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Effectiveness of Text-Only Cigarette Health Warnings in Japan: Findings from the 2018 International Tobacco Control (ITC) Japan Survey

Author

Listed:
  • Janet Chung-Hall

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

  • Geoffrey T. Fong

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada
    Ontario Institute for Cancer Research, 661 University Ave, Suite 510, Toronto, ON M5G 0A3, Canada
    School of Public Health and Health Systems, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada)

  • Gang Meng

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

  • Mi Yan

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

  • Takahiro Tabuchi

    (Cancer Control Center, Osaka International Cancer Institute, Chome-1-69 Otemae, Chuo Ward, Osaka 541-8567, Japan)

  • Itsuro Yoshimi

    (Division of Tobacco Policy Research, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan)

  • Yumiko Mochizuki

    (Japan Cancer Society, 13th Floor, Yurakucho Center Bldg. 2-5-1, Yurakucho, Chiyoda-ku, Tokyo 100-0006, Japan)

  • Lorraine V. Craig

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

  • Janine Ouimet

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

  • Anne C. K. Quah

    (Department of Psychology, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada)

Abstract

Health warnings are an effective strategy for communicating the health harms of smoking, encouraging quitting, and preventing smoking initiation. This study examines the effectiveness of existing text-only health warnings, identifies key predictors of warning effectiveness, and assesses support for pictorial warnings in Japan. Data are from the 2018 International Tobacco Control (ITC) Japan Survey, a cohort survey of adult cigarette smokers (n = 3306), dual users of cigarettes and heated tobacco products (n = 555), and non-cigarette smokers (n = 823). Weighted multivariable logistic regression models were used to assess predictors of warning effectiveness and support for pictorial warnings. Overall, 15.6% of respondents noticed warnings, and 7.9% read or looked closely at warnings. Overall, 10.3% of smokers and dual users said the warnings stopped them from having a cigarette, and 7.2% avoided warnings. Overall, 27.5% of respondents said the warnings made them think about health risks of smoking, but only 2.7% of smokers and dual users said the warnings made them more likely to quit. Overall, 57.6% of respondents supported pictorial warnings. The weak effectiveness of Japan’s text-only warnings is consistent with that in other countries with similar warnings. There is majority support for pictorial warnings in Japan, although the level of support is lower than in other countries.

Suggested Citation

  • Janet Chung-Hall & Geoffrey T. Fong & Gang Meng & Mi Yan & Takahiro Tabuchi & Itsuro Yoshimi & Yumiko Mochizuki & Lorraine V. Craig & Janine Ouimet & Anne C. K. Quah, 2020. "Effectiveness of Text-Only Cigarette Health Warnings in Japan: Findings from the 2018 International Tobacco Control (ITC) Japan Survey," IJERPH, MDPI, vol. 17(3), pages 1-17, February.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:3:p:952-:d:316160
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    References listed on IDEAS

    as
    1. Noar, Seth M. & Francis, Diane B. & Bridges, Christy & Sontag, Jennah M. & Ribisl, Kurt M. & Brewer, Noel T., 2016. "The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies," Social Science & Medicine, Elsevier, vol. 164(C), pages 118-129.
    2. Hammond, D. & Fong, G.T. & McDonald, P.W. & Brown, K.S. & Cameron, R., 2004. "Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers," American Journal of Public Health, American Public Health Association, vol. 94(8), pages 1442-1445.
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