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Int. J. Environ. Res. Public Health 2018, 15(3), 421; https://doi.org/10.3390/ijerph15030421

Global Evidence on the Association between Cigarette Graphic Warning Labels and Cigarette Smoking Prevalence and Consumption

1
Department of Economics, the University of Illinois at Chicago, Chicago, IL 60607, USA
2
Institute for Health Research and Policy, the University of Illinois at Chicago, Chicago, IL 60608, USA
3
School of Public Health, Georgia State University, Atlanta, GA 30303, USA
4
Division of Health Policy and Administration, School of Public Health, the University of Illinois at Chicago, Chicago, IL 60608, USA
*
Author to whom correspondence should be addressed.
Received: 28 December 2017 / Revised: 15 February 2018 / Accepted: 22 February 2018 / Published: 28 February 2018
(This article belongs to the Special Issue Reducing Exposure to Second-Hand Tobacco Smoke)
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Abstract

Background: In 2011, the courts ruled in favor of tobacco companies in preventing the implementation of graphic warning labels (GWLs) in the US, stating that FDA had not established the effectiveness of GWLs in reducing smoking. Methods: Data came from various sources: the WHO MPOWER package (GWLs, MPOWER policy measures, cigarette prices), Euromonitor International (smoking prevalence, cigarette consumption), and the World Bank database (countries’ demographic characteristics). The datasets were aggregated and linked using country and year identifiers. Fractional logit regressions and OLS regressions were applied to examine the associations between GWLs and smoking prevalence and cigarette consumption, controlling for MPOWER policy scores, cigarette prices, GDP per capita, unemployment, population aged 15–64 (%), aged 65 and over (%), year indicators, and country fixed effects. Results: GWLs were associated with a 0.9–3 percentage point decrease in adult smoking prevalence and were significantly associated with a reduction of 230–287 sticks in per capita cigarette consumption, compared to countries without GWLs. However, the association between GWLs and cigarette consumption became statistically insignificant once country indicators were included in the models. Conclusions: The implementation of GWLs may be associated with reduced cigarette smoking. View Full-Text
Keywords: graphic warning labels (GWLs); cigarette smoking; cigarette consumption graphic warning labels (GWLs); cigarette smoking; cigarette consumption
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Ngo, A.; Cheng, K.-W.; Shang, C.; Huang, J.; Chaloupka, F.J. Global Evidence on the Association between Cigarette Graphic Warning Labels and Cigarette Smoking Prevalence and Consumption. Int. J. Environ. Res. Public Health 2018, 15, 421.

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