Abstract
BackgroundPictorial cigarette pack warnings discourage smoking, but most evidence comes from studies of adults. Our qualitative study explored adolescents’ reactions to pictorial warnings on their parents’ cigarette packs.MethodsWe interviewed 24 adolescents whose parents received pictorial warnings on their cigarette packs as part of a randomized clinical trial. We conducted a thematic content analysis of the interview transcripts.ResultsPictorial cigarette pack warnings led adolescents to imagine the depicted health effects happening to their parents, which elicited negative emotions. The warnings inspired adolescents to initiate conversations with their parents and others about quitting smoking. Adolescents believed the warnings would help smokers quit and prevent youth from starting smoking. Some current smokers said the warnings made them consider quitting.ConclusionsConversations about the pictorial warnings may amplify their effectiveness for smokers, their adolescent children, and friends of the adolescent children. Cigarette pack warnings may reach a broad audience that includes adolescent children of smokers.
Highlights
Pictorial cigarette pack warnings discourage smoking, but most evidence comes from studies of adults
Most adolescents reported seeing their parents’ labeled packs when their parents pulled out cigarettes to smoke or when the packs were left around the house
In interviews with United States (US) adolescent children of smokers, we found that teens worried about their parents’ smoking, and pictorial cigarette pack warnings heightened this worry
Summary
Pictorial cigarette pack warnings discourage smoking, but most evidence comes from studies of adults. We conducted a thematic content analysis of the interview transcripts Adolescents, those with parents who smoke, are a key population to target with tobacco prevention messages and policy interventions. One study of US adolescents indicated that high-emotion pictorial warnings increase perceptions of risk and intentions to quit compared to text-only warnings [13]. Another found that strong negative emotions mediate the relationship between perceived graphicness of cigarette warning labels and increased negative beliefs about smoking [14].
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