Table 7.
Perceived harm outcomes
| No. | Author(s), publication year | Group | Perceived risk | OR or Beta | Measures | |
|---|---|---|---|---|---|---|
| Pre | Post | |||||
| 1 | Anshari et al., 2018 | Australia | 0.22 (0.03 to 0.40) | 0.36 (0.09 to 0.63) | NA | Negative affect: “How much does this warning make you feel worried about the health risks of smoking?” |
| Canada | 0.06 (−0.08 to 0.20) | 0.03 (−0.23 to 0.28) | NA | |||
| Mexico | 0.00 (−0.14 to 0.15) | −0.25 (−0.47 to 0.02) | NA | |||
| 2 | Borland et al., 2009* | Australia | 1.68 | 2.04 | NA | Cognitive responses combined two questions: “Extent to which the warnings both made the respondent think about the health risks of smoking” and “made them more likely to quit smoking” |
| UK | 1.95 | 1.81 | NA | |||
| Canada | 1.93 | 1.84 | NA | |||
| 3 | Brewer et al., 2016 | NA | 3.3 (0.9) | 3.4 (0.9) | NA | Combined three perceived harm questions: “What is the chance that you will one day get cancer if you continue to smoke cigarettes?”, “What is the chance that you will one day get heart disease if you continue to smoke cigarettes?” and “What is the chance that you will one day get a permanent breathing problem if you continue to smoke cigarettes?” |
| 4 | Brewer et al., 2019 | NA | 0.04 (−0.04, 0.13) | 0.03 (−0.05, 0.11) | NA | Perceived likelihood of harm from smoking combined 3 questions: “What is the chance that you will one day get cancer if you continue to smoke cigarettes?”, “What is the chance that you will one day get heart disease if you continue to smoke cigarettes?” and “What is the chance that you will one day get a permanent breathing problem if you continue to smoke cigarettes?” |
| 5 | Cho et al., 2018 | Australia | 1.14 | 1.22 | NA | “Indicate which illnesses, if any, are caused by smoking cigarettes (emphysema, heart attacks, bladder cancer, blindness, impotence in male smokers, gangrene, hepatitis, and diseases that lead to amputation)” and ‘Their own chance of getting the disease in the future to the chance of a nonsmoker if they continue to smoke the amount that they currently do’ |
| Canada | 1 | 1.22 | NA | |||
| Mexico | 1.25 | 1.26 | NA | |||
| 7 | Elton-Marshall et al., 2015 | NA | 6.90% | 11.80% | NA | “To what extent, if at all, do the health warnings on cigarette packs make you more likely to think about the health risks (health danger) of smoking?” |
| 8 | Fathelrahman et al., 2010 | NA | 8 (11.6%) | 20 (29.0%) | NA | “To what extent, if at all, do the health warnings on the cigarette pack designs make you more likely to quit smoking” |
| 9 | Fathelrahman et al., 2013 | NA | 3.6 (1.9) | 3.8 (2.0) | NA | Cognitive reactions combined two measures: “thinking about health risk because of them (think-harm)” and thinking about quitting because of them (think-quit)” |
| 10 | Glock & Kneer, 2009 | NA | 5.50 (2.05) | 4.67 (1.63) | NA | Pre health warning viewing: Six smoking-related and six non-smoking-related diseases were rated between 0 (no risk of developing disease) and 9 (highest risk of developing disease). Post health warning viewing: rated another 12 diseases under the same conditions |
| 11 | Gravely et al., 2016a | NA | 31.5% | 43.3% | OR: 1.66 | “To what extent do the health warnings make you think about the dangers from smoking?” |
| 12 | Gravely et al., 2016b | NA | 15.0 (95% CI 11.9; 18.8) | 17.5 (95% CI 12.1; 24.6) | NA | Cognitive reactions two questions: “To what extent, if at all, do the warning labels on smokeless tobacco packages make you more likely to think about the health risks (health danger) of using it?” and “To what extent, if at all, do the warning labels on smokeless tobacco packages make you more likely to quit using it?” |
| 13 | Green et al., 2014 | NA | 24.50% | 41.80% | OR: 2.47 (95% CI = 1.87–3.26) | “To what extent, if at all, do the warning labels make you think about the health risks of smoking” |
| 14 | Green et al., 2019 | Blindness | 14.70% | 36.70% | NA | “based on what you know or believe, does smoking cause (stroke, impotence, bladder cancer and blindness)” Note: blindness, bladder cancer and addiction were chosen because they were the new messages added to health warning labels |
| Bladder Cancer | 26.80% | 44.00% | NA | |||
| Addiction | 90.50% | 89.60% | NA | |||
| 15 | Hall et al., 2018 | NA | 3.3 (0.9) | 3.55 (0.63) | NA | Perceived likelihood of harm combined 3 questions: “What is the chance that you will one day get heart disease if you continue to smoke cigarettes?”, “What is the chance that you will one day get cancer if you continue to smoke cigarettes?” and “What is the chance that you will one day get a permanent breathing problem if you continue to smoke cigarettes?” |
| 16 | Hitchman et al., 2014* | NA | NA | NA | Log OR: −0.320 (×2 = 5.45) | “To what extent, if at all, do the warning labels make you think about the health risks of smoking” |
| 17 | Kasza et al., 2017 | Canada | NA | NA | OR: 1 (CI 1.00 to 1.01) | Concern/ risk reasons: “concern for personal health”, “setting example for children” and “concern for health of others” |
| Australia | NA | NA | OR: 1.01 (CI 1.00 to 1.01) | |||
| 18 | Kennedy et al., 2012 | Australia (Waves 1–7) | 50.1 | 69.5 | NA | ‘I am going to read you a list of health effects and diseases that may or may not be caused by smoking cigarettes. Based on what you know or believe.’ This statement was followed by possible health effects, including, ‘does smoking cause blindness?’ |
| Australia (Wave 8) | 69.5 | 57.5 | ||||
| 19 | Li et al., 2015 | NA | 2.1 | 1.9 | NA | Cognitive response combined 3 questions: “made them think about the health risks of smoking”, “made them more likely to quit smoking” and “if ‘warning labels on cigarette packages’ motivated them to think about quitting in the past 6 months” |
| 20 | Li et al., 2016 | Thailand | 0.49 (0.06) | 0.61 (0.06) | NA | Cognitive response combined 2 questions: “made them think about the health risks of smoking” and “made them more likely to quit smoking” |
| Malaysia (Waves 2–4) | 0.07 (0.06) | 1.01 (0.06) | NA | |||
| Malaysia (Waves 4–6) | 1.01 (0.06) | 0.47 (0.06) | NA | |||
| 21 | Mannocci et al., 2019 | NA | 11.6 (2.5) | 14.6 (1.8) | NA | “Identify tobacco related illnesses (from a list of 20 diseases)” |
| 22 | Mays et al., 2014 | NA | 2.2 (1.1) | 3.5 (1.3) | NA | Perceptions of warnings “warnings convey risks” |
| 23 | McQueen et al., 2015 | NA | 146 (79%) | 158 (86%) | NA | “Made them think about the health risks of smoking” |
| 24 | Nagelhout et al., 2016 | UK | NA | NA | OR: 1.34 | Cognitive responses combined 3 questions: “To what extent, if at all, do the warning labels make you think about the health risks of smoking?”, “To what extent, if at all, do the warning labels on cigarette packs make you more likely to quit smoking?” and “In the past 6 months, have warning labels on cigarette packages led you to think about quitting?” |
| France | NA | NA | OR: 0.7 | |||
| 25 | Ngan et al., 2016 | NA | 12.7 | 18.8 | NA | “Do you worry about the health consequences of smoking?” |
| 26 | Nicholson et al., 2017 | NA | 35 | 38 | NA | “Very worried that smoking will damage your health in future” |
| 27 | Osman et al., 2016 | NA | NA | NA | b = 0.23, SE = 0.03, p < .001 | “To what extent, if at all, do the health warnings make you think about the health risks of smoking?” |
| 28 | Parada et al., 2017* | NA | 3.2 (mean) | 3.1 | NA | two questions: “In the last week, how often did you think about the harm your smoking might be doing to you?” and “In the last week, how often did you think about the harm your smoking might be doing to other people?.” |
| 29 | Partos et al., 2013* | Australia (Waves 4–6) | 1.89 | 2.42 | NA | “To what extent, if at all, do the warning labels make you think about the health risks of smoking” |
| Canada (Waves 2–6) | 2.46 | 2.4 | NA | |||
| UK (Waves 2–6) | 2.49 | 2.07 | NA | |||
| 30 | Popova & Ling, 2014 | NA | 6.86 | 7.57 | NA | Two questions: ‘In your opinion, how harmful is … (moist snuff, snus, e-cigarettes) to general health?’ and ‘In your opinion, to what extent does … cause cancer?’ |
| 31 | Schneider et al., 2012 | NA | NA | NA | 18.59 (6.31) | Motivation to quit was assessed with four items: What extent the warnings induced them to: “consider ceasing their cigarette consumption”, “consider reducing their cigarette consumption”, “think about the health risks associated with smoking” and “refrain from smoking a cigarette at the moment” |
| 32 | Swayampakala et al., 2014 | Australia | 62.83 | 65.5 | NA | “To the best of your knowledge, indicate which illness (emphysema, heart attacks, bladder cancer, blindness, impotence in male smokers, gangrene and hepatitis (non-smoking related disease), if any, are caused by smoking cigarettes?” Note: percentages of the six risks were averaged for pre and post result |
| Canada | 56.5 | 61 | NA | |||
| Mexico | 55.5 | 55.3 | NA | |||
| 33 | White et al., 2008 | Experimental smoker | 69.6 | 79 | NA | Agreed or disagreed that smoking caused a number of different illnesses or harms (disease in toes and fingers, mouth cancer, clogs arteries, emphysema, leading cause of death). Note: percentages of the five risks were averaged for pre and post result |
| Established smoker | 67.4 | 78.4 | NA | |||
| 34 | Yong et al., 2013 | NA | 30.9 (2.14) | 48.3 (2.16) | NA | “To what extent, if at all, do the health warnings make you think about the health risks (health danger) of smoking?” |
| 35 | Yong et al., 2016 | NA | 1.82 | 1.95 | NA | Cognitive reactions combined 3 questions: “To what extent, if at all, do the warning labels make you think about the health risks of smoking?”; “To what extent, if at all, do the warning labels on cigarette packs make you more likely to quit smoking?”; “In the past 6 months, have warning labels on cigarette packages led you to think about quitting?”. |
*Results generated online from web plot digitize