Pictorial Health Warnings
Conditions
Brief summary
This proposed study will assess the effects of different scenarios of PHW policies on smokers' reactions to warnings, attitudes and beliefs, behavioral intentions, and quitting behaviors, with specific aims: 1) to assess the impact of new PHWs covering 50% of cigarette packs, 2) to assess the impact of new larger PHWs covering 85% of cigarette packs, 3) to assess the impact of incorporating quitline information on cigarette packs, and 4) to assess the impact of plain packaging. These aims will be achieved by conducting a five-arm RCT among 1000 adult smokers (n=200 per arm). It includes four intervention groups: 1) branded pack with a new set of 6 PHWs covering 50% of cigarette packs without quitline information, 2) branded pack with a new set of 6 PHWs covering 85% of cigarette packs without quitline information, 3) branded pack with a new set of 6 PHWs covering 85% of cigarette packs with quitline information, and 4) plain pack with a new set of 6 PHWs covering 85% of cigarette packs with quitline information. A control group will use branded packs with the current set of 6 PHWs, covering 50% of cigarette packs without quitline information. Given that the pictorial health warnings (PHW) on cigarette packs need to be renewed, this project will provide highly policy-relevant and timely scientific evidence on the effect of new PHW policies in Vietnam. Additionally, this project would be the first to address the research gap in understanding the effect of adding quitline information to PHWs-a gap not explored in previous studies. With the potential for significant outcomes, the findings will help Vietnamese policymakers enact stronger PHW policies in upcoming years, aiming to increase perceived harms of smoking and foster smoking cessation, ultimately saving millions of lives in Vietnam
Interventions
OTHERBranded pack with new PHWs covering 50% of the pack without quitline information
Participants received and were required to view six images depicting a branded cigarette pack with a new set of six pictorial health warnings covering 50% of the pack, without quitline information.
OTHERBranded pack with new PHWs covering 85% of the pack without quitline information
Participants received and were required to view six images depicting a branded cigarette pack with a new set of six pictorial health warnings covering 85% of the pack, without quitline information.
OTHERBranded pack with new PHWs covering 85% of the pack with quitline information
Participants received and were required to view six images depicting a branded cigarette pack with a new set of six pictorial health warnings covering 85% of the pack, with quitline information
OTHERPlain pack with new PHWs covering 85% of the pack with quitline information
Participants received and were required to view six images depicting a plain cigarette pack with a new set of six pictorial health warnings covering 85% of the pack, with quitline information
OTHERBranded pack with the current set of PHWs covering 50% of the pack without quitline information
Participants received and were required to view 6 images depicting a branded cigarette pack with a current set of 6 pictorial health warnings covering 50% of cigarette packs without quitline information (It is the current pictorial health warnings implemented in Vietnam)
Sponsors
Hanoi University of Public Health
Georgia State University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* having smoked at least 100 cigarettes in their lifetime and currently smoking * aged 18 or older * fluent in Vietnamese * smartphone users
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emotional and cognitive responses | At the enrollment | Negative emotions, including sadness, anger, fear, guilt, disgust, worry, and shame, were measured on a scale from 1 (not at all) to 9 (extremely). Perceived message effectiveness was assessed using the following statements: This warning discourages me from wanting to smoke. This warning makes smoking seem unpleasant to me. This warning makes me concerned about the health effects of smoking. Participants rated their agreement on a scale from 1 (strongly disagree) to 7 (strongly agree), with an additional don't know option. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Attitudes and beliefs | At the enrollment | Health risk perceptions were assessed using the following questions: If you were to smoke cigarettes every day, how likely is it that they would harm your overall health? If you were to smoke cigarettes every day, how likely is it that you would get addicted? Participants rated their responses on a scale from 1 (not at all likely) to 5 (extremely likely), with an additional don't know option. Health-related beliefs were assessed using the following statements: Tobacco smoke is dangerous for non-smokers' health. Smoking causes lung cancer. Smoking causes oral cancer. Smoking causes bleeding in the brain and stroke. Smoking causes neck cancer. Participants rated their agreement on a scale from 1 (strongly disagree) to 7 (strongly agree), with an additional don't know option. |
| Behavioral intentions | At the enrollment | Behavioral intentions were assessed using the following questions: Quit motivation: How motivated are you to quit smoking in the next month? Quit intention: How likely are you to quit smoking in the next month? Quitline call intention: How likely are you to call the quitline in the next month? Participants rated their responses on a scale from 1 (not at all) to 9 (extremely). |
| Recall and behavioral outcomes at 2-week follow-up | at 2 weeks | This study assessed various recall and behavioral outcomes at 2 -week follow-up, including whether participants had thought about the harms of smoking, recalled the national quitline number, engaged in communication behaviors related to smoking and quitting, forwent cigarettes due to harm-related thoughts, made a quit attempt, or reduced the number of cigarettes smoked per day after 2 weeks. All outcomes were recorded as binary (Yes/No). |
Countries
Vietnam
Outcome results
None listed