Systematic review of measures used in pictorial cigarette pack warning experiments

Diane B. Francis; Marissa G. Hall; Seth M. Noar; Kurt M. Ribisl; Noel T. Brewer

doi:10.1093/ntr/ntx082

Systematic review of measures used in pictorial cigarette pack warning experiments

Diane B. Francis
, Marissa G. Hall
, Seth M. Noar
, Kurt M. Ribisl
, Noel T. Brewer

Communication

Research output: Contribution to journal › Review article › peer-review

29 Scopus citations

Abstract

Background: We sought to describe characteristics and psychometric properties of measures used in pictorial cigarette pack warning experiments and provide recommendations for future studies. Methods: Our systematic review identified 68 pictorial cigarette pack warning experiments conducted between 2000 and 2016 in 22 countries. Two independent coders coded all studies on study features, including sample characteristics, theoretical framework, and constructs assessed. We also coded measurement characteristics, including construct, number of items, source, reliability, and validity. Results: We identified 278 measures representing 61 constructs. The most commonly assessed construct categories were warning reactions (62% of studies) and perceived effectiveness (60%). The most commonly used outcomes were affective reactions (35%), perceived likelihood of harm (22%), intention to quit smoking (22%), perceptions that warnings motivate people to quit smoking (18%), and credibility (16%). Only 4 studies assessed smoking behavior. More than half (54%) of all measures were single items. For multi-item measures, studies reported reliability data 68% of the time (mean α = 0.88, range α = 0.68-0.98). Studies reported sources of measures only 33% of the time and rarely reported validity data. Of 68 studies, 37 (54%) mentioned a theory as informing the study. Conclusions: Our review found great variability in constructs and measures used to evaluate the impact of cigarette pack pictorial warnings. Many measures were single items with unknown psychometric properties. Recommendations for future studies include a greater emphasis on theoretical models that inform measurement, use of reliable and validated (preferably multi-item) measures, and better reporting of measure sources. Implications: Robust and consistent measurement is important for building a strong, cumulative evidence base to support pictorial cigarette pack warning policies. This systematic review of experimental studies of pictorial cigarette warnings demonstrates the need for standardized, theory-based measures.

Original language	English
Article number	ntx082
Pages (from-to)	1127-1137
Number of pages	11
Journal	Nicotine and Tobacco Research
Volume	19
Issue number	10
DOIs	https://doi.org/10.1093/ntr/ntx082
State	Published - Oct 1 2017

Bibliographical note

Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.

Funding

Research reported in this publication was supported by The National Cancer Institute and FDA Center for Tobacco Products (CTP) under Award Numbers P30CA016086-38S2 and 1P50CA18090701. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration. The work was also supported by a seed grant from the School of Media and Journalism at UNC Chapel Hill.

Funders	Funder number
National Cancer Institute and FDA Center for Tobacco Products
School of Media and Journalism
Carolina Consortium (UNC-Chapel Hill, Duke, North Carolina State, UNC-Greensboro)
National Institutes of Health (NIH)
National Childhood Cancer Registry – National Cancer Institute	P50CA180907
Food and Drug Administration
Center for Tobacco Products (CTP)	1P50CA18090701, P30CA016086-38S2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

Access to Document

10.1093/ntr/ntx082

Cite this

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title = "Systematic review of measures used in pictorial cigarette pack warning experiments",

abstract = "Background: We sought to describe characteristics and psychometric properties of measures used in pictorial cigarette pack warning experiments and provide recommendations for future studies. Methods: Our systematic review identified 68 pictorial cigarette pack warning experiments conducted between 2000 and 2016 in 22 countries. Two independent coders coded all studies on study features, including sample characteristics, theoretical framework, and constructs assessed. We also coded measurement characteristics, including construct, number of items, source, reliability, and validity. Results: We identified 278 measures representing 61 constructs. The most commonly assessed construct categories were warning reactions (62\% of studies) and perceived effectiveness (60\%). The most commonly used outcomes were affective reactions (35\%), perceived likelihood of harm (22\%), intention to quit smoking (22\%), perceptions that warnings motivate people to quit smoking (18\%), and credibility (16\%). Only 4 studies assessed smoking behavior. More than half (54\%) of all measures were single items. For multi-item measures, studies reported reliability data 68\% of the time (mean α = 0.88, range α = 0.68-0.98). Studies reported sources of measures only 33\% of the time and rarely reported validity data. Of 68 studies, 37 (54\%) mentioned a theory as informing the study. Conclusions: Our review found great variability in constructs and measures used to evaluate the impact of cigarette pack pictorial warnings. Many measures were single items with unknown psychometric properties. Recommendations for future studies include a greater emphasis on theoretical models that inform measurement, use of reliable and validated (preferably multi-item) measures, and better reporting of measure sources. Implications: Robust and consistent measurement is important for building a strong, cumulative evidence base to support pictorial cigarette pack warning policies. This systematic review of experimental studies of pictorial cigarette warnings demonstrates the need for standardized, theory-based measures.",

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N2 - Background: We sought to describe characteristics and psychometric properties of measures used in pictorial cigarette pack warning experiments and provide recommendations for future studies. Methods: Our systematic review identified 68 pictorial cigarette pack warning experiments conducted between 2000 and 2016 in 22 countries. Two independent coders coded all studies on study features, including sample characteristics, theoretical framework, and constructs assessed. We also coded measurement characteristics, including construct, number of items, source, reliability, and validity. Results: We identified 278 measures representing 61 constructs. The most commonly assessed construct categories were warning reactions (62% of studies) and perceived effectiveness (60%). The most commonly used outcomes were affective reactions (35%), perceived likelihood of harm (22%), intention to quit smoking (22%), perceptions that warnings motivate people to quit smoking (18%), and credibility (16%). Only 4 studies assessed smoking behavior. More than half (54%) of all measures were single items. For multi-item measures, studies reported reliability data 68% of the time (mean α = 0.88, range α = 0.68-0.98). Studies reported sources of measures only 33% of the time and rarely reported validity data. Of 68 studies, 37 (54%) mentioned a theory as informing the study. Conclusions: Our review found great variability in constructs and measures used to evaluate the impact of cigarette pack pictorial warnings. Many measures were single items with unknown psychometric properties. Recommendations for future studies include a greater emphasis on theoretical models that inform measurement, use of reliable and validated (preferably multi-item) measures, and better reporting of measure sources. Implications: Robust and consistent measurement is important for building a strong, cumulative evidence base to support pictorial cigarette pack warning policies. This systematic review of experimental studies of pictorial cigarette warnings demonstrates the need for standardized, theory-based measures.

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Systematic review of measures used in pictorial cigarette pack warning experiments

Abstract

Bibliographical note

Funding

UN SDGs

ASJC Scopus subject areas

Access to Document

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