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The current issue of Tobacco Control highlights recent developments in research related to tobacco packaging, including issues as diverse as health warnings, plain packaging, messaging and novel products. Since the implementation of the first pictorial cigarette warnings by Canada nearly two decades ago, to the first implementation of plain packaging (PP) by Australia in 2012, the literature on this field has blossomed and diversified. The ability of health warnings to remain relevant and continue to command attention is an important question in public health education. Woelbert and d’Hombres1 conducted a large experimental study in 10 European countries that had implemented differing warning styles. They find that graphic and text combined have a maximum effect in reducing intentions to smoke, but that this was attenuated in countries that had already implemented this warning style. Novel pictures reversed the wearout effect, providing evidence to support rotating warning content over time.
Green2 and colleague address the issue of changing warnings from a different perspective, looking at the introduction of new warning content and the removal of other content as new, larger warnings were implemented in Canada. Adding and removing content from warnings generally affects smoker knowledge—removing carbon monoxide (CO) and impotence warnings led to decreased awareness that these were associated with smoking while adding blindness and bladder cancer warnings increased awareness, although adding an addiction warning had a little effect. Novelty appears to be important to consider when adding content, though it is also important to consider the …