Open AccessSystematic Review of the Effect of Pictorial Warnings on Cigarette Packages in Smoking Behavior
Author(s) -
Joel MonárrezEspino,
Bojing Liu,
Felix Greiner,
Sven Bremberg,
Maria Rosaria Galanti
Publication year - 2014
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2014.302129
Subject(s) - smoking cessation , cigarette smoking , medicine , environmental health , psychology , relevance (law) , outcome (game theory) , quality (philosophy) , demography , clinical psychology , pathology , mathematical economics , epistemology , sociology , political science , law , philosophy , mathematics
We used a structured approach to assess whether active smokers presented with pictorial warnings on cigarette packages (PWCP) had a higher probability of quitting, reducing, and attempting to quit smoking than did unexposed smokers. We identified 21 articles from among nearly 2500 published between 1993 and 2013, prioritizing coverage over relevance or quality because we expected to find only a few studies with behavioral outcomes. We found very large heterogeneity across studies, poor or very poor methodological quality, and generally null or conflicting findings for any explored outcome. The evidence for or against the use of PWCP is insufficient, suggesting that any effect of PWCP on behavior would be modest. Determining the single impact of PWCP on behavior requires studies with strong methodological designs and longer follow-up periods.