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CompletedNCT03446170Updated Jan 4, 2022

Effect of Cigarette Pack Warnings and Packaging Among Young Adult Smokers

An interventional study of Graphic cigarette warning labels, plain packaging in Tobacco Use, sponsored by Georgetown University. Completed at 1 site in United States. Open to participants aged 18 Years to 30 Years. Per ClinicalTrials.gov, last updated 2022-01-04.

Sponsored by Georgetown University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
400
Allocation
Randomized
Ages
18 Years to 30 Years
Sex
All
01

Study summary

The objective of this study is to examine whether cigarette packaging regulations including graphic health warning labels on cigarette packs and requiring plain, unbranded packaging reduce the appeal of cigarettes and prompt young adult smokers to quit.

Read the detailed description

The study includes young adult smokers ages 18 to 30. Eligible participants are young adults ages 18 to 30 years inclusive who report smoking at least 100 lifetime cigarettes and now smoking on all or some days. Participants must also reside in the metro Washington, DC area. The first portion of the study is a within-subjects experiment simulating point of sale cigarette purchase behaviors based on 2 packaging features: (1) graphic warning messages framed to emphasize either the health benefits of quitting (i.e., gain framed) or the health risks of smoking (i.e., loss-framed) and (2) industry branded or plain (i.e., standardized unbranded) packaging. In the second portion of the study, the same participants take part in a prospective experiment to determine the impact of graphic cigarette warning message framing (gain versus loss) and packaging (branded versus plain) on motivation to quit and smoking behavior. Participants are randomized to use 1 of 4 experimentally adapted cigarette packs in place of their regular packs for 4 weeks, or to a control condition which will continue to use their regular packs. All participants complete baseline and follow-up assessments and respond to daily mobile phone text message prompts on their personal mobile phones during the 4 week exposure period. Participants complete follow-up assessments capturing motivation to quit, smoking behavior, and quit attempts at the conclusion of the 4 week exposure period and 1- and 3-months later.

02

Conditions studied

  • Tobacco Use

Keywords

  • Young adults
  • Cigarette smoking
  • Warning labels
03

Who can participate

Ages eligible
18 Years to 30 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Ages 18 to 30 years
  • Smoke at least 100 cigarettes in their lifetime
  • Now smoke cigarettes on all or some days
  • Reside in the Washington, DC metro area
  • Willing to send and receive text messages on a personal mobile phone

Exclusion criteria

Exclusion Criteria:

  • No additional exclusion criteria
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Factorial assignment
Masking
None (open label)
Enrollment
400 participants (estimated)

Study arms

  • Experimental
    Loss-framed, branded

    Participants assigned to this arm use cigarette packs with loss-framed graphic warnings communicating the risks of smoking on branded packages.

    Behavioral: Graphic cigarette warning labels, plain packaging

  • Experimental
    Loss-framed, plain

    Participants assigned to this arm use cigarette packs with loss-framed graphic warnings communicating the risks of smoking on plain or standardized packages.

    Behavioral: Graphic cigarette warning labels, plain packaging

  • Experimental
    Gain-framed, branded

    Participants assigned to this arm use cigarette packs with gain-framed graphic warnings communicating the benefits of quitting smoking on branded packages.

    Behavioral: Graphic cigarette warning labels, plain packaging

  • Experimental
    Gain-framed, plain

    Participants assigned to this arm use cigarette packs with gain-framed graphic warnings communicating the benefits of quitting smoking on plain or standardized packages.

    Behavioral: Graphic cigarette warning labels, plain packaging

  • No intervention
    Control

    Participants assigned to this arm use their regular cigarette packs and complete study measures only.

Interventions

  • BehavioralGraphic cigarette warning labels, plain packaging

    This study tests the effects of graphic cigarette warning labels that include pictures and text, and plain or standardized packaging

05

What researchers measure

Primary outcomes

  1. Cigarette purchase appeal

    The effects of graphic cigarette warnings and plain packaging on cigarette purchase appeal will be measured using data collected from a within-subjects experiment at baseline. Participants are randomly assigned to compare each pair of packs from the experimental conditions versus a standard branded control pack. For each pair, cigarette purchase appeal is measured with 5 valid questions assessing: 1) Which pack would you be most likely to buy? 2) Which pack is the most appealing? 3) Which pack attracts your attention? 4) Which pack contains cigarettes that are the most harmful to your health? 5) Which pack makes you think about the health risks of smoking?

    Time frame: Baseline

  2. Motivation to quit smoking

    Motivation to quit smoking is measured using a valid scale comprised of 4 questions. Participants report how likely it is they will quit smoking completely, reduce the number of cigarettes they smoke, and talk to a friend, family member, or spouse/partner about quitting smoking. Participants respond using options for definitely will not, probably will not, probably will, or definitely will for each question.

    Time frame: At the conclusion of the 4 week exposure

Secondary outcomes

  1. Cigarette smoking behavior

    Cigarettes smoked per day is measured using a single valid question assessing about how many cigarettes participants smoked each day, on average.

    Time frame: At the conclusion of the 4 week exposure, and at 1- and 3-months post-exposure

  2. Smoking quit attempts

    Attempts to quit smoking is measured using a single valid item asking participants how many times they stopped smoking for 1 day or longer because they were trying to quit.

    Time frame: At the conclusion of the 4 week exposure, and at 1- and 3-months post-exposure

  3. Motivation to quit cigarette smoking.

    Motivation to quit smoking is measured using a valid scale comprised of 4 questions. Participants report how likely it is they will quit smoking completely, reduce the number of cigarettes they smoke, and talk to a friend, family member, or spouse/partner about quitting smoking. Participants respond using options for definitely will not, probably will not, probably will, or definitely will for each question.

    Time frame: At 1-month and 3-months post-exposure

06

Study locations

1 site
  • Georgetown University
    Washington, District of Columbia 20007, United States
07

References and documents

Publications

  • Johnson AC, Luta G, Tercyak KP, Niaura RS, Mays D. Effects of pictorial warning label message framing and standardized packaging on cigarette packaging appeal among young adult smokers. Addict Behav. 2021 Sep;120:106951. doi: 10.1016/j.addbeh.2021.106951. Epub 2021 Apr 13. PubMed 33895661 ↗
  • Johnson AC, Turner MM, Simmens SJ, Evans WD, Strasser AA, Mays D. Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults. Ann Behav Med. 2022 Jul 12;56(7):737-748. doi: 10.1093/abm/kaab073. PubMed 34415010 ↗
  • Johnson AC, Simmens SJ, Turner MM, Evans WD, Strasser AA, Mays D. Longitudinal effects of cigarette pictorial warning labels among young adults. J Behav Med. 2022 Feb;45(1):124-132. doi: 10.1007/s10865-021-00258-2. Epub 2021 Sep 23. PubMed 34554369 ↗

Individual participant data

Plan to share: Undecided — We will consider requests to share de-identified individual participant data by request and according to our study protocol and institutional data sharing policy.

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Registry details

Key details

Study ID
NCT03446170
Lead sponsor
Georgetown University
Responsible party
Darren Mays (Assistant Professor, Georgetown University) — Principal investigator
First posted
Feb 26, 2018
Start date
Sep 1, 2014
Primary completion
Aug 31, 2020
Completion
Aug 31, 2020
Last update
Jan 4, 2022

Study contacts

Darren Mays, PhD, MPH
principal investigator · Georgetown University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Dec 2021. You cannot join it, but the record below documents what was studied.

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