Cigarette Packet Warning Labels Can Prevent Relapse

Findings from the International Tobacco Control 4-Country Policy Evaluation Cohort Study

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Health warning labels on cigarette packets can have beneficial effects, including raising awareness of potential health risks and providing information. This study explores the impact of health warning labels on relapse among recently quit smokers.

The study included 1,936 recent ex-smokers from six waves (2002–2007) from the International Tobacco Control 4-Country policy evaluation project (ITC-4), a longitudinal cohort study surveying smokers from Australia, Canada, the United Kingdom, and the United States. Study participants were followed up in the next wave. Using this data, researchers examined if ex-smokers noticed warning labels and whether these warning labels were associated with a lower likelihood of relapse. This study controls for the effect that exposure to warning labels is also exposure to cigarettes.

Key Findings:

  • For ex-smokers, very frequent noticing of warning labels was associated with greater relapse rates one year later.
  • When controlling for urges to smoke and self-efficacy, this effect disappeared.
  • Participants reporting that warning labels making staying quit “a lot” more likely was associated with a lower likelihood of relapse one year later. This effect remained across all models tested.

Health warning labels can help ex-smokers stay quit when controlling for greater exposure to cigarettes, but the authors suggest that further exploration of this topic is needed, especially to better characterize total relapse and examine outcomes in a controlled experiment.

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