title: Public support for graphic health warning labels in the U.S.
abstract: BACKGROUND
  In 2009, the U.S. Food and Drug Administration was required to mandate that graphic health warning labels be placed on cigarette packages and advertisements.
  
  
  OBJECTIVE
  To assess public support in the U.S. for graphic health warning labels from 2007 to 2012.
  
  
  METHODS
  Data from 17,498 respondents from 13 waves of the National Adult Tobacco Survey, a list-assisted random-digit-dial survey, were used. Overall support for graphic health warning labels, as well as support by smoking status, and by sociodemographics and smoker characteristics are estimated. Analyses were conducted in 2014.
  
  
  RESULTS
  Since 2007, a majority of the public overall has been in favor of labels. Support increased significantly among the public overall and among non-smokers from 2007 through 2009 (p<0.001), after which it remained flat. Among smokers, support levels increased from 2007 through 2011 (p<0.001), but decreased significantly from 2011 through 2012 (p<0.001). Support was high regardless of smoking status, although among smokers, support varied by level of smoking, interest in quitting, and whether labels were seen as an important reason to quit. Support varied by sociodemographic characteristics, particularly among smokers. Younger, less-affluent, and less-educated smokers supported labels at higher levels than their counterparts.
  
  
  CONCLUSIONS
  A majority of U.S. residents support graphic health warning labels for cigarette packs, though support among smokers declined after 2011.
authors.affiliation: RTI International, Research Triangle Park, North Carolina. Electronic address: kkamyab@rti.org.
authors.forename: Kian
authors.initials: K
authors.lastname: Kamyab
authors.affiliation: RTI International, Research Triangle Park, North Carolina.
authors.forename: James M
authors.initials: JM
authors.lastname: Nonnemaker
authors.affiliation: RTI International, Research Triangle Park, North Carolina.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Farrelly
mesh_terms: D000328:Adult; D000329:Advertising / Q000331:legislation & jurisprudence*; D001294:Attitude to Health; D054626:Consumer Health Information / Q000331:legislation & jurisprudence* / Q000379:methods; D003625:Data Collection / Q000379:methods; D033161:Government Regulation; D006801:Humans; D011356:Product Labeling / Q000331:legislation & jurisprudence*; D011639:Public Opinion; D012907:Smoking / Q000009:adverse effects / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D062789:Tobacco Products / Q000009:adverse effects*; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence