Reactions to, and trial intentions for, three dissuasive cigarette designs: A cross-sectional survey of adolescents in Scotland

Danielle Mitchell, Nathan Critchlow, Crawford Moodie, Linda Bauld

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objectives: There has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a health warning. We therefore explored reactions to, and trial intentions for, three ‘dissuasive’ cigarette designs among adolescents in Scotland.
Methods: A cross-sectional survey with 12-17 year olds in Scotland (n=594) was conducted between November 2017 and November 2018. Participants were shown one ‘standard’ cigarette (imitation cork filter with white paper casing) and three dissuasive cigarettes: (1) a cigarette with the warning ‘smoking kills’; (2) a cigarette with the warning ‘toxic’ and a skull and cross-bones image; and (3) a dark green cigarette. Participants rated each cigarette on nine five-point reaction measures (e.g. appealing/unappealing or attractive/unattractive). A composite reaction score was computed for each cigarette, which was binary coded (overall negative reactions versus neutral/positive reactions). Participants also indicated whether they would try each cigarette (coded: Yes/No). Demographics, smoking status, and smoking susceptibility were also measured.
Results: More participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared to the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs. older adolescents), never-smokers (vs. ever smokers), and non-susceptible never-smokers (vs. susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84-91%).
Conclusion: Dissuasive cigarettes present an opportunity to further reduce the appeal of smoking among adolescents.
Original languageEnglish
JournalTobacco Control
Early online date19 Aug 2020
Publication statusE-pub ahead of print - 19 Aug 2020


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