title: [Systematic review of the effect of pictorial warnings on cigarette packages in smoking behavior].
abstract: We used a structured approach to assess whether active smokers presented with pictorial warnings on cigarette packages (PWCP) had a higher probability of quitting, reducing, and attempting to quit smoking than did unexposed smokers. We identified 21 articles from among nearly 2500 published between 1993 and 2013, prioritizing coverage over relevance or quality because we expected to find only a few studies with behavioral outcomes. We found very large heterogeneity across studies, poor or very poor methodological quality, and generally null or conflicting findings for any explored outcome. The evidence for or against the use of PWCP is insufficient, suggesting that any effect of PWCP on behavior would be modest. Determining the single impact of PWCP on behavior requires studies with strong methodological designs and longer follow-up periods.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Joel.Monarrez-Espino@ki.se.
authors.forename: Joel
authors.initials: J
authors.lastname: Monárrez-Espino
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Joel.Monarrez-Espino@ki.se.
authors.forename: Bojing
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Joel.Monarrez-Espino@ki.se.
authors.forename: Felix
authors.initials: F
authors.lastname: Greiner
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Joel.Monarrez-Espino@ki.se.
authors.forename: Sven
authors.initials: S
authors.lastname: Bremberg
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Joel.Monarrez-Espino@ki.se.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Galanti
mesh_terms: D015438:Health Behavior; D006801:Humans; D011356:Product Labeling; D012907:Smoking; D062789:Tobacco Products; D014029:Tobacco Use Disorder