title: Adolescents' Responses to Pictorial Warnings on Their Parents' Cigarette Packs.
abstract: Pictorial cigarette pack warnings are a promising policy solution to increase smoking cessation among adults. However, little is known regarding adolescents' responses to pictorial warnings, particularly in real-world settings.
  
  
  
  Participants were 112 adolescent children, ages 13-17, whose parents received either text-only warnings on the side of their cigarette packs or pictorial warnings on the top half of the front and back of their cigarette packs for 4 weeks as part of a trial. We measured adolescents' recall and recognition of these warnings, negative emotional reactions to the warnings, perceived effectiveness of the warnings, social interactions about the warnings, and smoking risk beliefs.
  
  
  
  Adolescents accurately recalled pictorial warnings more often than text-only warnings (82% vs. 19%, p < .001). Recognition of warnings was also higher for pictorial than text-only warnings (82% vs. 34%, p < .001). Pictorial warnings drew greater attention (p < .001), elicited greater negative emotional reactions (p < .05), and sparked more social interactions (p < .01) than text-only warnings.
  
  
  
  Pictorial warnings on cigarette packs may have important effects on adolescent children of smokers. Future research should further investigate the impact of such messages on adolescents' susceptibility to smoking initiation and interest in quitting smoking, particularly as the United States and other countries work to implement pictorial warning regulations.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Peebles
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Marissa G
authors.initials: MG
authors.lastname: Hall
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Pepper
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: M Justin
authors.initials: MJ
authors.lastname: Byron
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina; School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Noar
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina. Electronic address: ntb@unc.edu.
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D011356:Product Labeling / Q000379:methods*; D012306:Risk; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D062789:Tobacco Products
keywords: Adolescence; Cigarette pack warnings; Cigarette regulatory policy