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We used a structured approach to assess whether active smokers presented with pictorial warnings on cigarette packages (PWCP) had a higher probability of quitting, reducing, and attempting to quit smoking than did unexposed smokers. We identified 21 articles from among nearly 2500 published between 1993 and 2013, prioritizing coverage over relevance or quality because we expected to find only a few studies with behavioral outcomes. We found very large heterogeneity across studies, poor or very poor methodological quality, and generally null or conflicting findings for any explored outcome. The evidence for or against the use of PWCP is insufficient, suggesting that any effect of PWCP on behavior would be modest. Determining the single impact of PWCP on behavior requires studies with strong methodological designs and longer follow-up periods.
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Int J Behav Nutr Phys Act
August 2025
Department of Obstetrics and Gynecology, AIIMS Bibinagar, Hyderabad, Telangana, India.
Introduction: Sugar-sweetened beverages (SSBs) are a significant source of added sugars in the Indian diet, contributing to adverse health outcomes such as obesity, type 2 diabetes, and dental caries. Multi-component interventions (MCIs) have shown promise in reducing the consumption of harmful products like tobacco. This study assessed the effectiveness of a multi-component intervention-comprising Pictorial Health Warnings (PHWs), educational pamphlets, and targeted counseling-in reducing parental purchases of SSBs for children.
View Article and Find Full Text PDFPLoS One
August 2025
Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, United States of America.
Background: This study aims to assess the impact of six evidence-based Waterpipe (WP)-specific pictorial health warnings (HWs) placed on the WP device on puffing behavior, toxicant exposure, subjective smoking experiences, harm perception, motivation and intention to quit among young WP smokers in Florida.
Methods: In a crossover experiment, a total of 100 WP smokers completed two 45-minute ad-libitum WP smoking sessions (without HW vs. with HW on the device) after a 12-hour abstinence.
BMC Public Health
August 2025
Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Background: India, one of the largest consumers of tobacco, has seen a dramatic rise in tobacco-attributable deaths over the past three decades. Among proven tobacco control strategies, Pictorial Health Warning Labels (PHWL) are effective and cost-efficient, especially in countries with lower literacy rates. Despite global guidelines under the WHO FCTC and India's own COTPA legislation, implementation of PHWL has faced sustained resistance from the tobacco industry (TI).
View Article and Find Full Text PDFNicotine Tob Res
August 2025
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, N.C., United States.
Introduction: Waterpipe tobacco smoking (WTS) is associated with health harms, yet the U.S. requires only a single text warning.
View Article and Find Full Text PDFAm J Prev Med
July 2025
TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences, Oklahoma City, Oklahoma; Department of Pediatrics, College of Medicine, The University of Oklahoma Health Sciences, Oklahoma City, Oklahoma.
Introduction: Guided by the Extended Parallel Process Model, this study used BERTopic modeling and manual coding to analyze reactions to cannabis health warnings and to assess how those responses were associated with message reactions, health beliefs, and intentions.
Methods: In 2022, adults (aged ≥21 years; N=1,078) living in recreational cannabis-use-approved U.S.