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May 21st, 2014:

Pictorial health warning label content and smokers’ understanding of smoking-related risks-a cross-country comparison


The aim of the present study was to assess smokers’ level of agreement with smoking-related risks and toxic tobacco constituents relative to inclusion of these topics on health warning labels (HWLs). 1000 adult smokers were interviewed between 2012 and 2013 from online consumer panels of adult smokers from each of the three countries: Australia (AU), Canada (CA) and Mexico (MX). Generalized estimating equation models were estimated to compare agreement with smoking-related risks and toxic tobacco constituents. For disease outcomes described on HWLs across all three countries, there were few statistical differences in agreement with health outcomes (e.g. emphysema and heart attack). By contrast, increases in agreement where the HWLs were revised or introduced on HWLs for the first time (e.g. blindness in AU and CA, bladder cancer in CA). Similarly, samples from countries that have specific health content or toxic constituents on HWLs showed higher agreement for that particular disease or toxin than countries without (e.g. higher agreement for gangrene and blindness in AU, higher agreement for bladder cancer and all toxic constituents except nitrosamines and radioactive polonium in CA). Pictorial HWL content is associated with greater awareness of smoking-related risks and toxic tobacco constituents.

Passive exposure to electronic cigarette use increases desire for e-cigarettes in young adult smokers

Tob Control 2015;24:501-504 doi:10.1136/tobaccocontrol-2014-051563

  1. Andrea C King1,
  2. Lia J Smith1,
  3. Patrick J McNamara1,
  4. Alicia K Matthews2,
  5. Daniel J Fridberg1
    1. Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
    2. University of Illinois at Chicago, College of Nursing, Chicago, Illinois, USA
  6. Correspondence to Dr Andrea King, Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue (MC-3077), Chicago, IL 60637, USA; aking{at}

* Received 14 January 2014
* Accepted 30 April 2014
* Published Online First 21 May 2014


Background Passive exposure to combustible cigarette use has been shown to act as a cue to increase smoking urge. Given the resemblance of e-cigarettes and other electronic nicotine delivery systems (ENDS) to combustible cigarettes, we examined whether these devices could also act as a cue to increase smoking desire and urges in those passively exposed.

Methods Young adult daily smokers (age 18–35 years; N=60) completed subjective ratings before and after exposure to a study confederate drinking bottled water (control cue) and then smoking either a combustible or e-cigarette (active cue). Smoking desire and urge ratings were measured with visual analogue scale items for desire for a regular and an e-cigarette and the Brief Questionnaire of Smoking Urges.

Results Passive exposure to both the e-cigarette and combustible cigarette cue significantly increased observers’ ratings of desire and urge to smoke a regular cigarette (all ps<0.05). Exposure to the e-cigarette cue but not the regular cigarette cue also increased desire to smoke an e-cigarette (p<0.01).

Conclusions The results provide the first evidence in a controlled setting that electronic cigarette exposure may evoke smoking urges in young adult daily smokers. With replication, these findings may have relevance for ENDS regulation and policy.