PT - JOURNAL ARTICLE AU - Darren Mays AU - Raymond S Niaura AU - W Douglas Evans AU - David Hammond AU - George Luta AU - Kenneth P Tercyak TI - Cigarette packaging and health warnings: the impact of plain packaging and message framing on young smokers AID - 10.1136/tobaccocontrol-2013-051234 DP - 2015 Mar 01 TA - Tobacco Control PG - e87--e92 VI - 24 IP - e1 4099 - http://tobaccocontrol.bmj.com/content/24/e1/e87.short 4100 - http://tobaccocontrol.bmj.com/content/24/e1/e87.full SO - Tob Control2015 Mar 01; 24 AB - Objective This study examined the impact of pictorial cigarette-warning labels, warning-label message framing and plain cigarette packaging, on young adult smokers’ motivation to quit. Methods Smokers aged 18–30 years (n=740) from a consumer research panel were randomised to one of four experimental conditions where they viewed online images of four cigarette packs with warnings about lung disease, cancer, stroke/heart disease and death, respectively. Packs differed across conditions by warning-message framing (gain vs loss) and packaging (branded vs plain). Measures captured demographics, smoking behaviour, covariates and motivation to quit in response to cigarette packs. Results Pictorial warnings about lung disease and cancer generated the strongest motivation to quit across conditions. Adjusting for pretest motivation and covariates, a message framing by packaging interaction revealed gain-framed warnings on plain packs generated greater motivation to quit for lung disease, cancer and mortality warnings (p<0.05), compared with loss-framed warnings on plain packs. Conclusions Warnings combining pictorial depictions of smoking-related health risks with text-based messages about how quitting reduces risks, may achieve better outcomes among young adults, especially in countries considering or implementing plain packaging regulations.