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The European Journal of Public Health Advance Access originally published online on February 13, 2009
The European Journal of Public Health 2009 19(2):212-217; doi:10.1093/eurpub/ckp015
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Smoking

Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels

Constantine I. Vardavas1, Gregory Connolly2, Kostas Karamanolis1 and Anthony Kafatos1

1 Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
2 Harvard School of Public Health, Harvard University, Boston, MA, USA

Correspondence: Constantine I Vardavas, Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece, tel: +30 2810 394599, fax: +30 2810 394606, e-mail: vardavas{at}edu.med.uoc.gr

Received December 1, 2008 , accepted January 16, 2009

Background: Graphical tobacco product labelling is a prominent source of health information and has an important position among tobacco control initiatives. However, little is known about its effectiveness among adolescents. With this above in mind, we aimed to research into how adolescents perceive the proposed EU graphic tobacco product warning labels as an effective means of preventing smoking initiation in comparison to the current EU text-only warning labels. Methods: Five hundred seventy four adolescents (13–18, 54% male) from Greece were privately interviewed, with the use of a digital questionnaire and randomly shown seven existing EU text-only and proposed EU graphic warning labels. Non-smoking respondents were asked to compare and rate the warnings effectiveness in regard to preventing them from smoking on a 1–5 Likert type scale. Results: Irrespective of the warning category shown, on all occasions, non-smoking adolescents rated the suggested EU graphic labels as more effective in preventing them from smoking in comparison to the existing EU text-only warnings. Controlling for gender, age, current smoking status and number of cigarettes smoked per month, younger adolescents were found to opt for graphic warnings more often, and also perceive graphic warning labels as a more effective means of preventing them from smoking, in comparison to their elder peers (P < 0.001). Conclusions: The proposed EU graphic warning labels may play an important role in preventing of smoking initiation during the crucial years of early adolescence when smoking experimentation and early addiction usually take place.

Keywords: product labeling, smoking, prevention, health policy, public health adolescents, tobacco


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