title: Was the media campaign that supported Australia's new pictorial cigarette warning labels and plain packaging policy associated with more attention to and talking about warning labels?
abstract: BACKGROUND
  Population-level interventions can possibly enhance each other's effects when they are implemented simultaneously. When the plain packaging policy was implemented in Australia, pictorial health warning labels (HWLs) on cigarette packages were also updated and a national mass media campaign was aired. This study examined whether smokers who recalled the media campaign reported more attention to and talking about HWLs.
  
  
  METHODS
  Longitudinal survey data was obtained among Australian adult smokers, aged 18 years and older, from an online consumer panel. One survey wave was conducted before (September 2012) and two waves were conducted after (January 2013 and May 2013) the interventions. The sample was replenished to maintain a sample size of 1000 participants at each wave. Generalized Estimating Equations analyses were performed.
  
  
  RESULTS
  Compared to wave 1, attention to HWLs increased at wave 2 (b=0.32, SE=0.06, p<0.001), but not at wave 3 (b=0.10, SE=0.08, p=0.198). Talking about HWLs increased over time (IRR=1.82, 95% CI=1.58-2.09 and IRR=1.25, 95% CI=1.05-1.47, at wave 2 and wave 3 respectively). Campaign recall was significantly associated with more attention to HWLs (b=0.29, SE=0.05, p<0.001) and with more talking about HWLs (IRR=1.17, 95% CI=1.06-1.29) with similar effects across waves 2 and 3.
  
  
  CONCLUSIONS
  Recall of the campaign was associated with more attention to and talking about HWLs. When adjusting for campaign recall, there was still an increasing trend in attention and talking. This suggests that the media campaign and the new packaging and labeling policies had independent and positive effects on attention to and talking about HWLs.
authors.affiliation: Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands; Dutch Alliance for a Smokefree Society, The Hague, The Netherlands. Electronic address: Gera.Nagelhout@MaastrichtUniversity.nl.
authors.forename: Gera E
authors.initials: GE
authors.lastname: Nagelhout
authors.affiliation: Department of Health Promotion, Education and Behaviour, University of SC, Columbia, SC, USA.
authors.forename: Amira
authors.initials: A
authors.lastname: Osman
authors.affiliation: Nigel Gray Fellowship Group, Cancer Council Victoria, St Kilda, Victoria, Australia.
authors.forename: Hua-Hie
authors.initials: HH
authors.lastname: Yong
authors.affiliation: Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer Centre, University of NC, Chapel Hill, USA.
authors.forename: Li-Ling
authors.initials: LL
authors.lastname: Huang
authors.affiliation: Nigel Gray Fellowship Group, Cancer Council Victoria, St Kilda, Victoria, Australia.
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.affiliation: Department of Health Promotion, Education and Behaviour, University of SC, Columbia, SC, USA; Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
authors.forename: James F
authors.initials: JF
authors.lastname: Thrasher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention; D001315:Australia; D001364:Awareness; D005260:Female; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008402:Mass Media; D011939:Mental Recall; D008875:Middle Aged; D011356:Product Labeling / Q000331:legislation & jurisprudence*; D019064:Product Packaging / Q000331:legislation & jurisprudence; D011640:Public Policy; D012907:Smoking; D011795:Surveys and Questionnaires; D062789:Tobacco Products; D055815:Young Adult
keywords: Australia; Media campaign; Public policy; Smoking; Warning labels