Impact of Tobacco Control Interventions on Smoking Initiation, Cessation, and Prevalence: A Systematic Review

Table 6

Effects of health warning labels on smoking cessation and prevalence.

Author, year	Country; (data source)	Study design	Dates of data collection	Population	Intervention, n	Smoking measure	Effect on smoking cessation, or prevalence
Smoking cessation
Borland et al., 2009 [70]	Australia, Canada, UK, and US (ITC)	Longitudinal	2002–2006	Adults, age 18+	Australia; (B) 6 rotating, text labels, 25% of front, 33% of back; (I) 14 rotating, graphic labels, 30% of front, 90% of back*, 2305; Canada; (B) 16 rotating, graphic labels, 50% of pack, 2214; UK; (B) 6 rotating, text labels, 6% of front; (I-1) 16 rotating, text labels, 30% of front, 40% of back; (I-2) banned use of “light”, “mild”, 2401; US; (B) 4 rotating, text labels on side, 2138	Made a quit attempt lasting more than 24 hours since previous survey, and among those who did, whether quit attempt lasted at least 1 month	Australia; F1 quit rate: 14.99%; F2 quit rate: 22.93%; F3 quit rate: 25.15%; F4 quit rate: 25.90%; Canada; F1 quit rate: 19.84%; F2 quit rate: 23.96%; F3 quit rate: 22.81%; F4 quit rate: 21.34%; United Kingdom; F1 quit rate: 16.83%; F2 quit rate: 22.68%; F3 quit rate: 28.93%; F4 quit rate: 23.94%; United States; F1 quit rate: 14.42%; F2 quit rate: 19.23%; F3 quit rate: 20.31%; F4 quit rate: 20.36%
Borland, 1997 [69]	Australia (original data collection)	Longitudinal	1994-1995	Adults, age 16+; 51% male	(B) 4 rotating, text-only labels covering 15% of front and back of package, 510; (I) 6 rotating, text-only labels covering 25% of front and 33% of back of package, 243	Quit smoking at followup for at least 1 week	Quit rate: 11%
Smoking prevalence
Siahpush et al., 2009 [30]	Australia (Roy Morgan Single Source)	Before/after w/o comparison	1991–2006	Adults, age 18+; ages 18–29: 21%; ages 30–49: 41%; ages 50+: 38%; 48% male	(I) 6 rotating, text-only labels covering 25% of front and 33% of back of package, 515,866	Do you now smoke factory-made cigarettes? In the last month, have you smoked any roll-your-own cigarettes?	aRR = 1.00; 𝑃=0.96
Gospodinov and Irvine, 2004 [71]	Canada (CTUMS)	Before/after w/o comparison	2000-2001	Adults, age 15+; 46% male	(B) text only, 9729; (I) 16 rotating, graphic labels, 50% of pack, 10447	Current cigarette smoking	Smoking prevalence: (B) 25.0%; (I) 23.4%; Marginal effect prevalence rate ratio: −0.0034 (95% CI: −0.029, 0.021; se = 0.01)

*Health warning label also included the quitline phone number.
aRR: adjusted rate ratio; B: baseline; CI: confidence interval; CTUMS: Canadian Tobacco Use Monitoring Surveys; F: followup period; I: intervention; ITC: International Tobacco Control Policy Research Survey; se: standard error; UK: United Kingdom; US: United States.