RT Journal Article
SR Electronic
T1 Role of affective reactivity induced by cigarette packaging including graphic warning labels: the CASA Study
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 315
OP 322
DO 10.1136/tobaccocontrol-2021-056650
VO 32
IS 3
A1 Matthew Stone
A1 David Strong
A1 Claudiu Dimofte
A1 Elizabeth Brighton
A1 Jesica Oratowski
A1 Tingyi Yang
A1 Manar Alkuzweny
A1 Atean Asslani
A1 Katherine Velasco
A1 Michael Skipworth
A1 Noe C Crespo
A1 Samantha Hurst
A1 Eric C Leas
A1 Kim Pulvers
A1 John P Pierce
YR 2023
UL http://tobaccocontrol.bmj.com/content/32/3/315.abstract
AB Objective To identify whether three types of cigarette pack designs, including three versions of graphic warning label (GWL) plain packs, one GWL absent and branding absent pack (blank) and the smoker’s own GWL absent and branding present pack (US), elicit different valence, type and levels of affect.Design US daily smokers (n=324) were asked to handle each of the five pack types and ‘think aloud’ their reactions. To avoid a muted familiarity response, exposure to their own US pack followed exposure to at least one GWL plain pack. Reactions were scored on a reactivity scale (−3 to +3) and the text was coded for speech polarity (−1 to +1) and emotive word frequency.Results Reactivity scores had excellent inter-rater reliability (agreement ≥86%; intraclass correlation coefficient ≥0.89) and were correlated with speech polarity (r=0.21–0.37, p<0.001). When considering their US pack, approximately two-thirds of smokers had a low (31.5%) to medium (34.6%) positive response (reactivity=1.29; polarity=0.14) with expressed feelings of joy and trust. Blank packaging prompted a largely (65.4%) neutral response (reactivity=0.03; polarity=0.00). The gangrenous foot GWL provoked mostly medium (46.9%) to high (48.1%) negative responses (reactivity=−2.44; polarity=−0.20), followed by neonatal baby (reactivity=−1.85; polarity=−0.10) and throat cancer (reactivity=−1.76; polarity=−0.08) warnings. GWLs varied in their elicitation of disgust, anger, fear and sadness.Conclusion Initial reactions to GWL packs, a blank pack, and smokers’ current US pack reflected negative, neutral, and positive affect, respectively. Different versions of the GWL pack elicited different levels and types of immediate negative affect.Data are available upon reasonable request. Deidentified data and a measures codebook will be made available on request.