Search

Few studies have compared the effects of different front-of-package label (FOPL) systems in the 'real world'. This study assessed adults' awareness, use and understanding of nutrition facts labels (NFLs) and nationally implemented FOPLs such as Health Star Ratings (HSR), Traffic lights, and Guideline Daily Amounts (GDAs) in five countries, including before and after implementation of Mexico's warning FOPLs in 2020. Data were from the International Food Policy Study, an annual repeat cross-sectional study conducted in 2018-2020 among adults (N=64,032) in Australia, Canada, Mexico, the UK and the US. Self-reported awareness, use, and understanding of NFLs (in all five countries) and FOPLs (in Australia, Mexico, and UK) were assessed over time, between countries, and between NFLs and FOPLs. Most respondents in all countries reported seeing their country's NFLs (awareness) 'often' or 'all the time' across all three years, with one third to half of respondents using NFLs 'often' or 'all the time' (Australia: 43-45%; Canada: 47-50%; Mexico: 36-39%; UK: 32-34%; US: 47-49%), and approximately one half to two thirds finding NFLs 'easy' or 'very easy to understand' (56-57%; 67-69%; 51-54%; 48-51%; 70-71%). In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were highest among all countries with a FOPL (p<0.001), whereas awareness and use were lowest for Australia's HSR (p<0.001). In countries with FOPLs, self-reported understanding was higher for FOPLs than NFLs, except for the GDA FOPL in Mexico. Only modest changes were observed over time. Warning FOPLs were associated with greater levels of self-reported awareness, use and understanding among adults compared to NFLs and GDA-based FOPLs. FOPLs implemented on a voluntary basis, such as Australia's HSR, may be less likely to be seen and used., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

'Plain packaging' and health warnings can reduce appeal and increase risk perceptions of tobacco products. This study tested the effect of health warnings and restricted brand imagery on perceptions of cannabis products. Participants in Canada and the US (n = 45,378) were randomized to view packages of three cannabis brands in 2019. A 3 (health warning) x 4 (brand imagery) between-group factorial experimental design was used. Health warning conditions were: none, Canadian or US warning. The Canadian warning conditions had three messages counterbalanced across brands: pregnancy, adolescent risk, and impaired driving. The US warning mentioned the same broad risk categories. The four branding conditions ranged from packages displaying no brand imagery and uniform colours-'plain packaging'-to full brand imagery. Regression tested differences between conditions on product appeal, perceived harm, and free recall of warning messages. Overall, full branding and plain packaging were rated the most and least appealing, respectively (p < 0.001). Products were rated as significantly less harmful when they had a white background with no or limited branding versus a coloured background (p ≤ 0.01). Products with health warnings were rated significantly less appealing and more harmful than those with no warning (p < 0.001). Message recall was significantly higher for Canadian versus US health warnings, and for the US warning versus no warning (p < 0.001). Message recall was greater among those who saw plain versus fully branded packages for two of the three warning messages (p < 0.01). Prominent health warnings and restrictions on brand imagery may be warranted in jurisdictions considering non-medical cannabis legalization., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The current study examined prevalence and correlates of electronic cigarette (e-cigarette) use in the Canadian population, using data from the nationally representative 2013 Canadian Tobacco, Alcohol and Drugs Survey (n=14,565). Sociodemographic correlates of e-cigarette use (ever, and in the past 30 days) were examined using logistic regression models. Overall, 8.5% of Canadians aged 15 and older reported having ever tried an e-cigarette; 1.8% had used one in the past 30 days. E-cigarette use was particularly high among smokers and young people. Overall, prevalence did not differ between males and females, for ever (P=0.24) or past 30-day use (P=0.30). Smoking status was the strongest correlate of e-cigarette use (ever and in the past 30 days, P<0.0001): 37.3% of current smokers had ever tried an e-cigarette (9.6% used in the past 30 days), compared to 3.0% of never-smokers (0.3% past 30-days), and 5.1% of former smokers (0.9% past 30-day). E-cigarette use also varied by age (P<0.0001): prevalence was highest among youth aged 15-19 (19.8% ever; 2.6% past 30-day) and young adults aged 20-24 (20.1% ever; 3.9% past 30-day), and decreased with age. Among youth, the majority of e-cigarette users were never-smokers, while the majority of adult users were smokers. In Canada, e-cigarette use is particularly high among smokers and young people. Dual use with cigarettes was common, with most e-cigarette users also smoking conventional cigarettes. Continued monitoring of e-cigarette use and its relationship with smoking should be a priority, given the rapidly-evolving e-cigarette market and implementation of new policy measures., (Copyright © 2015 Elsevier Inc. All rights reserved.)