title: The Effect of Pack Warning Labels on Quitting and Related Thoughts and Behaviors in a National Cohort of Aboriginal and Torres Strait Islander Smokers.
abstract: BACKGROUND
  The high prevalence of smoking among Aboriginal and Torres Strait Islander people in Australia (39%) contributes substantially to health inequalities. This study assesses the impact of warning labels on quitting and related thoughts and behaviors for Aboriginal and Torres Strait Islander smokers.
  
  
  METHODS
  Participants were recruited from communities served by 34 Aboriginal Community Controlled Health Services and communities in the Torres Strait, Australia, using quota sampling. A cohort of 642 daily/weekly smokers completed relevant questions at baseline (April 2012-October 2013) and follow-up (August 2013-August 2014).
  
  
  RESULTS
  We considered three baseline predictor variables: noticing warning labels, forgoing cigarettes due to warning labels ("forgoing") and perceiving labels to be effective. Forgoing increased significantly between surveys only for those first surveyed prior to the introduction of plain packs (19% vs. 34%); however, there were no significant interactions between forgoing cigarettes and the introduction of new and enlarged graphic warning labels on plain packaging in any model. Forgoing cigarettes predicted attempting to quit (adjusted odds ratio [AOR]: 1.45, 95% confidence interval [CI]: 1.02-2.06) and, among those who did not want to quit at baseline, wanting to quit at follow-up (AOR: 3.19, 95% CI: 1.06-9.63). Among those less worried about future health effects, all three variables predicted being very worried at follow-up. Often noticing warning labels predicted correct responses to questions about health effects that had featured on warning labels (AOR: 1.84, 95% CI: 1.20-2.82) but not for those not featured.
  
  
  CONCLUSIONS
  Graphic warning labels appear to have a positive impact on the understanding, concerns and motivations of Aboriginal and Torres Strait Islander smokers and, through these, their quit attempts.
  
  
  CONCLUSIONS
  Graphic warning labels are likely to be effective for Aboriginal and Torres Strait Islander smokers as they are for the broader Australian population.
authors.affiliation: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Casuarina, Australia.|Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Nicholson
authors.affiliation: Nigel Gray Distinguished Fellow in Cancer Prevention, Cancer Council Victoria, Melbourne, Australia.
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.affiliation: Queensland Aboriginal and Islander Health Council, Brisbane, Australia.
authors.forename: Pele
authors.initials: P
authors.lastname: Bennet
authors.affiliation: Aboriginal Health Service, Tasmanian Aboriginal Centre, Hobart, Australia.
authors.forename: Maureen
authors.initials: M
authors.lastname: Davey
authors.affiliation: Aboriginal Health and Medical Research Council of NSW, Sydney, Australia.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Sarin
authors.affiliation: Alcohol Tobacco and Other Drug Association ACT, Canberra, Australia.
authors.forename: Anke
authors.initials: A
authors.lastname: Van der Sterren
authors.affiliation: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Casuarina, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Stevens
authors.affiliation: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Casuarina, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D015331:Cohort Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011356:Product Labeling; D011446:Prospective Studies; D012907:Smoking / Q000208:ethnology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples