Evaluating the perceived effectiveness of pregnancy-related cigarette package health warning labels among different gender/age groups.
INTRODUCTION
The impact of pregnancy-related health warning labels (HWLs) appearing on cigarette packages on women of reproductive age and other socio-demographic groups is not well understood. The current study analyzes how different age/gender groups respond to pregnancy-related HWLs as compared to non-pregnancy HWLs.


METHODS
Data were analyzed from four waves of an online longitudinal study with adult smokers aged 18-64 in Australia, Canada, Mexico, and the US. Participants were classified into four age\gender groups: women 40 and under; men 40 and under; women over 40; men over 40. Participants rated one pregnancy-related and several non-pregnancy related labels on worry, believability, and motivation to quit. Country-specific adjusted linear GEE were estimated regressing ratings for each of the three key outcomes for 1) pregnancy-related HWLs and 2) a rating difference score that subtracted the average ratings of the non-pregnancy warning from the rating of the pregnancy warning. All models adjusted for socio-demographics and smoking related variables.


RESULTS
In Mexico and Australia, where graphic pregnancy-related HWL imagery is used (i.e., premature infant), women of reproductive age reported stronger believability, worry, and quit motivation than all other groups. Results were similar in the US, where text only HWLs are used. In contrast in Canada, where the pregnancy-related HWL imagery features a pregnant woman, ratings were unassociated with gender/age groups. Stronger effects among women of reproductive age were limited to pregnancy HWLs in each country, except Canada.


CONCLUSIONS
HWLs that depict graphic effects to illustrate smoking-related pregnancy risks appear to be perceived as particularly effective among women of reproductive age.
['Kollath-Cattano|Christy|C|', 'Osman|Amira|A|', 'Thrasher|James F|JF|']
D000293:Adolescent D000328:Adult D017677:Age Distribution D001294:Attitude to Health D000073865:Cigarette Smoking D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009042:Motivation D010465:Perception D011247:Pregnancy D011356:Product Labeling D012307:Risk Factors D017678:Sex Distribution D016540:Smoking Cessation D054063:Superior Sagittal Sinus D062789:Tobacco Products D055815:Young Adult
Gender Australia Smoking Health policy North America Product labeling