title: Evaluating the effectiveness of a smoking warning label on raising patient awareness of smoking and bladder cancer.
abstract: OBJECTIVE
  We assessed the knowledge of patients with regard to the association between smoking and bladder cancer, and examined the impact of a novel smoking warning label on raising awareness of this issue.
  
  
  METHODS
  We conducted a prospective cross-sectional study involving patients who presented to urology and family practice clinics. A questionnaire was used to assess knowledge regarding the association between smoking and various diseases. Participants were also asked to evaluate a novel smoking warning label for bladder cancer.
  
  
  RESULTS
  A total of 291 (97%) patients responded to the questionnaire including 143 (95.3%) at urology clinics and 148 (98.7%) at family practice clinics. Overall only 45.2% of respondents were aware of the association between smoking and bladder cancer compared to 97.4% who knew that there was an association between smoking and lung cancer. There were no significant differences in knowledge between those at urology and family practice clinics. After viewing the warning label, 58.1% of respondents stated that it had changed their opinion on smoking and bladder cancer, and 74.8% felt that this label would be an effective tool to raise awareness of the issue. Patients who changed their opinion had statistically significantly less initial knowledge about the association between smoking and bladder cancer (36.7% vs 57.5% for those who did not change their opinion, p <0.001).
  
  
  CONCLUSIONS
  Awareness of the link between smoking and bladder cancer remains low. The use of a smoking warning label may help raise awareness of this important public health issue.
authors.affiliation: Division of Urology, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada. benjohnson003@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.forename: R
authors.initials: R
authors.lastname: Abouassaly
authors.forename: D
authors.initials: D
authors.lastname: Ghiculete
authors.forename: R J
authors.initials: RJ
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011356:Product Labeling; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000209:etiology*
keywords: BC; FPC; UC; bladder cancer; family practice clinic; questionnaires; smoking; urinary bladder neoplasms; urology clinic