Global Evidence on the Association between Cigarette Graphic Warning Labels and Cigarette Smoking Prevalence and Consumption.

Anh Ngo,Frank Chaloupka,Ce Shang,Jidong Huang,Kai-Wen Cheng

doi:10.3390/ijerph15030421

Abstract

Background: In 2011, the courts ruled in favor of tobacco companies in preventing the implementation of graphic warning labels (GWLs) in the US, stating that FDA had not established the effectiveness of GWLs in reducing smoking. Methods: Data came from various sources: the WHO MPOWER package (GWLs, MPOWER policy measures, cigarette prices), Euromonitor International (smoking prevalence, cigarette consumption), and the World Bank database (countries’ demographic characteristics). The datasets were aggregated and linked using country and year identifiers. Fractional logit regressions and OLS regressions were applied to examine the associations between GWLs and smoking prevalence and cigarette consumption, controlling for MPOWER policy scores, cigarette prices, GDP per capita, unemployment, population aged 15–64 (%), aged 65 and over (%), year indicators, and country fixed effects. Results: GWLs were associated with a 0.9–3 percentage point decrease in adult smoking prevalence and were significantly associated with a reduction of 230–287 sticks in per capita cigarette consumption, compared to countries without GWLs. However, the association between GWLs and cigarette consumption became statistically insignificant once country indicators were included in the models. Conclusions: The implementation of GWLs may be associated with reduced cigarette smoking.

Highlights

Graphic warning labels (GWLs) have been shown to be an effective tobacco control policy in providing health information to the public [1,2,3,4,5] and in increasing the knowledge of health risks of smoking [5,6]
This study provides global evidence on the associations between graphic warning labels (GWLs) and adult smoking prevalence and cigarette consumption
In this study, using the data from over 60 countries during the 2007–2014 period, we examined the associations between GWLs and smoking prevalence and cigarette consumption and provided global evidence on the impacts of GWLs on these smoking outcomes

Summary

Introduction

Graphic warning labels (GWLs) have been shown to be an effective tobacco control policy in providing health information to the public [1,2,3,4,5] and in increasing the knowledge of health risks of smoking [5,6]. Framework Convention on Tobacco Control (FCTC), with 180 parties to the treaty, calls for countries to adopt pictorial labels on cigarette packages, with warnings covering at least 50% coverage in the principal display area [7]. In 2011, the courts ruled in favor of tobacco companies in preventing the implementation of graphic warning labels (GWLs) in the US, stating that FDA had not established the effectiveness of GWLs in reducing smoking. GWLs and smoking prevalence and cigarette consumption, controlling for MPOWER policy scores, cigarette prices, GDP per capita, unemployment, population aged 15–64 (%), aged 65 and over (%), year indicators, and country fixed effects. Conclusions: The implementation of GWLs may be associated with reduced cigarette smoking

Methods

Results

Conclusion