A Randomized Trial

Principal Investigator: David Strong and John P. Pierce

Funding Mechanism:  National Institutes of Health - Grant

ID number: 1 R01 CA190347-01

Award Date: 3/26/2015

Institution: University of California San Diego


The impact of cigarette packaging and labeling on consumer perceptions and smoking behavior and the effectiveness of graphic warning labels for communicating tobacco product risks are two critical topics warranting further study. In a randomized controlled trial, investigators will enroll 450 committed smokers (ages 21-50 years) who currently smoke at least five cigarettes per day and who have no intention of quitting in the next six months. Study aims are: (1) to test how standard tobacco industry imagery from U.S. cigarette packs influences consumer perceptions of their cigarettes; (2) to test whether adding large graphic warning labels increases perceptions of the harm of tobacco products; and (3) to test whether the Australian model packs result in a change in cigarette pack handling, consumption patterns, and quitting cognitions. For four months, participants will order their cigarettes on a secure study website and have them delivered within two days. Participants will be randomized to receive one of three types of cigarette packs: a) cigarettes repackaged in a plain pack, with the Surgeon-General’s warning labels but no tobacco marketing; b) cigarettes repackaged into the Australian-type pack (large graphic warning label, highlighted warning labels but no tobacco marketing) and c) a standard U.S. pack. During the course of the study, participants will: a) complete a web-based questionnaire; b) provide a saliva sample for cotinine analysis; c) undergo a laboratory-based motion sensor technology assessment that will measure pack handling and time interacting with warning labels; and d) participate in interactive messaging. Research findings may inform regulatory activities related to cigarette packaging and labeling.


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