Review of the Size of Health Warning Labels on Tobacco Packaging

REVIEW OF THE SIZE OF HEALTH WARNING LABELS ON TOBACCO PACKAGING

Professor James F. Thrasher, PhD

Contents

Executive Summary ...... 3

Information about the author ...... 5

Review of rationale and effects of health warning labels ...... 7

I. Why put health warning labels on tobacco packaging? ...... 7

Tobacco causes a great range of serious diseases around the world ...... 7

The World Health Organization recommends policies to address tobacco use ...... 8

The WHO Framework Convention on Tobacco Control recommends large health warning labels to inform consumers about tobacco-related risks ...... 9

Consumers underestimate the magnitude and range of tobacco-related risks ...... 10

Summary ...... 13

II. How do health warning labels work? ...... 15

Advantages of cigarette packs as a channel for communicating health warning information ...... 15

Health warning label content influences perceptions and behavior ...... 18

Health warning labels with pictures are more effective than warnings with only text ...... 18

Summary ...... 20

III. Review of research on the effects of health warning label size on tobacco packaging ...... 21

Introduction ...... 21

The impact of health warning label size on increasing attention ...... 22

The impact of HWL size on the effectiveness of communicating health risks ...... 27

The impact of HWL size on discouraging tobacco use ...... 32

IV. Response to Chernev ...... 38

Evidence reviewed ...... 38

Relevance ...... 40

Validity ...... 42

Sufficiency ...... 43

V. Conclusions ...... 51

References: ...... 54

EXECUTIVE SUMMARY

1. I have been asked to provide an expert report evaluating the scientific evidence relevant to the Uruguayan government’s decision to increase the size of health warning labels from 50% to 80% of the primary surfaces of tobacco packaging. To do this, I have reviewed: (1) the rationale for health warning labels on tobacco packaging, including the consequences of tobacco use and consumer misunderstanding of these consequences; (2) basic communication principles that explain how health warning labels on tobacco packaging work; (3) research studies that used a range of different methods to assess the effects of differently sized health warning labels. To collect these studies, I reviewed documents mentioned in the Uruguay

Memorial on Jurisdiction, as well as others identified through examination of bibliographies from these documents and searches of peer-reviewed literature using academic research databases.

2. Based on this review, I have found that the scientific evidence consistently supports the conclusion that larger warnings, including those that cover 80% compared to 50% of the package, are more effective in communicating tobacco-related risks to both adult smokers and adolescents. Evidence available at the time of Uruguay’s decision to increase the size of warning labels from 50% to 80% of the package, which also informed the World Health

Organization’s scientific consensus recommending this type of increase in size, is consistent with studies that have been conducted since that time. As such, I conclude that Uruguay’s decision to increase the size of its warning labels from 50% to 80% was a logical and reasonable approach to more effectively communicate with adult smokers and adolescents about the

3 addictive nature of tobacco use, the great range of fatal diseases caused by tobacco, and the severity of those risks.

INFORMATION ABOUT THE AUTHOR

3. I am a behavioral scientist and communications specialist, with a Ph.D. in Health

Behavior and Health Education from the School of Public Health at the University of North

Carolina, Chapel Hill, USA. I also hold Masters degrees in Epidemiology and in Cultural

Anthropology from the State University of New York at Buffalo, USA, and a Bachelor of Arts

degree in Psychology from the University of North Carolina, Chapel Hill, USA. I am currently an

Associate Professor in the Department of Health Promotion, Education and Behavior at the

Arnold School of Public Health at the University of South Carolina, Colombia, USA. For over a decade, I have also been a Researcher and Visiting Professor at the Mexican National Institute of Public Health.

4. My primary area of expertise is assessing the influence of tobacco warning label characteristics on consumer perceptions and behaviors. I have published on this topic in 23 peer-reviewed articles across a variety of international scientific journals. These studies have involved diverse experimental, observational, and qualitative methods, and they have included data collection in Uruguay, Australia, Brazil, Canada, Mexico, the United Kingdom, and the

United States. I have also edited a book on tobacco warning labels in Latin America. My research on tobacco warning labels has been funded by a range of federal and foundation funding agencies. I am currently the primary investigator for a 5-year $2.7 million grant from

the US National Institutes of Health, which aims to understand the characteristics of tobacco

warning labels that produce the most sustainable impact on adult smokers.

5. Since 2006, I have been a co-Investigator on the Uruguay administration of the

International Tobacco Control Policy Evaluation Survey (i.e., ITC Uruguay), which has surveyed

Uruguayan adult smokers every two years. During this period, I have also been the Principal

Investigator of the ITC Mexico Survey. These surveys contribute to the larger ITC Project, which

collects data from adult smokers in more than 20 countries in order to assess the effectiveness

of different tobacco control policies, including health warning labels.

6. I have provided consultations to Latin American governments regarding tobacco

warning label testing and policy development, including a period when I led research projects to inform the selection of warning label content for the Mexican Ministry of Health. I am

Associate Editor for the international scientific journal Nicotine and Tobacco Research and the newly-founded journal Tobacco Regulatory Science, and I have guest-edited two special issues

of the Mexican Journal of Public Health on tobacco control policies in the Latin American region.

Of my 94 peer-reviewed publications that have either appeared or are forthcoming in scientific

journals, 86 are on the topic of tobacco. Most of these articles have appeared in the top

international public health journals (e.g., American Journal of Public Health, American Journal of

Preventive Medicine, Cancer Causes & Control, Cancer Epidemiology, Biomarkers & Prevention,

Health Policy, Health Policy & Planning, Preventive Medicine); social science and health journals

(e.g., Health Psychology, Health Education Research, Health Education & Behavior, Journal of

Health Communication, Journal of Health & Social Behavior, Social Science & Medicine); and

tobacco research journals (e.g., Addiction, International Journal of Drug Policy, Nicotine &

Tobacco Research, Tobacco Control). In recognition of my tobacco research contributions in

Latin America, I was elected and served as the Scientific Chair for the 4th Latin American and

Caribbean Conference on Tobacco or Health (2014).

6 REVIEW OF RATIONALE AND EFFECTS OF HEALTH WARNING LABELS

I. Why put health warning labels on tobacco packaging?

Tobacco causes a great range of serious diseases around the world

7. Tobacco use is the leading cause of preventable death around the world,1 causing an estimated 6 million deaths a year.2 While tobacco consumption has generally stabilized or fallen in high‐income countries, it has increased substantially in low‐ and middle‐income countries, where most of the world’s population lives. As a result, the global impact of tobacco consumption on public health is projected to increase significantly, particularly in low‐ and middle‐income countries.3, 4 Tobacco use accounted for 100 million deaths in the 20th century.

If current consumption trends continue, tobacco is projected to kill 1 billion people in the 21st century.2 In Uruguay, 25% of people age 15 years and older (31% of men; 20% of women) were current smokers in 2009, when tobacco‐attributable deaths exceeded the total number of deaths from traffic accidents, homicides, suicides, alcoholism, tuberculosis, and HIV/AIDS.5

8. Tobacco use damages most every organ in the body (see Figure 1), killing half of all smokers prematurely from Figure 1. Diseases caused by tobacco use tobacco‐related diseases. Tobacco causes at least 12 fatal cancers and a variety of cardiovascular diseases

(e.g., heart attacks, stroke, diabetes), respiratory diseases

(e.g., chronic obstructive

7 pulmonary disease, emphysema, and chronic bronchitis), and other diseases (e.g., blindness, infertility, arthritis, poor neonatal health).6, 7 Indeed, new diseases caused by tobacco continue to be discovered (see new diseases in red, Figure 17). No other consumer product causes this diversity and magnitude of health problems.

The World Health Organization recommends policies to address tobacco use

9. To reduce the public health impact of tobacco use around the world, the 56th World

Health Assembly of the World Health Organization adopted the Framework Convention on

Tobacco Control (FCTC) in May 2003.8 As of September 2014, the FCTC has been ratified by 179

Parties.9

10. The policies and programs required by the FCTC were based on prevailing scientific consensus.8 Furthermore, FCTC Articles 20, 21, and 22 emphasize the importance of conducting, sharing, and reviewing scientific research that is relevant to the further development of tobacco policy. As scientific understanding of tobacco policy has advanced, implementation guidelines have been developed to make FCTC policy recommendations more consistent with scientific understanding. As with the original FCTC document, the development of implementation guidelines involves comprehensive review and input from internationally recognized scientific experts from diverse sectors and regions of the world. This process ensures that FCTC recommendations reflect the most up-to-date, scientific consensus regarding

“best practices” for tobacco control policies and programs.

8 The WHO Framework Convention on Tobacco Control recommends large health warning labels to inform consumers about tobacco-related risks

11. FCTC Article 11 focuses on the packaging and labeling of tobacco products.

Implementation guidelines for Article 11 are based on the FCTC guiding principle that:

“Every person should be informed of the health consequences, addictive nature and mortal threat posed by tobacco consumption and exposure to tobacco smoke….”8

12. The Article 11 implementation guidelines further recognize that:

“Globally, many people are not fully aware of, misunderstand or underestimate the risks for morbidity and premature mortality due to tobacco use and exposure to tobacco smoke.”10

As such, Article 11 recognizes the significant potential of health warning labels (HWLs) on

cigarette packaging for communicating about the range of serious tobacco-related health risks

to all consumers, including youth before they try and ultimately become addicted to tobacco.

13. The original Article 11 recommendations were based on the scientific evidence available

in 2003. To ensure that HWLs effectively communicate health risk information, Article 11

specified that HWLs:

• shall be rotating;

• shall be large, clear, visible and legible;

• should be 50% or more of the principal display areas but shall be no less than 30% of the

principal display areas;

• may be in the form of or include pictures or pictograms.

The 2008 implementation guidelines more strongly recommended the use of pictorial imagery

(i.e., change from “may” to “should” use pictures) due to the scientific evidence that HWLs with pictures are more effective than HWLs with only text.10

14. Article 11 implementation guidelines also expanded upon the original recommendations regarding HWL size. In particular, the new guidelines stated:

“Parties should consider using health warnings and messages that cover more than 50% of the principal display areas and aim to cover as much of the principal display areas as possible.”10

This recommendation to cover “more than 50% of the principal display areas”(emphasis added) reflected the scientific evidence available when the guidelines were finalized and adopted in

2008.

Consumers underestimate the magnitude and range of tobacco-related risks

15. As Article 11 recognizes, consumers are not adequately informed about the range of grave dangers that tobacco consumption causes. Although most consumers are generally aware that smoking is harmful, this general awareness does not indicate that they are fully informed about the types and severity of tobacco-related health effects. Furthermore, general awareness of tobacco-related harms does not reflect the extent to which individuals personalize this risk by viewing themselves as susceptible to these harms should they start or continue to consume tobacco. General awareness of harm also does not reflect consumer understanding of the addictive nature of tobacco consumption or how susceptibility to these health effects decreases following long-term abstinence from consumption.

16. The US Surgeon General has identified a dozen cancers and a host of other fatal diseases from tobacco use (see Figure 17). Studies have consistently shown that smokers’ knowledge of smoking-related diseases is relatively high for a few of these risks, such as lung cancer and some cardiovascular diseases; however, awareness is much lower for other smoking-related risks.11, 12 Data from the 2010-2011 ITC Uruguay Survey show a similar pattern,13 with 97% of adult smokers agreeing that smoking causes cancer and 84% agreeing that it caused coronary heart disease. However, only 54% were aware that smoking causes stroke, a leading cause of death from smoking. This percentage jumped to 71% in the next wave of the ITC study, which correlates with the introduction of a new warning label in Uruguay stating “fumar causa infartos cerebrales” (“smoking causes stroke”).36

17. Yet these assessments may overestimate actual knowledge of smoking-related health effects. Knowledge could be substantially lower if assessed by asking participants to state which diseases they think are caused by tobacco use without naming any diseases. This type of

“top of mind,” unprompted recall assesses more readily available knowledge and therefore is a more precise approach to assessing awareness of risks. One US-based study that used this method concluded:

“The great majority of smokers and nonsmokers realized that smoking can cause life-threatening illnesses, but, except for lung cancer, no specific smoking-linked illness could be named by more than half of our respondents. About half mentioned emphysema, about a quarter mentioned any kind of cancer other than lung, and only about a quarter mentioned any kind of cardiovascular risk. About 10% did not mention cancer at all.”14 (p.354)

18. Important health risks from smoking that were mentioned by less than 5% of

participants include stroke, diabetes, and hypertension. As the paper notes, “If individuals

cannot identify the best-known, most severe health effects of smoking without prompting, they are certainly unable to apply that information in deciding whether to smoke.”14 (p.350)

Furthermore, the researchers for this study do not report on many of the other diseases that smoking causes (see Figure 17). Presumably, responses regarding these diseases were either

completely absent or their frequency was below the level at which they would be meaningful to

report in a scientific publication. Hence, this study provides strong evidence that smokers are

generally not aware of the broad range of diseases that are caused by tobacco.

19. Smokers also underestimate the severity of tobacco-related diseases.14 For example, more than a quarter of smokers in the United States were unaware that smoking shortens one’s life.15 Furthermore, many smokers gravely underestimate the fatality of smoking

compared to other risks, such as car accidents.15, 16 Smokers also underestimate their own risk

of disease and death relative to other smokers.17 These misunderstandings about the severity and personal susceptibility to tobacco-related diseases indicate that consumers are inadequately informed about the consequences of tobacco consumption.

20. The health risks of smoking matter to most consumers. Of all the reasons that smokers provide for quitting, concern about the personal health impact of smoking is the most common motivation and the best predictor of long-term abstinence.18 For example, data collected as part of the 2010-2011 ITC Uruguay Survey indicates that more than 8 in 10 of Uruguayan smokers cite “concern for personal health” as motivation for quitting smoking—the most frequently cited motivation to quit.36 Hence, like consumers in other countries around the

world, Uruguayans care about health risks from tobacco use. Government efforts to more

adequately inform the public about the health risks of tobacco products are thus reasonable.

21. It is especially important to communicate the range and severity of tobacco-related risks to young potential consumers before they try tobacco and become addicted to it. The tendency to underestimate tobacco-related risks is particularly pronounced in adolescents, as they also express “unrealistic optimism” about their ability to quit smoking after they start.16, 19 For

example, only 3% of high school students in the United States who smoked daily reported that

they would still be smoking in five years.16 Seven to nine years later, however, 63% were daily smokers.16 Indeed, most adult smokers want to quit, and the vast majority who try to quit

fail.16, 20 Given the highly addictive nature of tobacco, it is critical to communicate tobacco risks

to youth so that they fully understand these risks. Because of their broad reach and

sustainability, prominent HWLs on tobacco packaging are a cost-effective manner of repeated

communication of health information to youth and adult smokers alike, and the messages are

delivered at the moment of making the decision to smoke.

Summary

22. Tobacco use poses a significant burden to public health around the world. To address

this challenge, the WHO-FCTC recommends a variety of policies and programmatic strategies,

including the adoption of prominent pictorial HWLs that cover more than 50% of tobacco

packaging. This policy recognizes that adult consumers and youth are not aware of the full

scope and severity of health risks from tobacco consumption. Prominent HWLs on tobacco

packaging allow for regular communication of tobacco risks to these important groups. While

13 providing smokers with this information is important, it is even more critical that this information reach young people before they become addicted tobacco consumers.

II. How do health warning labels work?

23. The effective design of warning labels for a variety of products has received substantial

scientific study.21-23 Research on warnings has focused on the effects of different types of pictorial and textual content,24, 25 color and design features,26 and the relative prominence of

warnings.25, 27 General models of how warnings work draw on basic principles of

communication and information processing.28, 29 The channel through which a message is transmitted must first “reach” the consumer, providing an opportunity for engagement with message content.30, 31 The warning must be salient enough to capture the attention of the

consumer, which often requires breaking through the “noise” of other information in the

environment.32 Once consumers attend to a message, the depth at which they process the message depends on a number of factors, including both characteristics of the message (e.g., complexity, legibility, pictorial accompaniments) and characteristics of the message receiver

(e.g., motivation, ability to process the message).33-35 Repeated attention to and engagement

with message content is often necessary to influence consumer attitudes and beliefs.29 These attitudes and beliefs may then influence behavior.

Advantages of cigarette packs as a channel for communicating health warning information

24. For communications to be effective, messages must reach their target audiences.30, 31 In

this regard, health warning labels (HWLs) have clear advantages over communications efforts

that rely on traditional mass media (e.g., television, radio, billboards). Communication through

mass media channels may or may not reach a consumer, since the consumer must be in the

right place at the time when a message is transmitted through the channel. HWLs, on the other

hand, reach all tobacco consumers each time they access their package to consume tobacco.

For someone who smokes a package of cigarettes a day, which is the average daily

consumption among Uruguayan smokers,36 this translates into 20 or more potential exposures to HWL messages a day, or over 7,000 exposures a year.

25. The potential power of HWLs to communicate information about tobacco-related risks is partly due to their ability to repeatedly reach consumers at tobacco product selection, purchase, and consumption,37 which are critical moments for effective marketing

communications.31 Indeed, the marketing and design of tobacco products and packaging aims to reassure consumers that tobacco products are not so harmful. 38-42 HWLs can compete with these and other positive messages about tobacco use, promoting “cognitive dissonance,” which is the unpleasant state that accompanies awareness of information that is discrepant with behavior.34 In particular, HWLs can remind and make salient to tobacco users that their

tobacco use behavior contradicts their beliefs that engaging in this behavior harms them. The

guilt or psychic tension that comes from this conflict between belief and behavior can motivate

behavior change, such as decreasing or stopping tobacco consumption.34

26. The motivation to process messages evolves over time, as does the motivation to quit

smoking,43 and HWLs may serve different beneficial functions as these motivations change. For

smokers who are not currently planning to quit, the HWLs may serve as a consistent reminder

of the compelling health-related reasons for quitting. For other smokers who attempt to quit,

HWLs may act in synergy with other life events, such as experiencing the symptoms of an illness or when a friend or family member talks with them about quitting. For example, seeing a HWL for lung cancer shortly after experiencing early symptoms of respiratory disease may prompt a

quit attempt or help to sustain a quit attempt that is already in progress. HWLs serve as readily

available reminders not only about the severity of tobacco-related risks, but also about where

consumers can find health-related information, including cessation resources (i.e., quitlines,

cessation websites). In this regard, HWLs go beyond merely establishing knowledge—they also

serve as both cues for thinking about quitting and a readily available source of information for

moments when smokers become motivated to engage in purposeful processing of HWL

content.

27. The nature of tobacco product packaging also expands the potential reach of HWL

messages to include non-consumers, including youth. Tobacco packs have a high degree of

“socially visibility” compared to many other consumer goods.44 Tobacco consumers display packages to others around them when they access their tobacco, often keeping packages in public view during and after they consume tobacco. Furthermore, HWLs potentially reach non- consumers in the places where tobacco is sold. Tobacco products are often displayed prominently at the “point of sale” in retail establishments. Hence, HWLs on socially visible packages that are also prominently displayed at point of sale reach a significant percentage of nonsmokers and youth, including those who are susceptible to smoking.45, 46

28. A further advantage of using the cigarette package as a channel for communicating health information is its relatively low cost and high sustainability. Communication campaigns

through mass media require substantial resources to be effective. Government funding for

such campaigns is often entirely lacking, not sufficient to generate an impact, or available only

sporadically. By contrast, the cost of using HWLs on cigarette packages for communications is

primarily associated with the development of HWL content. Because HWLs are mandated for

all tobacco packages, communication through HWLs is also sustainable over time.

Health warning label content influences perceptions and behavior

29. As has been found for other types of warning labels,29 the content of tobacco package

HWLs influences their effectiveness. For example, specific HWL content promotes consumer awareness of that content, such as smokers’ awareness of smoking-related risks,11 particularly less well-known risks.12 In 2010-2011, over one third of Uruguayan smokers indicated that they

were prompted to think about quitting by “advertisements or information about the health

risks of smoking” (37%) and, similarly, by “warning labels on cigarette packages” (31%).36

Hence, many Uruguayan smokers appear to value information about the health effects of

tobacco use that is found on HWLs. Also, when HWLs provide information on how to access

resources for smoking cessation (e.g., quitline, websites), utilization of these resources

increases.47-49 Larger HWLs provide more space to include content that is known to enhance

message effectiveness. These can include, for example, headers, larger pictures, explanations

of health effects, smoking cessation tips, calls to action, information about smoking cessation

resources.

Health warning labels with pictures are more effective than warnings with only text

30. Research on a variety of types of warnings has underscored the importance of pictorial

content to enhance their efficacy.23, 29 Similarly, research on tobacco HWL content consistently finds that HWLs with imagery illustrating the consequences of smoking is more effective than

HWLs that only contain textual content.37 Experimental studies indicate that pictorial HWLs are more effective than text only HWLs with regard to:

• capturing attention;51, 53

• message credibility;52, 53

• message relevance to the consumer;54

• promoting negative affective reactions;55-58

• enhancing risk perceptions;59

• perceived effectiveness;53, 60-63

• motivating smokers to quit;52, 53, 56-58, 63-65

• reducing smokers’ demand for cigarettes;66, 67

• dissuading smoking initiation;68

• communicating with low literacy smokers and youth.54, 60

Results from these and other studies have produced consistent results across diverse populations and contexts.

31. Similar results have been found in observational studies. Amongst these studies are surveys of smokers or adolescents both before and after pictorial HWLs were first introduced, as well as surveys that compared countries with and without pictorial HWLs. These studies have found that pictorial HWLs promote:

• greater attention towards HWLs;69-73

• greater awareness of smoking-related harms;11, 73, 74

• more frequent thoughts about quitting;70, 71

• more frequent cessation-related behaviors, including foregoing cigarettes70, 72, 73 and

calling quitlines.47, 48

32. The consistency of results across studies and countries provided the scientific basis for

the 2008 FCTC Article 11 implementation guidelines that included strong recommendations for

countries to integrate pictorial imagery into HWL content.10 Scientific studies conducted after

2008 have supported this recommendation.

Summary

33. HWLs on tobacco packaging work like other warnings used to inform consumers about

dangers and health risks. According to widely accepted communication and information

processing models, warnings must first capture attention if they are to influence consumer

perceptions and behaviors. Furthermore, repeated message exposure is often necessary to

influence consumer attitudes and beliefs. Tobacco packaging is an ideal channel for

communicating health information to consumers, as it repeatedly reaches current and potential tobacco consumers at the point of selection, point of sale, and moments of consumption.

Furthermore, HWLs are a low-cost and sustainable approach to communicating information.

HWL content influences consumer perceptions and behaviors, with consistent evidence showing that the inclusion of pictorial imagery enhances HWL effectiveness. The Uruguayan government’s decision to increase HWLs from 50% to 80% appears reasonable and consistent with this general model of how warnings work, particularly with regard to the importance of capturing attention as the first step of message processing.

III. Review of research on the effects of health warning label size on tobacco packaging

Introduction

34. The following section provides an overview of the studies carried out to assess the

effects of increasing the size of health warning labels (HWLs). The studies reviewed herein

include those mentioned in the Uruguay Memorial on Jurisdiction, as well as others identified

through examination of bibliographies from this material and searches using academic research

databases (e.g., PubMed). The review includes 42 studies that report primary, original data or

analysis on consumer responses to differently sized HWLs.

35. Results from these studies are organized by the effect that the study assessed. Thus,

the sections that follow address the effect of HWL size on: (1) attention, (2) communication of

health risks, and (3) eventually discouraging tobacco use. These outcomes reflect key steps in

the aforementioned general model of communication as applied to HWLs on tobacco products.

36. Each of these three sections is further broken down by the type of study design: (a)

“experimental studies” that generally aim to isolate the effects of HWL size, independent of other HWL characteristics;i (b) “observational studies,” where adult smokers or youth are

surveyed before and after HWL size is increased in the countries where they live;ii and (c)

i Experimental studies that compare small, text-only HWLs that only appear on the side of the cigarette package to large pictorial HWLs that appear on the front of the package were excluded from this review because these studies are less able to isolate the effects of HWL size independent of HWL content and location on the primary pack surface (i.e., front or back). Experimental studies that included comparisons of differently sized HWLs that appeared on the front of the package were included for consideration. The review mentions when experimental manipulations do not distinguish between the effects of size and content. ii Observational studies included in this report involve simultaneous changes in HWL size and content, since governments inevitably change both at the same time. However, cross-sectional studies that directly compared HWL responses across countries with differently sized HWLs were excluded from the review due to confounding factors that might impact results. In other words, differences between countries that are unrelated to HWLs (e.g.,

“qualitative studies” that involve unstructured, open discussion or open responses from

participants regarding their attitudes, beliefs and responses to differently sized HWLs (e.g.,

focus groups and individual interviews with open-ended questions).iii This approach aims to

determine the consistency of the empirical evidence for each key communication outcome

across different study designs.

37. The studies demonstrate the consensus that the effectiveness of HWLs increases as

their size increases. These conclusions are consistent with prior literature reviewsiv that have

assessed the effects of increasing HWL size.37, 75-83 Results from studies that include data on the effects of HWLs that occupy more than 50% of the primary package surfaces are highlighted and discussed as either consistent or inconsistent with the other studies on the effects of HWL size. Whether assessing warning labels smaller or larger than 50% of the pack surfaces, the studies show that the largest warnings labels are the most effective.

The impact of health warning label size on increasing attention

38. Attention is the critical gateway towards the comprehension of message content, and

prior research on non-tobacco warnings indicates that size influences the amount of attention

that a warning attracts.32, 34 The relationship between tobacco HWL size and attention to HWLs

have been examined in: (a) two experimental studies; (b) eight observational studies before

and after larger HWLs were implemented; and (c) six studies that collected qualitative data on

consumer responses to differently sized HWLs.

different cultures, varying histories and strength of the collection of tobacco control policies) may affect differences observed between countries.

iii All qualitative studies that assessed HWL size were included for consideration and evaluated for evidence regarding the effects of size. iv Reviews funded by the tobacco industry are not considered because of the conflict of interest.

a. Larger HWLs enhance attention to HWLs

39. Two experimental studies assessed consumer attention (i.e., visibility, self-reported attention) toward differently sized HWL stimuli. One study documented that the larger the pictorial HWL (i.e., 40%, 50%, 60%), the easier it was for the HWL to be seen at greater distances.84 This suggests that larger HWLs increase the reach of HWLs, particularly for non-

consumers who encounter packages at the point of sale or in contexts where tobacco packages

are “socially visible.” Another experiment found that when adults in the US were presented

with three cigarette packages that had differently sized HWLs (i.e., 30%, 50%, 100%), 95% of

them selected the pack with the largest HWLs as most likely to attract their attention.85 These

studies show that the largest HWLs, including those that are greater than 50%, are most

effective in capturing attention.

b. Implementation of larger HWLs increases attention toward HWLs

40. Data collected in observational studies shows that larger HWLs increase attention

toward HWL messages. Attention is assessed in a variety of ways,86 one of which is awareness.

After Canada implemented larger HWLs in January 2001, repeated cross-sectional surveys

found that the awareness of HWLs increased substantially among 12- to 18-year old youth (i.e.,

from 28% to 70%), including smokers (i.e., from 47% to 83%) and youth who were susceptible

to smoke (i.e., from 28% to 77%).46

41. Noticing HWLs is another measure of attention. Four observational studies assessed the

frequency of noticing HWLs among adult smokers in the United Kingdom,70, 87 Mexico,73 and

Uruguay.13 All four studies found that adult smokers noticed HWLs more often after larger

HWLs were implemented in their countries; however, according to the 2014 ITC Report, the

increase in Uruguay (i.e., 64% to 70% of smokers noticing “often” or “very often”) was not

deemed statistically significant.36 Over this time, the frequency of reading HWLs increased

among adult smokers in these countries,13, 70, 73, 87 as well as among adolescents in Australia

after larger HWLs were implemented there.72 Reports on Uruguay (i.e., 49% to 51% reading

“often” or “very often”) do not indicate whether this increase was statistically significant.36

One study of Australian smokers and nonsmokers found that noticing and reading HWLs on the back of the package increased after HWL size was increased (i.e., 30% to 90%); however, noticing and reading the front and side of package HWLs declined, where HWL size for these package surfaces was similar or the same over time.81 Furthermore, an indicator of attention

that combined frequency of both noticing HWLs and reading HWLs increased among adult

smokers in the United Kingdom and Australia after implementation of larger HWLs.71

42. All observational studies reviewed here found that the implementation of larger HWLs was accompanied by greater attention toward HWLs. Data from Uruguayan smokers before to after HWL size increased from 50% to 80% of the package show an increase in attention, although this increase was not deemed statistically significant.36

c. Consumers prefer more prominent HWLs that capture their attention

43. Results from focus groups among adult smokers and adolescents collected in qualitative

studies on consumer reactions across a number of countries also indicate that larger HWLs

generate greater consumer attention. Smokers who participated in 56 focus groups conducted

across seven EU countries generally preferred larger HWLs because of their greater

prominence. One representative comment from a participant stated that “the bigger it is, the

better we see the warnings.”88 In New Zealand, one smoker reported that the larger HWL (i.e.,

30% vs. 50% of the front) was better because it “draws you toward the pack, is ‘in your face.’”89

In Australia, where pictorial HWLs were significantly smaller on the front compared to the back of the pack (i.e., 30% vs. 90%), researchers typified focus group participants who “often described the image on the front of pack as ‘too small’, particularly when compared to the image depicted on the back of the pack. […] If the image was larger on the front panel, most conceded that the message and the picture would be harder to avoid, be more dramatic, and more dominant.”81 An illustrative quote for this perspective was provided by a female

adolescent nonsmoker: “If it was the same on the front and the back you wouldn’t be able to

look at the pack without seeing what it can do to you. It’s only tiny on the front so they just

ignore it.”81

44. Three Canadian studies found that adolescents and adults selected packages with the

largest HWLs as the most effective for a variety of goals.90-92 When participants were asked why, their unprompted responses mostly concerned enhanced attention (e.g., “noticeable,”

“attractive,” “no distractions,” “in your face”). Two of these studies91, 92 were conducted seven years after pictorial HWLs that covered 50% of the package had been implemented in Canada.

Nevertheless, these open responses about enhanced attention toward HWLs that were larger than 50% HWLs were similar to responses found in the study conducted before 50% HWLs were implemented (i.e., when HWLs covered 35% of the pack).90 In other words, although the HWLs had already increased to occupy 50% of the pack, respondents continued to believe that warnings would be even more effective if they were made larger.

d. Implementation of larger HWLs increases attempts to avoid HWLs

45. The prior studies indicate that larger HWLs are better able to capture attention, making

it harder for consumers to ignore HWLs. Nevertheless, larger HWLs prompt some consumers to

try to avoid attending to the information in HWLs. For example, observational studies show

that after larger HWLs were implemented in Australia, the UK, and Uruguay, more smokers

reported attempts to avoid looking at them.13, 36, 71 One might think that avoidance of HWLs potentially diminishes HWL effects. However, studies have found that smokers who avoid

HWLs are more likely than or equally likely as other smokers (who do not avoid HWLs) to think about health risks due to HWLs or to try to quit later on.93-96

46. These results are consistent with research on “ironic processes” that can accompany

attempts to suppress thoughts. Many experimental and observational studies across a range of

contexts find that attempts to suppress thoughts and information often lead to the opposite

effect: suppression attempts make the thought or idea more likely to arise in the mind of the

person attempting to suppress it.97 This model of ironic processes predicts that attempts to

avoid HWLs will produce the ironic effect of making HWL messages more effective for some

people. Consistent with this prediction, observational studies suggest that avoidance behaviors

that accompany implementation of larger HWLs do not reduce the effects of HWLs.

e. Summary

47. Results from studies that employed diverse methods and participants across varying

contexts provide consistent support for the principle that larger HWLs generate greater

attention than smaller HWLs, whether examined among established adult smokers or

adolescents. According to the evidence, larger HWLs are more visible and therefore help

expand the reach of HWLs to include non-consumers, including youth, who might otherwise not

notice HWLs. Similarly, HWLs that are greater than 50% attract more attention than HWLs that

cover 50%.

The impact of HWL size on the effectiveness of communicating health risks

48. A primary aim of HWLs is to address the lack of consumer understanding of tobacco-

related risks. Neither adult smokers nor youth are fully informed about the range or great

severity of tobacco-related risks. To reduce cognitive dissonance associated with engaging in a

behavior that can harm them, they often express unrealistic optimism, believing that tobacco-

related health risks do not apply to them (see Section II above). Because larger HWLs attract

greater attention, they confront consumers with the risks that tobacco consumption poses,

making it more difficult to ignore HWL content.

49. The depth at which someone processes warnings and other messages depends on their

motivation and ability to process the message.33-35 People who are motivated and able to process a message thoughtfully engage with the information, and as a result, attitudes and beliefs related to the message can be formed, reinforced, or transformed. People who are less

motivated or able to process a message are more influenced by “peripheral cues” (e.g., colors,

design features, emotional content, heuristics) that are easier to process than the primary

message content. The size of a warning is an important “peripheral cue” for communicating

with consumers. Indeed, consumers appear to equate the relative size of warnings with the

magnitude of the risk.37, 98

50. This section reviews: (a) 11 experimental studies; (b) eight observational studies; and

between HWL size and communication of health risks.

a. Consumers select larger HWLs as more effective in communicating tobacco-related risks

51. Experimental studies that evaluated HWLs that explicitly compared 50% HWLs with

larger HWLs independent of other HWL or packaging characteristics have been conducted

amongst adult smokers and adolescents in Canada 90-92, 99-101 and adults in the US.85 The largest

HWLs were consistently evaluated as the most effective for informing others (e.g., smokers,

Canadians, the public, people) about the risks of smoking. This result was also found among

adult smokers100 and adolescents99 in Canada who were asked to evaluate HWL effectiveness for themselves personally (i.e., “In increasing your personal belief in the message conveyed by

the warning”). One study of Australian smokers found no effect of HWL size on the perceived

harmfulness of cigarettes.102 Three other studies found that packs with larger HWLs (with

content that differed from the smaller HWLs with which they were compared) were evaluated

as more effective for communicating risk among adolescents in the UK,103 young adult smokers

in the US,104v and among adult smokers, adult nonsmokers, and adolescents in China.63 Across

studies that examined effects in different subpopulations, the stronger effect of larger HWLs

was seen for all subpopulations examined. In addition, the relationship between size and

v This study compared graphic warning labels covering 50% of the package versus smaller, text-only graphics. While the study focused on the outcome in terms of the graphic versus text-only warnings, the results also apply to the increased size of the warning.

communication efficacy appeared stronger for adolescents91, 99 compared to adult smokers92, 100

in the studies where the same study protocols were administered to both groups.

b. Larger HWLs promote stronger negative emotions

52. Experimental studies also show that effective communication about health risks often

involves arousing anxiety or negative emotions.105, 106 Research suggests that effective HWLs

also work in this manner.55-58 To assess the relationship between HWL size and negative arousal, two experimental studies among adolescents99 and adults100 involved rating differently

sized pictorial HWLs with same content for: (1) being disturbed by the HWL; (2) having strong

feelings when looking at the HWL; (3) difficultly hiding feelings about the HWL; (4) being

shocked by the HWL. One comparison was not statistically different (i.e., youth being disturbed

by 50% vs. 100% HWL).99 Otherwise, participants consistently rated HWLs that were larger than

50% as prompting stronger, more negative emotions than HWLs covering 50%. Furthermore,

ratings were higher for each incremental increase over the next smallest size (i.e., 50% vs. 75%;

75% vs 90%; 90% vs. 100%). These results indicate that smaller HWLs, including those that are

50%, are less likely to promote negative emotions than larger HWLs.

c. Implementation of larger HWLs increases awareness of smoking- related risks

53. The effectiveness of larger HWLs in communicating the risks of smoking was examined

in six observational studies. One study in Australia found that smokers and recent quitters

reported greater general awareness of smoking-related risks after larger HWLs were

implemented.81 Five other studies examined changes in the awareness of specific smoking-

related health risks after countries adopted larger HWLs that included information about these

risks. For example, adult smokers’ awareness of smoking-related harms and tobacco

constituents increased after larger graphic HWLs were introduced in Australia107 and Mexico,73

a pattern also found among Australian adolescents.72 Awareness of more well-known smoking-

related risks, such as lung cancer and emphysema, did not appear to change with

implementation of larger HWLs in Uruguay (50% to 80% of pack front and back)13, 36 or Australia

(30% to 75% of package front),12 suggesting that there may be ceiling effects for enhancing

awareness of widely known smoking-related outcomes. Smokers’ awareness of less well- known risks (e.g., blindness, impotence), however, increased after larger HWLs were introduced in both countries. This was found even though these outcomes had been included on prior, smaller pictorial HWLs, suggesting that the larger HWL size accounted for this enhanced awareness. These data suggest that larger HWLs, including those that are greater than 50%, are more effective than smaller HWLs in increasing consumers’ awareness of tobacco constituents and smoking-related harms, particularly harms that are less well known.

d. Implementation of larger HWLs promotes deeper processing of smoking-related risks

54. The efficacy of communicating risk information should be evaluated through measures besides simple awareness of health risks. This is because youth and adult smokers who report awareness of smoking-related diseases often underestimate disease severity and are unrealistically optimistic that they will avoid these diseases, as discussed in Section I of this report. A number of observational studies have examined the depth of processing HWL messages by asking consumers about the frequency with which they think about HWL content and talk to others about HWLs. Implementation of larger HWLs has been accompanied by greater thinking about smoking-related harms among adolescents in Australia,72 as well as

30 among adult smokers in Mexico,73 Australia,71, 81 and Uruguay.36 In Uruguay, for example, the percentage of adult smokers who reported that HWLs made them think “somewhat” or “a lot” about health risks from smoking increased from 35% to 43% after HWLs were increased to cover 80% of the package.36 In the UK, studies have found conflicting results.70, 87 Thoughtful processing of messages often involves talking to others about the messages.108-110 The frequency with which Australian adolescents talked about HWLs increased after larger HWLs were introduced there.72 Overall, these observational studies indicate that larger HWLs cause adolescents and adult smokers to more frequently process information about smoking-related risks described in HWLs.

e. Larger HWLs are easier to understand

55. In focus groups, consumers say that they find larger HWLs make message comprehension easier. Smokers in New Zealand described how “the accompanying text is easier to read” with larger HWLs, and how “The big picture is easier to understand because you don’t have to look so hard”.89 Focus groups with smokers and adolescent nonsmokers in

England found “a tendency to equate the size of the warning with the magnitude of the risk.”98

Canadian adolescents91 and adults92 who selected the largest HWLs (i.e. 100%) as most effective for communicating risks were asked why without providing them with fixed response options. The 3rd and 4th most common responses were that it made them “more aware of health risk” or served as a “constant reminder.” Larger HWLs were generally perceived as more effective because their greater visibility made them easier to process and understand.

f. Summary

56. The experimental, observational, and qualitative studies evaluated herein provide

consistent support for the basic principle that larger, more prominent HWLs are more effective

in communicating risk. The evidence included experimental and observational studies among

populations that had already been exposed for a number of years to pictorial HWLs that

covered 50% of the package. No clear evidence for a threshold effect was found, with relatively

larger HWLs better communicating risk.

The impact of HWL size on discouraging tobacco use

57. Informing consumers about tobacco-related risks may ultimately promote cessation of tobacco use among current consumers and prevent tobacco use initiation among youth.

Nevertheless, behavior change is a complex process, particularly when it involves an addictive behavior or when the initiation and cessation of the behavior involves multiple influences that unfold over time. Because tobacco use is highly addictive, it is best conceived as a chronic relapsing disorder that requires multiple attempts to quit before succeeding. Furthermore, initiation of tobacco use mostly occurs over the entire period of adolescence and, occasionally, into young adulthood. HWLs are one of many factors that can deter tobacco use, and the scientific study of HWL effects on the behaviors of entire populations requires extensive periods of follow up. Finally, the primary objective of HWLs is to communicate health risks to consumers; subsequent influences on consumption behavior are secondary benefits. As such, studies that address the aforementioned outcomes of attention and risk communication are more relevant. Nevertheless, studies that address the issue of behavior change are included

below because discouraging smoking is a desirable, although distal, public health outcome that

can result from HWLs.

58. This section presents information from: (a) 16 experimental studies; (b) 16 observational studies; and (c) six qualitative studies that have assessed whether HWL size influences beliefs and intentions related to ultimately discouraging cigarette consumption.

This section also includes studies that have assessed the overall effectiveness of HWLs. This latter outcome is assessed in the present section because perceptions of the global effectiveness of HWL likely reflect consumer assessments of the joint effects of communicating risks and discouraging tobacco use.

a. Consumers report that larger HWLs are more effective in discouraging smoking

59. Experiments among adult smokers and adolescents in Canada,90-92, 99, 100, 111-115 adult smokers in Australia,102 and adults in the US85 evaluated different cigarette packages whose

only difference was HWL size. When participants evaluated packages for their effectiveness in

discouraging smoking (e.g., reducing smoking, motivating smokers to quit, discouraging others

from smoking [for youth]), larger HWLs were consistently viewed as more effective than smaller

HWLs across all studies, but two. One study that found that 35% HWLs were less effective than

50% and 60% HWLs, but no difference was found between 50% HWLs and 60% HWLs.115

Another study reported that after adult Australian smokers evaluated a pack with one of three

sizes of pictorial HWLs (i.e., 30%, 70%, 100%), no differences in the level of interest in quitting

were found.102 In all other studies, participants attributed greater effectiveness in discouraging

smoking to HWLs that covered more than 50% of the pack compared to 50% HWLs. In general,

consistent incremental increases were found for the effectiveness of larger HWLs compared to

the next smaller HWL size. This greater effectiveness for larger HWLs was found across study

subgroups when they were examined. Results were similar when examining differently sized

HWLs that also included differences in HWL content.63, 104 Differences in the strength of

response between adolescents and adult smokers were not explicitly tested; however, when

the same protocols were used for both groups in Canada, adolescents appeared to exhibit

stronger responses to relatively larger HWLs than adult smokers.90-92

b. Implementation of larger HWLs promotes thoughts about quitting

60. Four observational studies have assessed whether larger HWLs motivate smokers to quit and keep adolescents from starting to smoke. Adolescent smokers in Australia were more likely to report that HWLs made them think about quitting after HWLs were increased in size.72 After

the introduction of larger HWLs in Mexico,73 the UK,70 and Uruguay,13, 36 more smokers

reported that HWLs made them think about quitting. One study combined the frequency of

thinking about quitting and thinking about smoking-related harms because of HWLs, finding

significant increases after larger HWLs were introduced in Australia and the UK.71 In Australia,

Canada, the UK, and the US,93, 116 as well as in Thailand,95 these responses to HWLs have

predicted later smoking cessation behaviors, indicating that they are accurate measures of HWL

impacts on smoking cessation.

c. Implementation of larger HWLs promotes smoking-cessation behaviors

61. Specific behaviors related to smoking cessation have also been studied before and after

countries introduce larger HWLs. Larger HWLs in Australia, Mexico, the UK, and Uruguay have

been associated with more smokers reporting that, in the prior month, HWLs had stopped them

from having a cigarette when they were about to smoke.13, 36, 70, 71, 73, 87 This behavior predicts later smoking cessation behaviors.93, 95

62. In other studies, recent ex-smokers in Canada117 and Mexico73 were more likely to report that HWLs motivated them to quit when cigarette packages contained larger HWLs compared to when HWLs were smaller. Introduction of larger HWLs that described cessation support services available through telephones (i.e., “quitlines”) significantly increased use of the quitlines in Brazil,118 Holland,49 and Australia. 47, 119 In Australia, the volume of telephone calls to quitlines increased both when HWLs were increased from 25%/33% (front/back) to

30%/90%47 and again when they were increased from 30%/90% to 75%/75%.119vi In Canada, increasing pictorial HWL size from 50% to 75% of the primary package surfaces also increased quitline call volume.120 Hence, the studies indicate that increasing HWL size to greater than

50% of the package eventually leads to behavioral change associated with smoking cessation.

63. The impact of increasing HWLs size on the prevalence of smoking has also been studied

for Canada and Australia. Repeat cross-sectional surveys in Australia indicate a small decrease

in smoking prevalence correlated with the increased HWL size.81 Studies have found varying

levels of impact for the larger Canadian HWLs on smoking behavior.75, 121-123 Recent research121,

122vi above that includes more adequate adjustment for tobacco policies has found larger reductions in smoking prevalence than those estimated in prior studies.

vi While these studies focused on other elements of the warnings and packaging (i.e., graphic v. text-only, and plain packaging v. branded packaging), the results also apply to the increased size of the warning.

d. Consumers evaluate larger HWLs as most effective overall

64. Four experimental studies have assessed global evaluations of effectiveness and eight qualitative studies have analyzed how HWLs could be improved and why study participants consider larger HWLs better. Canadian adolescents 91 and adult smokers92 were asked which size HWLs were “the best choice for Canada,” adolescents in the UK were asked which HWLs had the greatest impact,103 and adult smokers and nonsmokers in the US were asked which

HWLs were most effective.85 All four studies found that more people selected larger than

smaller HWLs as the most effective. Where shared protocols were used for adolescents and

adults,91, 92 the effect of HWL size appeared relatively stronger amongst adolescents.

65. In focus groups, when smokers have been asked how HWLs could be improved,

increasing the size of HWLs invariably came up.81, 88, 89, 124 Individual interviews with adult

smokers and adolescents in Canada were conducted when pictorial HWLs covered 50% of the

package. When asked without prompting (i.e., “top of mind”) which changes to HWLs could

increase their effectiveness, increasing HWL size was the third most frequently mentioned

suggestion out of more than 30 types of responses among both adolescents (19%) and adult

smokers (11%).91, 92 Participants in these studies were asked later to select which HWL size is

best for Canada (see paragraph above), and those who selected the largest HWL (100%) were

asked why. The most common response amongst both adolescents and adult smokers

concerned attention (i.e., “Just a big health warning/no label/no distractions”), followed by

discouraging smoking (i.e., “encourage people to cut down or quit”), visual impact (i.e., “Visual

impact/in your face/noticeable”) and warning effectiveness (i.e., “Effective warning/clear

message/straight to the point” and “More aware of the health risk/constant reminder”).

Overall, these qualitative data from consumers are consistent with the results reported in this

and other sections of the review.

e. Summary

66. The above studies provide consistent evidence that the largest HWLs on cigarette packaging are the most effective in discouraging smoking. Experiments show that most adolescents and adult smokers favored the greater efficacy of larger HWLs, including when

HWLs were larger than 50% of the package. Observational studies consistently found more frequent thoughts about quitting and quitting-related behaviors when larger HWLs were

implemented, including when HWLs larger than 50% were implemented. When asked how to

make HWLs more effective, making them bigger is amongst the most often mentioned

recommendations that consumers make.

IV. Response to Chernev

Evidence reviewed

67. The Claimants’ Memorial is accompanied by an expert report by Professor Alexander

Chernev, who either criticizes as inadequate or does not consider the studies reviewed herein.

A principal reason for these criticisms and exclusions is due to his limited focus on the single outcome of decreased consumption when evaluating the research that Uruguay’s Memorial on

Jurisdiction cites to support 80% HWLs and the single presentation requirement. In particular,

Chernev evaluates this evidence with respect to whether these regulations “will contribute to decreasing tobacco consumption in Uruguay by discouraging nonsmokers from taking up smoking and/or encouraging smokers to give up smoking” (pg. 2, para 2).125 Indeed, each of the specific criteria Chernev uses to evaluate empirical studies (discussed below) with regard to both the 80% HWL and the single presentation requirement are defined with reference to this outcome of “decreasing tobacco consumption.” However, the primary objective of increasing

HWL size was to “raise the population’s awareness regarding the harmful effects that tobacco causes in human beings.”vii The primary objective for the single presentation requirement was to reduce the false perception that some cigarettes brand varieties are less harmful than others. The objective for which Chernev evaluates existing evidence leads to the inappropriate and excessive exclusion of studies from consideration.

68. Chernev’s specific criteria for evaluating studies (i.e., relevance, validity, sufficiency) and his application of these criteria are also flawed. His “relevance” criterion is excessive and vii Uruguayan Ministry of Public Health (MSP), Commitment to the Health of the Population: Strengthening the Anti-Tobacco Campaign (1 Jun. 2009) (R-37).

unnecessarily restrictive, as it excludes all observational studies and most experimental studies

because they do not involve controlled comparison of HWLs that are sized like those in the 80%

regulation. His “validity” criterion involves a generic criticism that can be made of almost any

study that involves human participants, and he does not adequately recognize researchers’

efforts to minimize related biases. Chernev’s “sufficiency” criterion involves three components:

behavioral impact, consistency, effectiveness. With regard to behavioral impact, Chernev dismisses studies that do not focus on behavioral outcomes, even though the Uruguayan regulations primarily aim to influence consumer perceptions, and not necessarily behavior.

When evaluating the consistency of study results, Chernev’s report illustrates the supposed inconsistency of studies through selective “cherry picking” and misrepresentation of discrepant results without engaging in logical or systematic analysis of the body of evidence. Finally, his

“effectiveness” criterion incorrectly focuses on whether the objectives of the Uruguay regulations can be met by alternative measures, which reflects his inadequate understanding of how tobacco control policies and programs work. Along with Professor Chernev’s misconstrued

objective for the Uruguayan regulations, these problems with his criteria and their application

lead to conclusions that are not valid regarding the empirical evidence supporting the

Uruguayan government’s decision to adopt the 80% HWL and the single presentation

requirement.

69. In addition to the studies that Chernev has intentionally excluded through his criteria,

the evidence he reviews with respect to the 80% HWL regulation is incomplete. He includes for

consideration 33 studies, comprising both the studies cited in the Memorial on Jurisdiction and

an additional 17 studies that these papers cite. He then excludes from consideration 10

reviews because they do not provide “original empirical evidence,” resulting in 23 studies for consideration. However, he does not consider all of the relevant studies with original empirical data that the reviews in the Memorial cite. For example, among the cited studies, Chernev does not consider early experiments on attention and risk communication that assessed HWLs covering more than 50% of the package.84, 90 Hence, the Chernev report does not consider the

full range of available evidence.

Relevance

70. Using his first criterion of relevance, Chernev indicates that only seven experimental studies explicitly addressed “the claim that 80% warnings are more effective than 50% warnings” (pg. 15, para 35).125 The level of specificity he uses to determine whether a study is

substantively different from the 50% to 80% increase is excessive and unnecessarily restrictive.

By restricting relevant studies to those that most closely approximate this size difference,

Chernev excludes many original studies that contribute data that are relevant for assessing the

principal that bigger HWLs on tobacco products are more effective than smaller HWLs. The

studies that provide data on the specific comparison of HWLs that are larger than 50% should

be viewed in light of their consistency with the general pattern of responses to differently sized

HWLs. Indeed, results from my review of the studies herein do not find evidence that there is a

threshold for efficacy, where HWL size would matter only up to a certain point, such as 50%.

Instead, the empirical evidence consistently indicates that each incremental increase in HWL

size corresponds with an increase in consumer attention to HWLs and efficacy of risk

communication. The present review used broader inclusion criteria for relevance in order to

allow for such a determination.

71. Another criterion of relevance that Chernev uses to exclude studies concerns all studies

that “confound the effects of increasing the size of health warnings with other factors, such as the addition of pictures to health warnings” (pg. 15, para 34).125 In this way, Chernev

effectively eliminates all observational studies from consideration. This is not appropriate.

Countries inevitably issue regulations that change both the size and content of HWLs because

these two measures are complimentary and mutually reinforcing. Canada and Uruguay both

changed the content of HWLs when they increased HWL size from 50% of the primary package

surfaces (i.e., to 75% and 80%, respectively). Chernev’s relevance criterion excludes original

empirical studies of consumer responses to these changes. By contrast, the current review

considers these and other observational studies as relevant, even though they do not – indeed,

they cannot – involve experimental control over HWL size independent of other HWL

characteristics.

72. Chernev’s relevance criterion clearly shows his over-reliance on experimental studies to

evaluate causal relationships. In so doing, Chernev underestimates the importance of “external

validity,” which is a fundamental drawback of experimental studies. In other words,

experimental studies can represent what happens under tightly controlled laboratory

conditions; however, these conditions may not adequately represent what happens under the

less well-controlled conditions of real-world exposure to the causal agent of interest (in this

case, differently sized HWLs). For this reason, population-based, observational studies like

those considered in the current review, provide important information regarding effects of

HWLs once consumers are repeatedly exposed to HWLs on cigarette packages in their daily

lives.

73. There is no perfect study design for determining causality, particularly for understanding the effects of national policy decisions. Experimental studies to evaluate national policies would involve randomly allocating people to countries that are equivalent except for the policy of interest, and then following these people over time in order to determine policy effects which is, of course, impossible. Hence, causality should be assessed through examination of evidence across a range of empirical studies on the topic of interest. Results from these studies should be examined in light of adherence to basic principles of conceptual plausibility, statistical reasoning, and threats to study validity. Different study designs contain different strengths and weaknesses. In recognition of these issues, the review I conducted considers evidence from a range of empirical studies, including observational and qualitative studies that do not involve experimental control over HWL characteristics that are unrelated to size. Results from these studies are examined as complementary to studies that experimentally manipulate

HWL size independent from other HWL characteristics. Chernev’s sole reliance on experimental studies fails to recognize the nature of HWL policies, and therefore his review did not adequately assess the entire body of empirical evidence that is relevant to the issue of HWL size.

Validity

74. Chernev’s criterion of validity focuses on “demand effects” or the potential biases introduced by a “respondents’ tendency to guess the purpose of the experiment and answer accordingly” (pg. 15, para 36).125 He then uses this criterion to cast the results of all remaining

“relevant” studies for both measures in doubt. To confirm his point, Chernev mentions how some studies he reviews acknowledge the possible influence of demand effects. However, this

generic criticism can be made of almost any study that involves human participants. It is

common practice for researchers to describe this possible bias, their efforts to try to reduce its

effects, and to interpret its potential effects on study results. Indeed, many of the empirical

studies dismissed by Chernev included standard procedures for reducing the effects of this type

of bias. For example, some experimental studies randomized the order in which differently

sized HWLs were presented and included different types of pictorial HWL content and/or

branding information, so that the focus on HWL size was not clearly apparent to participants.99,

100 In sum, Chernev’s summary dismissal of the validity of the few studies he deems relevant is

not justified.

Sufficiency

75. For his third and final criterion – “sufficiency” – Chernev applies three different

elements: behavioral impact, consistency, and effectiveness.

a. Behavioral impact

76. When considering “behavioral impact,” Chernev includes as sufficient only studies that measure behavioral outcomes that indicate that the “regulation will reduce tobacco consumption (as opposed to influencing only perceptions, memory, beliefs, and intentions and/or influencing brand switching rather than the total consumption across brands)” (pg. 16, para 37).125 Chernev’s criteria for sufficiency appear to be his own rather than reflecting the

rationale or objective of the regulations. As described above, this fundamental flaw affects

nearly all of his criteria, which are inappropriately oriented toward assessing the single

outcome of reducing consumption, not towards Uruguay’s primary aim to inform consumers

about tobacco-related risks.

77. Using the limiting criteria of behavioral impact, Chernev dismisses studies that assess consumer perceptions, beliefs, and intentions, rather than actual behavior. However, consumer perceptions in the form of attitudes and beliefs have a central role in models of health behavior,126-128 communications, 30, 129 and marketing.130 Consumer perceptions are, particularly in the case of evaluating HWLs, critical endpoints in and of themselves (e.g., knowledge of the magnitude and/or range of tobacco-related health effects). Furthermore, many behavioral outcomes are impractical or impossible to measure in the context of an experimental design. Elicitation of smoking cessation behavior through short-term exposure to different packaging and labeling alternatives is likely to be one of those cases. A unique feature of cigarette packaging concerns its ability to repeatedly expose consumers to HWL messages at diverse moments of product purchase and consumption, and at different moments of vulnerability to their messages. Experimental studies that rely on brief exposures to HWLs in order to elicit cessation behavior would be analogous to clinical trials assessing drug effects after administering only 1% of the standard dose. It would be even more difficult to design an experimental study to assess the influence of HWL characteristics on tobacco use initiation amongst youth, as youth are unlikely to exhibit the behavior for years, if ever.

78. By disregarding consumer perception studies, Chernev disregards a mainstay of research used by public health experts and by the tobacco companies themselves. Thousands of corporate documents from the tobacco industry highlight the importance of consumer perceptions. For decades, the tobacco companies have found consumer perception studies directly relevant and informative when developing new products, product designs, and marketing strategies.42, 44 Many tobacco company studies use the same or very similar

protocols and measures to those used in the empirical studies reviewed herein. For example,

many industry protocols involve showing participants images or packages of the product being

tested, asking them to rate or select a package based on specific criteria, such as measures of

appeal. Indeed, the tobacco industry’s marketing strategies have long sought to influence

consumer perceptions in order to recruit and retain smokers.131

b. Consistency

79. Chernev defines consistency, his second criterion for sufficiency, as concerning “the

degree to which these data agree with (as opposed to showing no effect or contradicting) the

proposition that increasing the size of the warning to 80% will reduce smoking” (pg. 17, para

39).125 Again, the objective he posits is misconstrued. Consistency is critical to adequate evaluation of the state of science in an area; however, Chernev’s examples to illustrate the

“inconsistency” of results amount to selective “cherry picking” of discrepant results across a variety of domains without attempting to organize his analysis around any classes of meaningful outcomes. For example, Chernev points to two Canadian studies99, 100 that conclude: “considering all effectiveness indicators, [graphic health warnings] with increased size option B (75%) were unlikely to remain more effective over a number of years than with the current scenario A (50%).” However, Chernev states that these studies “show that increasing the size of the [HWLs] from 50% to 75% did not have an impact on most of the key measures of

effectiveness” (pg. 17, para 40, emphasis added).125 This representation of these studies is off base and incorrect.

80. Contrary to Chernev’s conclusion, the authors of the cited studies find that effectiveness indicators favored the 75% over the 50% HWL size in five of the seven domains of interest. The

two domains for which evidence is less compelling (i.e., smoker image and product imageviii) do

not address the primary objective of the Uruguayan 80% HWL regulation. When considering all

indicators of risk communication and discouragement of smoking (as described in the current

report), 75% HWLs were more effective than 50% HWLs. Furthermore, these results actually

provide consistent evidence for increasingly stronger effects as HWLs were made incrementally

larger than 75% (i.e., 90% and 100%), with the report recommending that HWLs be 90% or

larger to maximize effects. Hence, Chernev misrepresents conclusions from key studies that

even he views as relevant to Uruguay’s 80% HWL regulation. By contrast, my review of the

scientific evidence is organized by the types of outcomes explored, so that consistencies can be

examined logically, systematically, and in relationship to general principles of communication

and how warning labels work.

81. Chernev is selective in his representation of other studies as well. For example, he cites

the Liefeld study115 as providing evidence that the 50% HWL is sufficiently large. However,

Chernev had previously excluded that study as not relevant to his charge because it did not adequately allow for assessment of the 50% versus 80% HWL size difference. Liefeld’s study compared HWLs that occupied 35%, 50% and 60% of the primary package surface, and Liefield’s conclusions regarding the non-significant difference between 50% and 60% HWLs should be interpreted in light of the minimal difference between these two HWL sizes. While this finding is relevant, it should be situated alongside findings from studies where the HWL size

viii These studies examined 38 different indicators that were grouped into seven different sets: (1) Perceived communication impact (5 indicators); (2) Personal persuasiveness (1 indicator); (3) Persuasiveness associated with six social style of smokers (6 indicators); (4) Smoker image (12 indicators); (5) Product image (9 indicators); (6) Emotional impact (4 indicators); (7) Packaging attractiveness (1 indicator). Smoker image (i.e., personality traits of people who smoke the cigarettes with differently sized HWLs) and product image (i.e., attributes of cigarette packs with differently sized HWLs) were less sensitive to size manipulations than indicators in the other domains.

differentials are greater, including when size differentials more directly approximate the change

that resulted from the Uruguayan regulation.

82. To further illustrate his supposed concerns with consistency, Chernev inadequately and

selectively interprets other data that he had also previously ruled out as irrelevant. He states

that the Shanahan and Elliott study81 finds that “the awareness of health warnings on the front and the side of the pack has significantly decreased in 2008 compared to 2000, despite the increase in the size of health warnings and the use of graphic warning messages” (pg. 18, para

42).125 Although this decline was found, Chernev does not mention three key issues that are

critical to interpret these study results: (1) HWL size on the package front increased only

slightly (i.e., from 25% to 30%), and the size of the HWL on the package side remained the

same; (2) awareness of warning information on the front of the package was extremely high

both before (98%) and after (91%) the new HWL policy was implemented; and (3) the HWL size

increase was greater for the back of the package (i.e., from 33% to 90%), and awareness of the

warning information on the back of the package increased significantly (i.e., 63% to 73%).

Hence, where a significant HWL size increase was implemented, awareness of warning

information increased. Where the change in HWL size was minimal (25% to 30%), occupying

less than 50% of the package face, and awareness was already extremely high (and therefore

unlikely to increase further), awareness declined. Chernev does not adequately interpret these

results because he does not contextualize them, excluding from his analysis the key results that

are most relevant to evaluating the Uruguay regulatory decision about HWL size.

83. Chernev also selectively highlights a tangential finding from the Shanahan and Elliot

report regarding an increase in smokers who reported consuming greater quantities of high

nicotine cigarettes. In so doing, he neglects to report on other key outcomes related to

consumer perceptions and behaviors, including the lower prevalence of smoking found after

larger HWLs were implemented. Overall, the examples that Chernev provides under the rubric

of consistency underscore the idiosyncratic nature of his approach, which violates even his own

overly restrictive rules for relevance, misrepresents study results, and fails to employ a

systematic approach to evaluating the consistency of evidence.

c. Effectiveness

84. Chernev’s third criterion of sufficiency – effectiveness – involves assessment of “the relative effectiveness of increasing the size of health warning labels compared to the alternative measures, such as introducing graphic warnings” (pg. 18, para 43).125 In addition to

misconstruing the Uruguayan HWL policy objective, Chernev incorrectly focuses on the impact

of increasing the size of HWL (or requiring a single presentation) over and above that of

alternative measures. Chernev does not contend that increasing the size of HWLs is ineffective.

He cannot because empirical studies consistently show the greater effectiveness of larger

HWLs. Chernev simply argues that some studies show that increasing HWL size may not be the

most effective measure. This is beside the point. By analogy, speed limits may be less effective

than seat belts in preventing injuries from car accidents; nevertheless, speed limits are still a

fundamental regulatory strategy for promoting road safety.

85. Chernev’s effectiveness criterion disregards the fundamental nature of tobacco control

regulations. Tobacco control is most effective as an evolving collection of policies and

programs that work in concert to influence the biological, psychological, and social forces that

affect tobacco-related perceptions and behaviors. Governments therefore often

simultaneously implement a range of tobacco control strategies. For example, it is common

practice for countries to issue regulations that change both the size and content of HWLs

because these two measures are complimentary and mutually reinforcing. A large HWL is less

effective if it includes bland imagery or text, just as a strong HWL content is less effective if it is

small or placed on an inconspicuous package surface.

86. The data that Chernev marshals to support his point of view regarding effectiveness also

illustrate his biased selection and inadequate interpretation of prior research. He focuses on

two Canadian reports,91, 92 stating that “When asked to name alternative options for reducing

smoking prevalence, only 11% of the adult respondents and 19% of the youth respondents

identified increasing the size of the warning label as an effective means for reducing smoking

prevalence” (pg. 18, para 45).125 While this is true, low percentages would be expected for this

kind of unprompted, “top of mind” response regarding a topic about which people are unlikely

to have given much thought. Even the most frequent response of changing pictorial content

was mentioned by less than a third of adults (29%) and youth (29%). Changing HWL size was

the third most often-mentioned suggestion for improving HWL efficacy out of more than 30

types of responses that researchers coded for both adults and youth. As such, increasing the

size of HWLs was amongst the top 10% of suggested improvements for HWLs. Chernev ’s

representation of the results from this part of study does not consider this additional

information, which should serve as context for interpreting the data that he presents.

87. Chernev also misrepresents other important information from these two Canadian studies. He describes how, “when asked to rank order the effectiveness of four potential ways to improve health warnings, respondents indicated that they believed increasing the size of

49 warning labels to be the least effective way to improve health warning labels, compared to all of the alternative options” (pg. 18, para 45).125 However, these studies did not ask participants to rank order these options. Instead, participants rated the effectiveness of each option, one at a time.ix Although ratings of perceived efficacy were somewhat lower for increasing HWL size than the three other options, the majority of youth and adults alike believed each of these measures would be effective. Furthermore, one-third to one-half of youth and adults believed that each of the four measures, including increasing HWL size, would be “very effective.” To illustrate his point, Chernev again misrepresents study results so that they produce an inappropriately pessimistic portrayal of the effects of increasing HWL size.

88. In summary, Professor Chernev’s criteria for excluding study after study are unnecessarily restrictive and lack a solid scientific rationale. In fact, Chernev’s criteria would dismiss a majority of the studies that his clients — the tobacco companies — have conducted to understand the effects of tobacco packaging on their potential and existing consumers.

Furthermore, Chernev not only incorrectly represents the objectives of the Uruguayan regulations, he misrepresents and inappropriately interprets results from the few key studies that he deems relevant. For these reasons, his expert review is deeply flawed.

ix A rank order task involves putting a list of options in sequential arrangement according to some criterion for evaluation, such as ordering from best to worst or most to least effective. Participants evaluate options relative to one another; however, ranking does not allow determination of the magnitude of the perceived difference between options. A rating task involves evaluating each item individually, one at a time, according to some evaluation criterion. An advantage of rating over ranking tasks is that rating allows participants to give the same rating to more than one option if they wish (which cannot be done with ranking) and it allows determination of the magnitude of difference between options.

V. Conclusions

89. This report has provided an overview of the empirical evidence assessing the impact of

increasing the size of health warning labels (HWLs) on tobacco packaging. The evidence, both

before and after Uruguay adopted its 80% HWL regulation, indicates that increasing HWL size

enhances HWL effectiveness and that, as a consequence, the largest HWLs are the most

effective.

90. The studies considered in this review were conducted across diverse populations (e.g.,

adolescents and adults; nonsmokers and smokers; smokers who do and do not want to quit;

respondents from different countries; respondents from the same country over time) and

involved an array of different protocols (e.g., ratings of single packages; direct comparison

between packages; consumer perceptions before and after implementation of larger HWLs;

focus group discussions). Outcomes were assessed for key conceptual domains that are

commonly used to assess the effectiveness of communication campaigns, from exposure to

HWLs and message attention to communication of risk and behavior.

91. Overall, the results are consistent across diverse study populations and methods,

providing convincing evidence that HWLs covering 80% of the package are more effective than

HWLs that cover 50% of the package.

92. Capturing attention is the critical first step towards effective communication according

to general theories of communication and specific applications of these theories to warnings.

The evidence reviewed provides substantial and consistent support for the basic principle that

larger HWLs, including those that are larger than 50%, are more effective in capturing attention than smaller HWLs. The greater salience of larger HWLs reminds smokers of the risks that

51 tobacco use poses. Perhaps more important is the evidence that larger HWLs attract greater attention among adolescents who do not consume tobacco. It is critical to communicate risks to youth before they try and become addicted to tobacco use.

93. After capturing attention, the next goal is for the HWL to effectively communicate risk information. In other words, the best HWLs will impact the extent to which someone truly appreciates the risks they incur by consuming the product. The vast majority of experimental, observational, and qualitative studies evaluated herein provided support for the contention that larger HWLs are more effective in communicating risk. Several of the experimental studies on this topic were carried out amongst Canadians who, at the time when the studies were conducted, had been exposed for a number of years to pictorial HWLs that covered 50% of the package. In this regard, the conditions of natural exposure in Canada were similar to the

Uruguayan context before the 80% HWL regulation was adopted. Consistent with observational data on the implementation of larger HWLs up to 50% in other countries, observational data from Uruguay from before and after implementation of the 80% HWL regulation showed that smokers more frequently processed HWL messages about risk. The conclusions from these and the other related studies reviewed above indicate that HWLs that cover 80% of the package better communicate risks than those that cover 50%.

94. Finally, we reviewed studies that have addressed the issue of whether larger HWLs are more effective in eventually discouraging smoking. Experiments that evaluated adolescents’ and adult smokers’ perceptions favored the greater efficacy of larger HWLs, including when

HWLs were increased to sizes that were larger than 50% of the package. Observational studies have consistently found more frequent thoughts about quitting and quit-related behaviors

52 when larger HWLs were implemented, including among Uruguayan smokers after implementation of the 80% HWL regulation. Moreover, when consumers have been asked how to make HWLs more effective, they inevitably point to making them bigger.

95. In addition to this review, all prior literature reviews of the evidence available regarding the effect of increasing HWL size, except those funded by the tobacco industry, have come to the same conclusion reached here: the evidence shows that the largest HWLs are the most effective. Nine literature reviews examining the available evidence on the effects of larger

HWLs have been conducted by government agencies,75, 81 nongovernmental organizations,76, 77 independent research organizations,78-80 and academic researchers.37, 82, 83 One review concluded, for example, that:

“The evidence shows that a warning message should be optimally 100% and at least 50% of the facial area (excluding borders) to maximise the effectiveness of the warning.”79

96. The prior reviews of scientific evidence consistently conclude that larger HWLs are more effective than smaller HWLs, including in all three studies that specifically addressed the issue of whether HWLs that are larger than 50% are more effective than smaller HWLs.76, 77, 79

97. Given the evidence, it is my opinion that Uruguay’s decision to increase the size of HWLs to 80% of the package was a logical and reasonable approach to more effectively communicate with youth and adult smokers about the range of fatal diseases that tobacco causes, as well as about the severity of those risks.

James F. Thrasher September 15, 2014

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60 93. Borland R, Yong H-H, Wilson N, et al. How reactions to cigarette packet health warnings influence quitting: Findings from the ITC 4 country survey. Addiction 2009; 104: 669-75. (JT-055) 94. Hammond D, Fong GT, McDonald PW, Brown S, Cameron R. Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers. American Journal of Public Health 2004; 94(8): 1442-5. (R-168) 95. Fathelrahman AI, Li L, Borland R, et al. Stronger pack warnings predict quitting more than weaker ones: finding from the ITC Malaysia and Thailand surveys. Tobacco Induced Diseases 2013; 11: 20. (JT-056) 96. Yong H-H, Borland R, Thrasher J, et al. Mediational pathways of the impact of cigarette warning labels on quit attempts. Health Psychology in press. JT-057 97. Wegner D. Ironic process of mental thought. Psychology Review 1994; 101(34-52). (JT- 058) 98. Cragg R, & Dawson Ltd.,. Health warnings on cigarette and tobacco packs: Report on research to inform European standardization. London, 1990. (R-125) 99. Les Études de Marché Créatec. Quantitative study of Canadian youth smokers and vulnerable non-smokers: Effects of modified packaging through increasing the size of warnings on cigarette packages. Montreal: prepared for Health Canada, 2008. (C-225) 100. Les Études de Marché Créatec. Quantitative study of Canadian adults: Effects of modified packaging through increasing the size of warnings on cigarette packages. Montreal: prepared for Health Canada, 2008. (C-224) 101. Environics Research Group. Testing the size of cigarette package health warnings: An online survey of Canadians, Study 2. Toronto: Prepared for Health Canada, 2011. (JT- 059) 102. Wakefield M, Germain D, Durkin S, Hammond D, Goldberg M, Borland R. Do larger pictorial health warnings diminish the need for plain packaging of cigarettes? Addiction 2012; 107: 1159–67. (JT-060) 103. Hammond D, White C, Anderson W, Arnott D, Dockrell M. The perceptions of UK youth of branded and standardized, ‘plain’ cigarette packaging. European Journal of Public Health 2014; online(24): 4. (JT-061) 104. O'Hegarty M, Pederson LL, Nelson DE, Mowery P, Gable JM, Wortley P. Reactions of young adult smokers to warning labels on cigarette packages. American Journal of Preventive Medicine 2006; 30(6): 467-73. (R-21) 105. Witte K, Allen M. A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Education & Behavior 2000; 27: 608-32. (JT-062) 106. Durkin S, Brennan E, Wakefield M. Mass media campaigns to promote smoking cessation among adults: an integrative review. Tobacco Control 2012; 21(2): 127-38. (JT- 063)

107. Borland R, Hill D. Initial impact of the new Australian tobacco health warnings on knowledge and beliefs. Tobacco Control 1997; 6: 317-25. (JT-064) 108. Durkin S, Wakefield M. Maximising the impact of emotive anti-tobacco advertising: Effects of interpersonal discussion and program placement. Social Marketing Quarterly 2006; 12(3): 3-14. (JT-065) 109. Southwell BG, Yzer MC. The roles of interpersonal communication in mass media campaigns. In: Beck CS, ed. Communication Yearbook 31 New York: Erlbaum; 2007: 419–62. (JT-066) 110. Van den Puttte B, Yzer MC, Southwell BG, De Bruijn G-J, Willemsen MC. Interpersonal communication as an indirect pthway for the effect of antismoking media content on smoking cessation. Journal of Health Communication 2011; 16: 470-85. (JT-067) 111. Environics Research Group. Testing the size of cigarette package health warnings: An online survey of Canadians, Study 1. Toronto: Prepared for Health Canada, 2011. (JT- 068) 112. Environics Research Group. Testing the size of cigarette package health warnings: An online survey of Canadians, Study 3. Toronto: Prepared for Health Canada, 2011. (JT- 069) 113. Environics Research Group. Testing the size of cigarette package health warnings: An online survey of Canadian youth. Toronto: Prepared for Health Canada, 2011. (C-232) 114. Environics Research Group. Reactions to cigarette packaging formats. Toronto, Canada: prepared for Health Canada, 1999. (R-142) 115. Liefeld JP. The relative importance of the size, content & pictures on cigarette package warning messages. . Guelph, Canada: Department of Consumer Studies, University of Guelph, 1999. (R-8) 116. Hammond D, Fong GT, MacDonald P, Cameron R, Brown K. Impact of graphic Canadian warning labels on adult smoking behavior. Tobacco Control 2003; 12: 391-5. (R-17) 117. Hammond D, McDonald PW, Fong GT, Brown KS, Cameron R. The impact of cigarette warning labels and smoke-free bylaws on smoking cessation. Canadian Journal of Public Health 2004; May-June: 201-4. (R-164) 118. Cavalcante TM. Labelling and packaging in Brazil. Geneva, Switzerland: Organizacion Mundial de Salud, 2003. (R-14) 119. Young JM, Stacey I, Dobbins TA, Dunlop S, Dessaix AL, Currow DC. Association between tobacco plain packaging and Quitline calls: A population-based, interrupted time-series analysis. Medical Journal of Australia 2014; 200: 29–32. (R-286) 120. Czuka D, Bhatti F. Canada’s implementation of graphic health warning labels. North American Consortium of Quitlines Conference; 2012. (JT-070)

62 121. Huang J, Chaloupka F, Fong G. Cigarette graphic warning labels and smoking prevalence in Canada: a critical examination and reformulation of the FDA regulatory impact analysis. Tobacco Control in press. (JT-071) 122. Azagba S, Sharaf M. The effect of graphic cigarette warning labels on smoking behavior: Evidence from the Canadian experience. Nicotine & Tobacco Research 2013; 15(3): 708- 17. (JT-072) 123. Gospodinov N, Irvine I. Global health warnings on tobacco packaging: Evidence from the Canadian experiment. Topics in Economic Analysis & Policy 2004; 4(1): 1-23. (JT-073) 124. O'Hegarty M, Pederson LL, Yenokyan G, Nelson DE, Wortley P. Young adults' perceptions of cigarette warning labels in the United States and Canada. Preventing Chronic Disease 2007; 4(2): A27. (JT-074) 125. Chernev A. Report on the relevance, validity and sufficiency of the empirical evidence cited by the Uruguayan government in support of the single presentation regulation and the 80% graphic warning regulation, 2014. (CWS-009) 126. IOM. Speaking of health: Assessing health communication strategies for diverse populations. Washington DC: National Academy of Sciences, Institute of Medicine; 2002. (JT-075) 127. Swinehart JW. Health behavior research and communication campaigns. In: Gochman DS, ed. Handbook of Health Behavior Research, IV: Relevance for professionals and issues for the future. New York: Plenum Press; 1997: 351-73. (JT-076) 128. Hornik R, editor. Public health communication: Evidence for behavior change. Mahwah, NJ: Lawrence Erlbaum; 2002. (JT-077) 129. McQuail D. McQuail's mass communication theory. 5th ed. London: Sage; 2005. (JT-078) 130. Hawkins D, Best R, Coney K. Consumer behavior: Building marketing strategy. Boston, MA: McGraw-Hill; 2001. (JT-079) 131. Brandt AM. The cigarette century: The rise, fall, and deadly persistence of the product that defined America. New York: Basic Books; 2007. (JT-080)

63 Appendix 1

JAMES F. THRASHER [email protected] (803)777-4862 EDUCATION

PhD University of North Carolina, Chapel Hill May 2005 Health Behavior & Health Education School of Global Public Health

MS State University of New York, Buffalo May 2000 Epidemiology

MA State University of New York, Buffalo May 1994 Cultural Anthropology

BA University of North Carolina, Chapel Hill May 1990 Psychology

CURRENT POSITIONS & AFFILIATIONS Associate Professor 2012-present Department of Health Promotion, Education and Behavior 800 Sumter Street, Room #215 Arnold School of Public Health University of South Carolina Columbia, SC 29208 USA

Researcher and Visiting Professor 2003-present Instituto Nacional de Salud Pública Av. Universidad #655, Col. Sta. Ma. Ahuacatitlán Cuernavaca, Morelos CP 62100 México

Research Affiliate 2007-present Walker Institute of International and Area Studies University of South Carolina, Columbia, SC, USA

Research Affiliate 2008-present Center for Research in Nutrition & Health Disparities University of South Carolina, Columbia, SC, USA

Faculty Affiliate 2008-present Prevention Research Center University of South Carolina, Columbia, SC, USA JF THRASHER

Affiliate Researcher 2012- present Hollings Cancer Center, Cancer Prevention and Control Program Medical University of South Carolina Charleston, SC, USA

Adjunct Associate Professor 2012- present Department of Public Health & Health Systems University of Waterloo, Canada

PAST POSITIONS Assistant Professor Department of Health Promotion, Education & Behavior 2007-2012 University of South Carolina, Columbia, SC, USA Post-doctoral Research Associate Institute for Health Research and Policy, University of Illinois, Chicago & 2005-2006 Instituto Nacional de Salud Pública, Cuernavaca, México

Research Policy Analyst I 2001-2005 Public Health Economics & Policy Research Program Research Triangle Institute, International, RTP, NC, USA

Fulbright Fellow 2003 Institute of International Education, New York & Instituto Nacional de Salud Pública, Cuernavaca, México

National Cancer Institute Pre-Doctoral Fellow 2001-2003 Lineberger Comprehensive Cancer Center University of North Carolina, Chapel Hill, USA

Royster Society Fellow 2000-2005 The Graduate School University of North Carolina, Chapel Hill, USA

Health Communication Fellow 1999-2000 Centers for Disease Control and Prevention Atlanta, GA, USA

National Cancer Institute Training Fellow & Research Assistant 1998-1999 Roswell Park Cancer Institute Buffalo, NY, USA

JF THRASHER

GRANTS – ACTIVE (UNDERLINED = STUDENT/ADVISEE) Title: Building evidence for effective and sustainable cigarette warning label policy Funding agency: NCI/NIH (R01 CA167067) PI: James F. Thrasher Amount: $2,701,557 Dates: 7/2012 – 4/2017 Role: Primary Investigator (30% effort) – Design and analyze post-market quasi-experimental studies and pre-market experimental studies to assess pictorial warning label impacts and their wear out among adult smokers in Australia, Canada, Mexico, and the US. Results aim to inform policy development around warning label content, design, size and rotation frequency. Title: Cinema smoking and youth smoking in Latin America Funding agency: Fogarty International Center & NCI/NIH (R01 TW009274) PI: James F. Thrasher (with James D. Sargent) Amount: $1,643,491 Dates: 8/2012 – 7/2017 Role: Primary Investigator (15% effort) – Build research capacity to monitor tobacco and other risk behavior content in nationally produced films in Mexico and Argentina; study the impact of exposure to movie content and tobacco marketing on youth smoking; inform policy development in this area.

Title: Design, implementation and evaluation of a national quitline registry to enhance smoking cessation in the United States. Funding agency: CDC (3U48DP001936-05S2) PI: James F. Thrasher (with Scott Strayer) Amount: $199,973 Dates: 9/2013 – 9/2014 Role: Primary Investigator (5% effort) – Conduct needs assessment for establishment of a national registry of smokers who call smoking cessation quitlines, in order to allow for sustained followup and interventions; design and implement a registry for use with multiple states; pilot a communication intervention through the registry. Title: Enhancing the effectiveness of cigarette package health warnings in Indonesia Funding agency: Institute for Global Tobacco Control, Johns Hopkins University PI: Dien Anshari (PhD student) Amount: $109,342 Dates: 1/2014 – 12/2014 Role: Co- Investigator (2% effort) – Help PhD student with the design and analysis of pre-market experimental studies to assess efficacy of different pictorial warning label content among adult smokers and youth in Indonesia. Coordination with Ministry of Health officials aims to ensure acceptance of study recommendations for the next round of warning content.

JF THRASHER

Title: Waterpipe tobacco smoking among college students: Understanding attitudes and intentions using a discrete choice experiment Funding agency: USC Provost grant PI: Ramzi Salloum, PhD Amount: $14,996 Dates: 5/2014 – 9/2015 Role: Co-Investigator (2% in kind) - Describe the prevalence and correlates of waterpipe tobacco smoking among student tobacco smokers across five USC campuses, and conduct experiments to determine the effects of price increases and warning labels on waterpipe tobacco consumption.

Title: Tobacco packaging and labeling policies: Expanding the evidence on novel policies PI: David Hammond, PhD (P01 PI – K. Michael Cummings, PhD) Funding agency: National Cancer Institute, National Institutes of Health (P01 CA138389) Amount: Subcontract to USC for $34,518 Date: 09/09 – 08/14 Role: Co-Investigator/USC Primary Investigator (5% effort) – Develop survey translation and pretesting protocols; analyze data from experiments to determine the most effective health warning labels and the influences of cigarette packaging on risk perceptions in seven countries (Mexico, China, India, Bangladesh, Germany, South Korea, and the US).

Title: Tobacco policy evaluation in low- and middle-income countries: The ITC Surveys - Data Management Core PI: Mary Thompson, PhD (P01 PI – K. Michael Cummings, PhD) Funding agency: National Cancer Institute, National Institutes of Health (P01 CA138389) Amount: Subcontract to USC for $107,451 Date: 09/09 – 08/14 Role: Co-Investigator/USC Primary Investigator (15% effort) – Develop translation and pretesting protocols for survey instruments; conduct analyses; write papers for publication

Title: Effectiveness of tobacco control in high vs. low income countries - Administrative supplement PI: K. Michael Cummings, PhD Funding agency: National Cancer Institute, National Institutes of Health (P01 CA138389) Amount: Subcontract to USC for $78,457 Date: 08/12 – 07/14 Role: Co-Investigator/USC Primary Investigator (5% effort) – Develop, pretest and analyze data from surveys of US youth and adults to determine the impacts of tobacco product packaging and health warning labels; conduct fMRI study to cross-validate self-report measures of responses to pictorial health warning labels.

Title: Childhood obesity prevention in South Carolina communities PI: Sonya Jones, PhD Funding agency: United States Department of Agriculture Amount: $2,401,772

JF THRASHER

Date: 05/12 – 04/17 Role: Co-Investigator (5%-10% effort) – This project aims to increase the capacity of South Carolina community leaders and the University of South Carolina (USC) faculty and students to develop practice-based evidence for community-based childhood obesity prevention.

Title: Evaluating the impact of mandatory nutrition information on menus PI: David Hammond, PhD Funding agency: National Cancer Institute, National Institutes of Health (R01 CA169045) Amount: $637,729 Date: 08/13 – 07/15 Role: Co-Investigator (5% effort) – This project uses a naturalistic, quasi-experimental design which compares nutrition-related perceptions and eating behavior of restaurant patrons in jurisdictions with and without mandatory nutrition information on menus (e.g., calories of meal).

Title: Innovative messaging on tobacco control policies targeting diverse populations Funding agency: Centers for Disease Control and Prevention (3U48DP001909-04S1) PI: Carla Berg, PhD Amount: $128,204 Dates: 10/2012 – 9/2014 Role: Consultant – assist with design and analysis of data from experiments on innovative messages to promote tobacco control policies among diverse populations in the Southeastern US.

Title: International tobacco policy survey PI: Geoff Fong, PhD Funding agency: National Cancer Institute, National Institutes of Health (R01 CA100362) Amount: $562,763 Date: 09/09 – 08/14 Role: Consultant (2% effort) – Provide analytic support around cross-country comparisons regarding policy effects, particularly among disadvantaged groups and Latino smokers

Title: Exploring current smokers’ interest in using smokeless tobacco products PI: Richard O’Connor, PhD Funding agency: National Cancer Institute, National Institutes of Health (R01 CA141609) Amount: Subcontract to USC for $134,096 Date: 09/09 – 08/14 Role: Co-Investigator/USC Primary Investigator (10% effort) – Help develop and pretest study protocols; conduct analyses; write papers for publication

Title: Nutritional labeling on menus in Canada and the United States: Evidence to inform policy. PI: David Hammond, PhD Funding agency: Canadian Institute for Health Research Amount: $200,000 Dates: 03/ 2012 – 03/2014

5 JF THRASHER

Role: Co-Investigator – Contribute to protocols and papers based on results

Title: Modeling Tobacco Control Policy in Mexico: A Tool for Public Health PI: K Michael Cummings, PhD Funding agency: Center for Global Health, Medical University of South Carolina Amount: $20,000 Dates: 09/2013 – 08/2014 Role: Consultant – Analyze data for use in simulation models; contribute to workshop on simlulation modeling; contribute to papers on results

Title: Addressing acquiescence: Reducing survey error to promote Latino health PI: Rachel Davis, PhD Funding agency: National Cancer Institute, National Institutes of Health (R01 CA172283) Amount: $2,624,172 Date: 07/13 – 04/18 Role: Co-Investigator (5% effort) – Help develop survey to identify factors associated with acquiescent response style measurement error among diverse Latino survey respondents; provide input into the study design to test methods to reduce acquiescence among Latinos.

Title: Validation of instruments to assess ethnic discrimination among Arab Israelis Funding agency: USC Provost grant PI: Amira Osman (PhD student) Amount: $14,996 Dates: 5/2013 – 9/2014 Role: Co-Investigator (2% in kind) – Conduct qualitative pretesting and quantitative analysis of questions to assess ethnic discrimination to determine measurement validity.

GRANTS – COMPLETED

Title: Validation of measurement approaches to assess the impact of pictorial warning labels on cigarette packaging Funding agency: USC Provost grant PI: James F. Thrasher Amount: $19,557 Dates: 7/2012 – 6/2014 Role: Primary Investigator (5% effort) - Assess the reliability and validity of self-reported measures of the affective, cognitive, and behavioral impacts of pictorial HWLs using multiple datasets.

Title: Using a novel experimental approach with eye tracking to examine how different front-of-package labels influence parents’ selection of foods and beverages for their children PI: Christine Blake, PhD Funding agency: University of South Carolina Provost Grant Amount: $14,997

6 JF THRASHER

Dates: 05/ 2013 – 04/2015 Role: Co-Investigator - Develop and pretest protocols; contribute to papers on results

Title: Impact of tobacco control policies in a cohort of adult smokers in Mexico Funding: Mexican National Council on Science and Technology (Salud-2007-C01-70032) PI: Edna Arillo-Santillán Amount: $4,746,471 Mexican Pesos (approximately $439,500 USD) Dates: 7/2008 – 9/2012 Role: Co-Primary Investigator – Expand and follow up over three years a cohort of adult smokers to determine tobacco control policy and communication impacts during rapid policy uptake

Title: Partnering with media and a vaccination program to improve infant and young child feeding PI: Eva Monterrosa, PhD Funding: Gates Foundation, Alive & Thrive program Amount: $100,000 Date: 09/01/10 – 08/31/12 Role: Co-Investigator – Provide input into formative and impact evaluation of media component in a multi-level intervention

Title: The impact of regulating nutritional information on menus: evidence to inform policy PI: David Hammond, PhD Funding: Canadian Cancer Society Research Institute Amount: $281,549 Date: 09/10 – 08/12 Role: Co-Investigator/USC Primary Investigator (2% effort) – Develop and pretest protocols; contribute to papers on results

Title: Assessing and increasing the effectiveness of cigarette pack warnings in Mexico PI: James Thrasher, PhD Funding: Bloomberg Global Initiative to Reduce Tobacco Use & the International Union against Tuberculosis & Lung Disease (Mexico 7-01) Amount: $334,221 Date: 10/10 – 03/12 Role: Primary Investigator (35% effort) – Conduct pre- and post-market assessments of pictorial warning label impacts among adult smokers and youth, to inform policy development around future warning label content, design, size and rotation frequency.

Title: Assessing the impact of pictorial health warning labels on cigarette packages: Implications for FDA policy development and smoking-related health disparities PI: James Thrasher, PhD Funding: South Carolina Clinical & Translational Research Institute, NIH/NCRR (UL1RR029882) Amount: $49,999 Date: 10/10 – 03/12

JF THRASHER

Role: Primary Investigator (5% effort) – Determine cognitive and affective impacts of different warning labels, including moderation of warning label effects by SES, ethnicity and health literacy.

Title: Assessing the influence of brand, product and packaging considerations on the perceived risk of tobacco products. (Administrative supplement for Effectiveness of tobacco control in high vs. low income countries) PI: K. Michael Cummings Funding: National Cancer Institute, National Institutes of Health (P01 CA138389) Amount: $200,000 Date: 09/10 – 08/11 Role: Co-Investigator/USC Primary Investigator (5% effort) – Contribute to protocol development; manage data collection in one site; conduct analyses; write papers for publication

Title: El cigarro consume a tus hijos: Evaluation of a mass media campaign to accompany pictorial health warnings on cigarette packs in Mexico PI: James Thrasher, PhD Funding: Bloomberg Global Initiative to Reduce Tobacco Use, World Lung Foundation and the International Union against Tuberculosis & Lung Disease Amount: $400,000 Date: 04/10 – 03/11 Role: Primary Investigator (5% effort) – Design study and disseminate results on the evaluation of a media campaign designed to link to the initial pictorial health warning labels in Mexico

Title: Developing a model of parent decision making to assess the impact of labels on demand for children’s beverages PI: Christine Blake, PhD Funding: Uni of South Carolina Center for Research in Nutrition and Health Disparities Amount: $8,200 Date: 07/2010 – 12/2011 Role: Co-Investigator (2% effort) – Design survey, stimuli and experimental auction protocols

Title: Communications and coalition building across civil society to promote tobacco control policy in 12 Mexican cities Funding: Bloomberg Global Initiative to Reduce Tobacco Use & Tobacco Free Kids (Mexico 4-1) Amount: $487,000 Dates: 4/2009 – 3/2012 Role: Consultant (10% effort) – Help disseminate media-advocacy workshop; evaluate coalition-building and earned media training to promote tobacco control policies in major Mexico cities

Title: South Carolina Cancer Prevention and Control Research Network (SCCPCRN) PI: James Hebert, PhD Funding: Centers for Disease Control & Prevention, Special Interest Project Amount: $180,000

JF THRASHER

Date: 10/09 – 04/11 Role: Investigator (2% effort) – Participate in network of cancer prevention specialists

Title: Cigarette warning label policy and trajectories of cognitive processing: A latent curve approach to assessing individual variation and its behavioral impacts PI: James F. Thrasher, PhD Funding: Roswell Park Cancer Institute, National Cancer Institute (P50 CA111236, seed grant) Amount: $25,000. Dates: 2/2009-1/2010 Role: Primary Investigator (5% effort) – Apply Latent Growth Curve modeling to six waves of panel data to determine how smokers respond over time to different warning label policies

Title: A mass media campaign to promote smoke-free policy in Mexico City PI: James F. Thrasher, PhD Funding: Bloomberg Global Initiative to Reduce Tobacco Use, Union against Tuberculosis & Lung Disease (Mexico 02-2) Amount: $1,076,996. Date: 4/2008 – 10/2009 Role: Primary Investigator (30% effort) – Design and evaluate a social marketing campaign to promote norms and attitudes related to compliance with smoke-free policies in Mexico City

Title: Comprehensive smoke-free legislation in Mexico City: Evaluation & dissemination of results PI: James F. Thrasher, PhD Funding: Global Smokefree Partnership Amount: $10,000 Date: 6/2009 – 10/2009 Role: Primary Investigator – Conceive and disseminate Spanish- and English-language report on the evaluation of comprehensive smoke-free policy in Mexico City.

Title: Estimating the impact of alternative warning labels on cigarette demand in the United States: Evidence from experimental auctions PI: Matthew Rousu, PhD Funding: Robert Wood Johnson Foundation (RWJF 22-00-25528) Amount: $99,000 Dates: 10/2008 – 9/2009 Role: Co-Primary Investigator (25% effort) – Developed protocols for estimating demand reduction associated with different warning label sizes and presentations on cigarette packages

Title: Material development and capacity building for tobacco policy media advocacy in Mexico Funding: Bloomberg Global Initiative to Reduce Tobacco Use, Union against Tuberculosis & Lung Disease (Mexico 01-6) Co-PI: Edna Arillo-Santillán Amount: $261,327

JF THRASHER

Dates: 8/2007 – 7/2009 Role: Co-Primary Investigator (15% effort) –Adapt media advocacy principles and materials to Mexico through stakeholder analysis, opinion surveys and message testing

Title: How smokers from different countries interpret tobacco survey questions: Ensuring valid cross- national comparison of tobacco policy impacts Funding: Roswell Park Cancer Institute / National Cancer Institute (P50 CA111236, seed grant) PI: James F. Thrasher, PhD Amount: $50,850 Dates: 3/2007-2/2008 Role: Primary Investigator (10% effort) – Develop and coordinate mixed methods study to determine equivalence of measurement across cultural and linguistic groups in 6 countries

Title: Implementation and evaluation of a tobacco intervention in secondary schools from ten Mexican states Funding: Mexican National Council on Science and Technology (Salud-2003-C01-78). PI: Edna Arillo-Santillán Amount: $1,000,000 Mexican Pesos (approximately $100,000 USD). Dates: 6/2004 – 12/2007 Role: Co-Investigator – Assist in study and survey design to assess curriculum to prevent smoking among Mexican middle school students

Title: Denormalization of tobacco products, smoking behavior, and the tobacco industry in Mexico Funding: Roswell Park Cancer Institute / National Cancer Institute (P50 CA111236, seed grant) PI: James F. Thrasher, PhD Amount: $25,000 Dates: 7/2006-6/2007 Role: Primary Investigator – Evaluate tobacco policy impacts through surveying a representative sample of 1081 adult smokers in 4 major Mexican cities

Title: Evaluating tobacco policy in Uruguay Funding: Roswell Park Cancer Institute / National Cancer Institute (P50 CA111236, seed grant) PI: Eduardo Bianco Amount: $25,000 Dates: 7/2006-6/2007 Role: Co-Investigator – To develop study and survey design to evaluate tobacco policy impacts through surveying a representative sample of 1000 adult smokers in Montevideo, Uruguay

Title: The International Tobacco Control Policy Evaluation Project: A pilot study among Mexican adult smokers Funding: University of Illinois, Chicago, Cancer Education & Career Development Program / National Cancer Institute (R25-CA57699) PI: James F. Thrasher, PhD

JF THRASHER

Amount: $45,673 Dates: 7/2005-12/2006 Role: Primary Investigator – Adapt and validate survey questions through focus groups, committee translation methods, cognitive interviewing, pilot survey administration. Coordinate survey in a representative sample of 1081 adult smokers in four major Mexican cities

Title: Development and implementation of a tobacco intervention for secondary schools in Mexico Funding: Initiative for Cardiovascular Health Research in Developing Countries, WHO & Global Forum for Health Research PI: Edna Arillo-Santillán Amount: $75,000 Dates: 11/2004 – 12/2006 Role: Co-Investigator – Assist in curriculum development, piloting and design of intervention study to prevent tobacco use among Mexican secondary students

Title: How does targeting industry attitudes prevent smoking? PI: James F. Thrasher, PhD Funding: Center for Health Promotion & Disease Prevention, Centers for Disease Control & Prevention, & University of North Carolina, Chapel Hill Amount: $5,000 Dates: 8/2004 – 5/2005 Role: Primary Investigator – Conduct data analyses to assess the role of trust in tobacco prevention campaign to prevent smoking by fostering negative perceptions of the tobacco industry

Title: Truth, trust, and smoking PI: James F. Thrasher, PhD Funding: Tobacco Use Prevention Training Program, American Legacy Foundation & University of North Carolina, Chapel Hill Amount: $1,500 Dates: 8/2003 – 7/2004 Role: Primary Investigator – Analyze interviews with Mexican university students about their perceptions of smoking, the tobacco industry, and other large companies

Title: Smoking, advertising, & trust among Mexican youth PI: James F. Thrasher, PhD Funding: Fulbright Program, Institute of International Education, NY Amount: $10,000 Dates: 4/2004 – 12/2004 Role: Primary Investigator – Conduct mixed methods interviews and message testing with Mexican university students regarding smoking risks, the tobacco industry, and other large companies

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PEER-REVIEWED PUBLICATIONS (UNDERLINED = STUDENT/ADVISEE)

Rousu MC, Marette S, Thrasher JF, Lusk JL. The economic value to smokers of graphic warning labels on cigarettes: Evidence from combining market and experimental auctions data. Journal of Economic Behavior & Organization. In press.

Hall MG, Fleischer NL, Reynales-Shigematsu LM, Arrillo-Santillan E, Thrasher JF. Increasing availability and consumption of single cigarettes: Trends and implications for smoking cessation from the ITC Mexico Survey. Tobacco Control. In press.

Fleischer NL, Thrasher JF, Sáenz de Miera Juárez B, Osman A, Reynales-Shigematsu LM, Arillo- Santillán E, Siahpush M, Fong GT. Neighborhood deprivation and smoking behavior in Mexico: Findings from the ITC Mexico Survey. Tobacco Control. In press.

Hitchman S, Fong GT, Zanna MP, Thrasher JF, Chung-Hall J, Siahpush M. Socioeconomic status and smokers' number of smoking friends: Findings from the International Tobacco Control (ITC) Four Country Survey. Drug & Alcohol Dependence. In press.

Thrasher JF, Osman A, Moodie C, Hammond D, Bansal-Travers M, Cummings KM, Borland R, Yong H- H, Hardin J. Promoting cessation resources through cigarette package warning labels: A longitudinal survey with adult smokers in Australia, Canada and Mexico. Tobacco Control. In press.

Huang L, Thrasher JF, Jiang Y, Li Q, Fong GT, Chang Y, Walsemann KA, Friedman DB. Impact of the “Giving cigarettes is giving harm” campaign on knowledge and attitudes of Chinese smokers. Tobacco Control. In press. doi:10.1136/tobaccocontrol-2013-051475

Swayampakala K, Thrasher JF, Hammond D, Yong HH, Bansal-Travers M, Krugman D, Brown A, Borland R, Hardin J. Pictorial health warning label content and smokers’ understanding of smoking-related risks – A cross-country comparison. Health Education Research. In press.

Salloum RG, Osman A, Masiak W, Thrasher JF. How popular is waterpipe tobacco smoking? Findings from Internet search queries. Tobacco Control. In press.

Partos TR, Borland R, Thrasher JF, Li L, Yong HH, O’Connor RJ, Siahpush M. The predictive utility of micro indicators of concern about smoking: Findings from the International Tobacco Control 4- country study. Addictive Behaviors. In press.

Yong HH, Borland R, Thrasher JF, Thompson ME, Nagelhout G, Fong GT, Hammond D, Cummings KM. Mediational pathways of the impact of cigarette warning labels on quit attempts: An application of the International Tobacco Control (ITC) Conceptual Model. Health Psychology. In press.

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Hitchman S, Fong GT, Zanna MP, Thrasher JF, Laux F. The relation between number of smoking friends and quit intentions, attempts, and success: Findings from the International Tobacco Control (ITC) Project Four Country Survey. Psychology of Addictive Behaviors. In press.

Thrasher JF, Kim SH, Rose I, Craft MK, Biggers S. Media coverage of smoke-free policies after their innovation. Journal of Health Communication. In press.

Thrasher JF, Kim SH, Rose I, Navarro A, Craft MK, Davis KJ, Biggers S. Media coverage around failed and successful tobacco tax initiatives: The South Carolina experience. American Journal of Health Promotion. 29(1): 29-36. 2014.

Chu YH, Jones SJ, Frongillo EA, DiPietro RB, Thrasher JF. Investigating the impact of menu labeling on revenue and profit in a foodservice operation. Journal of Foodservice Business Research. 17:215–227. 2014.

Kollath-Cattano C, Abad-Vivero AN, Thrasher JF, Bansal-Travers M, O’Connor RJ, Krugman D, Berg C, Hardin J. Adult smokers’ responses to “corrective statements” regarding tobacco industry deception. American Journal of Preventive Medicine. 47(1): 26–36. 2014.

Rousu M, Thrasher JF. Examining the relationship between psychosocial and behavioral proxies for future behavior: Self-reported impact and bidding behavior in an experimental auction study on cigarette labeling. Health Education Research. 29(2):183-94. 2014. doi: 10.1093/her/cyt114

Thrasher JF, Sargent JD, Vargas R, Braun S, Barrientos-Guitierrez T, Sevigny EL, Billings DL, Arillo- Santillan E, Hardin J. Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth?: A comparison of rating systems in Argentina, Brazil, Mexico, and the United States. International Journal of Drug Policy. 25: 267-275. 2014.

Harmon BE, Blake CE, Thrasher JF, Hébert JR. An evaluation of diet and physical activity messaging in African-American churches. Health Education & Behavior. 41(2): 216 - 224. 2014.

Saenz de Miera B, Thrasher JF, Reynales-Shigematsu LM, Hernández-Ávila M, Chaloupka FJ. Tax, price, and cigarette brand preferences: A longitudinal study of adult smokers from the ITC Mexico Survey. Tobacco Control. 23:i80-i85. 2014. doi: 10.1136/tobaccocontrol-2012- 050939.

Rennen E, Nagelhout GE, van den Putte B, Janssen E, Mons U, Guignard R, Beck R, de Vries H, Thrasher JF, Willemsen MC. Associations between tobacco control policy awareness, social acceptability of smoking and smoking cessation: Findings from the International Tobacco Control (ITC) Europe Surveys. Health Education Research. 29 (1):72-82; 10. 2014.

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Rousu M, O'Connor RJ, Thrasher JF, June KM, Bansal-Travers M, Pitcavage J. The impact of product information and trials on demand for smokeless tobacco and cigarettes: Evidence from experimental auctions. Preventive Medicine. 60: 3–9. 2014.

O’Connor RJ, June KM, Bansal-Travers M, Rousu MC, Thrasher JF, Hyland A, Cummings KM. Estimating demand for alternatives to cigarettes with online purchase tasks. American Journal of Health Behavior. 38(1):103-13. 2014. doi: 10.5993/AJHB.38.1.11.

Thrasher JF, Abad-Vivero EN, Sebrié EM, Barrientos-Gutierrez T, Boado M, Yong HH, Arillo-Santillán E, Bianco E. Tobacco smoke exposure in public places and workplaces after smoke-free policy implementation: A longitudinal analysis of smoker cohorts in Mexico and Uruguay. Health Policy & Planning. 28:789–798. 2013. doi: 10.1093/heapol/czs118

Li L, Borland R, Fong GT, Thrasher JF, Hammond D, Cummings KM. Impact of point-of-sale tobacco display bans: Findings from the International Tobacco Control (ITC) Four Country Survey. Health Education Research. 28(5):898-91. 2013. doi:10.1093/her/cyt058

Mutti S, Hammond D, Reid JL, Thrasher JF. The efficacy of cigarette warning labels on health beliefs in the United States and Mexico. Journal of Health Communication. 18(10):1180-92. 2013. doi: 10.1080/10810730.2013.778368

Siahpush M, Thrasher JF, Yong H-H, Cummings KM, Fong GT, Sáenz de Miera B, Borland R. Cigarette prices, cigarette expenditure, and smoking-induced deprivation: Findings from the International Tobacco Control (ITC) Mexico Survey. Tobacco Control. 22: 223-226. 2013. doi:10.1136/tobaccocontrol-2012-050613

Monterrosa EC, Frongillo EA, González de Cossío T, Bonvecchio A, Villanueva MA, Thrasher JF, Rivera JA. Scripted messages delivered by nurses and radio improved infant and young child feeding. Journal of Nutrition. 143: 915–922. 2013. doi:10.3945/jn.112.169235.

Yong H-H, Savvas S, Borland R, Thrasher JF, Sirirassamee B, Omar M. Secular versus religious norms against smoking: Which is more important as a driver of quitting behaviour among Muslim Malaysian and Buddhist Thai smokers? International Journal of Behavioral Medicine. 20: 252- 58. 2013. DOI 10.1007/s12529-012-9225-6

Partos T, Borland R, Yong H, Thrasher JF, Hammond D. Cigarette packet warning labels can prevent relapse: Findings from the International Tobacco Control 4-country Policy Evaluation cohort study. Tobacco Control. 22: e43-e50. 2013.

Thrasher JF, Murukutla N, Pérez-Hernández R, Alday J, Arillo-Santillán E, Cedillo C, Gutierrez JP. Linking mass media campaigns to pictorial warning labels on cigarette packages: A cross- sectional study to evaluate impacts among Mexican smokers. Tobacco Control. 22: e57-e65. 2013. doi:10.1136/tobaccocontrol-2011-050282

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Szklo A, Thrasher JF, Pérez C, Figueiredo V, Fong GT, de Almeida ML. Understanding the relationship between socioeconomic status, smoking cessation services provided by the health system and smoking cessation behavior in Brazil. Cadernos Saúde Pública. 29(3):485-495. 2013.

Swayampakala K, Thrasher JF, Carpenter M, Reynales-Shigematsu LM, Cupertino P, Berg C, Sansores R. Level of cigarette consumption and quit behavior in a population of low-intensity smokers – Longitudinal results from the International Tobacco Control (ITC) Survey in Mexico. Addictive Behaviors. 38: 1958–1965. 2013.

Rousu M, Thrasher JF. Demand reduction from “plain” packaging and pictorial cigarette warning labels: Evidence from experimental auctions. Applied Economic Perspectives & Policy. 35(1): 171–184. 2013.

Adkison SE, O’Connor RJ, Bansal-Travers, M, Hyland A, Borland R, Yong HH, Cummings KM, McNeil A, Thrasher JF, Hammond DH, Fong GT. Awareness, trial, and current use of electronic nicotine delivery systems (ENDS): Findings from the ITC Four Country Survey. American Journal of Preventive Medicine. 44(3):207–215. 2013.

Cantrell J, Vallone DM, Thrasher JF, Nagler RH, Feirman SP, Muenz LR, He DY, Viswanath K. Impact of tobacco-related health warning labels across socioeconomic, race and ethnic groups: Results from a randomized web-based experiment. PLoS One. (8)1: e52206. 2013. de Ojeda A, Barnoya J, Thrasher JF. Availability and costs of single cigarettes in Guatemala. Nicotine & Tobacco Research. 15(1): 83-87. 2013. doi: 10.1093/ntr/nts087

Huang LL, Thrasher JF, Jiang Y, Li Q, Fong GT, Quah ACK. Prevalence and correlates of receiving cigarettes as gifts and selecting preferred brand because it was gifted: Findings from the ITC China Survey. BMC Public Health. Nov 17;12:996. 2012.

Foster CD, Thrasher JF, Kim S, Rose I, Besley J, Navarro A. Agenda-building influences on the news media’s coverage of the U.S. Food and Drug Administration’s push to regulate tobacco, 1993- 2009. Journal of Health and Human Services Administration. 35(3):303-30. 2012.

Nagelhout GE, de Vries H, Fong GT, Candel MJJM, Thrasher JF, van den Putte B, Thompson ME, Cummings KM, Willemsen MC. Pathways of change explaining the effect of smoke-free legislation on smoking cessation in the Netherlands. An application of the International Tobacco Control (ITC) Conceptual Model. Nicotine & Tobacco Research. 14(12):1474-82. doi: 10.1093/ntr/nts081. 2012.

Brown A, Boudreau C, Moodie C, Fong GT, Li G, McNeill A, Thompson ME, Hassan L, Hyland A, Thrasher JF, Yong H, Borland R, Hastings G. Support for removal of point-of-purchase tobacco advertising and displays: Findings from the International Tobacco Control (ITC) Canada Survey. Tobacco Control. 21: 555-559. 2012.

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Thrasher JF, Carpenter M, Andrews JO, Gray KM, Alberg AJ, Navarro A, Friedman DB, Cummings KM. Cigarette warning label policy alternatives and smoking-related health disparities. American Journal of Preventive Medicine. 43(6):590–600. 2012. doi: 10.1016/j.amepre.2012.08.025.

White CM, Hammond D, Thrasher JF, Fong GT. The potential impact of plain packaging of cigarette products among Brazilian young women: an experimental study. BMC Public Health. 12(1):737. 2012.

Thrasher JF, Arillo-Santillán E, Villalobos V, Pérez-Hernández R, Hammond D, Carter J, Sebrie E, Sansores R, Regalado-Piñeda J. Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content. Cancer Causes and Control. 23:69–80. 2012. DOI: 10.1007/s10552-012-9899-8

Hammond D, Thrasher JF, Reid JL, Driezen P, Boudreau C, Arillo-Santillán E. Perceived effectiveness of pictorial health warnings among Mexican youth and adults: a population-level intervention with potential to reduce tobacco-related inequities. Cancer Causes and Control. 23:69–80. 2012. DOI: 10.1007/s10552-012-9902-4

Moore K, Borland R, Yong HH, Siahpush M, Cummings KM, Thrasher JF, Fong GT. Support for tobacco control interventions: do country of origin and socioeconomic status make a difference? International Journal of Public Health. 57(5):777-86. 2012.

Thrasher JF, Pérez-Hernández R, Arillo-Santillán E, Barrientos-Gutierrez I. Impacto de las advertencias con pictogramas en las cajetillas de cigarrillos en México: resultados de una encuesta en fumadores de Guadalajara [Impact of pictorial warning labels on cigarette packs in Mexico: Results from a survey of smokers in Mexico]. Revista de Salud Pública de México. 54:254-263. 2012.

Thrasher JF, Pérez-Hernández R, Arillo-Santillán E, Barrientos-Gutierrez I. Hacia el consumo informado de tabaco en México: Efecto de las advertencias en población fumadora [Towards informed tobacco consumption in Mexico: Effects of pictorial warning labels among smokers]. Revista de Salud Pública de México. 54:242-253. 2012.

Pérez-Hernández R, Thrasher JF, Rodríguez-Bolaños R, Barrientos-Gutierrez I, Ibañez-Hernández NA. Autorreporte de exposición a publicidad y promoción de tabaco en una cohorte de fumadores mexicanos [Self-reported exposure to tobacco advertising and promotion in a cohort of Mexican smokers]. Revista de Salud Pública de México. 54:204-212. 2012.

Barrientos-Gutiérrez T, Barrientos-Gutiérrez I, Reynales-Shigematsu LM, Thrasher JF, Lazcano-Ponce E. Se busca mercado adolescente: Internet y videojuegos, las nuevas estrategias de la Industria Tabacalera [Searching for the adolescent market: Internet, videogames and other new strategies of the tobacco industry]. Revista de Salud Pública de México. 54:303-314. 2012.

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Yong H, Borland R, Thrasher JF, Thompson ME. Stability of cigarette consumption over time among continuing smokers: A latent growth curve analysis. Nicotine & Tobacco Research. 14(5):531- 9. 2012.

Barrientos-Gutierrez T, Barrientos-Gutierrez I, Thrasher JF. Videogames and the next tobacco frontier: smoking in the Stracraft universe. Tobacco Control. 21: 443-444. 2012. DOI: 10.1136/tobaccocontrol-2011-050314

Tanner A, Blake C, Thrasher JF. Tracking beverage consumption trends in the news: An evaluation of beverage information on network television. Ecology of Food and Nutrition, 51:1–21. 2012.

Borland R, Li L, Driezen P, Wilson N, Hammond D, Thompson ME, Fong GT, Mons U, Willemsen MC, McNeill A, Thrasher JF, and Cummings KM. Cessation assistance reported by smokers in 15 countries participating in the International Tobacco Control (ITC) policy evaluation surveys. Addiction. 107(1):197-205. 2012. DOI: 10.1111/j.1360-0443.2011.03636.x

Thrasher JF, Quah ACK, Dominick G, Borland R, Driezen P, Awang R, Omar M, Hosking W, Sirirassamee B, Boado M, Miller K. Using cognitive interviewing and behavioral coding to determine measurement equivalence across linguistic and cultural groups: An example from international tobacco survey research. Field Methods. 23(4): 439-460. 2011. DOI:10.1177/1525822X11418176

Berg CJ, Thrasher JF, Westmaas JL, Buchanan T, Pinsker EA, Ahluwalia JS. College student reactions to health warning labels: Sociodemographic and psychosocial factors related to perceived effectiveness of different approaches. Preventive Medicine. 53(6):427-30. 2011. DOI: 10.1016/j.ypmed.2011.09.006

Thrasher JF, Rousu MC, Hammond D, Navarro A, Corrigan J. Estimating the impact of pictorial health warnings and “plain” cigarette packaging: Evidence from experimental auctions among adult smokers. Health Policy. 102: 41–48. 2011. DOI: 10.1016/j.healthpol.2011.06.003

Vargas RC, Thrasher JF, Sargent JD. A Classificação de Filmes de Maior Popularidade nos Cinemas Brasileiros e sua Implicação para o Tabagismo entre Jovens [Ratings for popular movies in Brazil and their implications for youth smoking]. Brazilian Journal of Cancer. 57(3): 365-377. 2011

Thrasher JF, Villalobos VE, Barnoya J, Sansores R, O’Connor R. Consumption of single cigarettes and quitting behavior: A longitudinal analysis of Mexican smokers. BMC Public Health. 11:134. 2011. DOI: 10.1186/1471-2458-11-134

Berg CJ, Lessard L, Parelkar PP, Thrasher JF, Escoffery C, Kegler MC, Goldade K, Ahluwalia JS. College student reactions to smoke-free policies in public, on campus, and at home. Health Education Research. 26(1):106-18. 2011. DOI: 10.1093/her/cyq076

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Thrasher JF, Huang L, Pérez-Hernández R, Niederdeppe J, Arillo-Santillán E, Alday J. Evaluation of a social marketing campaign to support Mexico City’s comprehensive smoke-free law. American Journal of Public Health. 101(2): 328-335. 2011. DOI: 10.2105/AJPH.2009.189704

King B, Yong HH, Borland R, Omar M, Ahmad AA, Sirirassamee B, Hamann S, O'Connor RJ, Bansal- Travers M, Elton-Marshall T, Lee WB, Hammond D, Thrasher JF. Malaysian and Thai smokers' beliefs about the harmfulness of 'light' and menthol cigarettes. Tobacco Control. 19:444-450. 2010. DOI: 10.1136/tc.2009.034256

Saenz de Miera B, Thrasher JF, Chaloupka FJ, Waters HR, Hernández-Ávila M, Fong GT. Self-reported price, consumption and brand switching of cigarettes in a cohort of Mexican smokers before and after a cigarette tax increase. Tobacco Control. 19: 481-487. 2010. DOI: 10.1136/tc.2009.032177

Thrasher JF, Swayampakala K, Arillo-Santillán E, Sebrié E, Walseman K, Bottai M. Differential impact of local and federal smoke-free legislation in Mexico: A longitudinal study among adult smokers. Salud Pública de México. 52(sup 2): S244-253. 2010. DOI: 10.1590/S0036- 36342010000800020

Villalobos V, Ortiz-Ramirez O, Thrasher JF, Arillo-Santillán E, Pérez-Hernández R, Cedillo C, González W. Mercadotecnia social y políticas públicas de salud: Campaña para promover espacios libres de humo de tabaco en México. [Social marketing and public health policy: Development of a campaign to promote smoke-free policies in Mexico] Salud Pública de México. 52(sup 2): S129-137. 2010

Thrasher JF, Villalobos V, Szklo A, Fong G, Pérez C, Sebrié E, Boado M, Figueiredo V, Arillo-Santillán E, Bianco E. Assessing the impact of cigarette package warning labels: a cross-country comparison in Brazil, Uruguay and Mexico. Salud Pública de México. 52(sup 2): S206-215. 2010. DOI: 10.1590/S0036-36342010000800016

Barrientos-Gutierrez T, Gimeno D, Thrasher JF, Reynales-Shigematsu LM, Amick III BC, Lazcano-Ponce E, Hernández-Ávila M. Implementación de espacios 100% libres de humo de tabaco: Opiniones, conocimiento y apreciación de posibles efectos entre administradores de bares y restaurantes de México. [Implementation of 100% smoke-free policies: Opinions, knowledge and appreciation of possible effects among bar and restaurant workers] Salud Pública de México. 52(sup 2):149-156. 2010

Brown AK, Moodie C, Hastings G, Mackintosh A, Hassan L, Thrasher JF. The association of normative perceptions with adolescent smoking intentions. Journal of Adolescence. 33:603-14. 2010. DOI: 10.1016/j.adolescence.2009.12.003 Thrasher JF, Pérez-Hernández R, Swayamkapala K, Arillo-Santillán E, Bottai M. Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive

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smoke-free policy in Mexico City. American Journal of Public Health. 100(9): 1079-1096. 2010. DOI: 10.2105/AJPH.2009.180950

Fix BV, O’Connor R, Hammond D, King B, McNeill A, Thrasher JF, Boado M, Cummings KM, Yong H, Thompson M, Hyland A. ITC ‘Spit and Butts’ pilot study: The feasibility of collecting biologic samples from population-based samples to evaluate policy. Nicotine and Tobacco Research. 12(3): 185-90. 2010. DOI: 10.1093/ntr/ntp191

Thrasher JF, Besley JC, González W. Perceived justice and popular support for public health laws: Citizens’ perceptions of comprehensive smoke-free legislation in Mexico City. Social Science & Medicine. 70: 787-93. 2010. DOI: 10.1016/j.socscimed.2009.10.064

Thrasher JF, Villalobos V, Dorantes-Alonso AC, Arillo-Santillán EJ, Cummings KM, O’Connor R, Fong GT. Does the availability of single cigarettes promote or inhibit cigarette consumption?: Perceptions, prevalence and correlates of single cigarette use among adult Mexican smokers. Tobacco Control. 18: 431-437. 2009. DOI: 10.1136/tc.2008.029132

Thrasher JF, Sargent JD, Huang L, Arillo-Santillán EJ, Dorantes-Alonso AC. Does exposure to smoking in films promote smoking in middle-income countries?: A longitudinal study among Mexican adolescents. Cancer Epidemiology, Biomarkers & Prevention. 18:3444-3450. 2009. DOI: 10.1158/1055-9965.EPI-09-0883

Borland R, Wilson N, Fong GT, Hammond D, Cummings KM, Yong HH, Hosking W, Hastings G, Thrasher JF, McNeill A. Impact of graphic and text warnings on cigarette packs: findings from four countries over five years. Tobacco Control. 18: 358-364. 2009. DOI: 10.1136/tc.2008.028043

Thrasher JF, Boado M, Sebrié EM, Bianco E. Smoke-free policies and the social acceptability of smoking in Uruguay and Mexico. Nicotine & Tobacco Research. 11(6): 591-599. 2009. DOI: 10.1093/ntr/ntp039

Hosking W, Borland R, Yong HH, Fong G, Zanna M, Laux F, Thrasher JF, Lee W, Sirirassamee B, Omar M. The effects of norms and attitudes towards smoking on interest in quitting in Malaysia, Thailand, and four Western nations: A cross-cultural comparison. Psychology & Health. 24(1): 95-107. 2009. DOI: 10.1080/08870440802385854

Thrasher JF, Jackson C, Arillo-Santillan E, Sargent JD. Exposure to smoking in movies and adolescent smoking in Mexico. American Journal of Preventive Medicine. 35(2):95-102. 2008. DOI: 10.1016/j.amepre.2008.03.036

Thrasher JF, Reynales-Shigematsu LM, Baezconde-Garbanati L, Villalobos V, Téllez-Girón P, Arillo- Santillán E, Dorantes-Alonzo A, Valdés-Salgado R, Lazcano-Ponce EC. Promoting the effective translation of the Framework Convention on Tobacco Control: A case study of challenges and

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opportunities for strategic communications in Mexico. Evaluation & the Health Professions. 31(2): 145-166. 2008. DOI:10.1177/0163278708315921

Llaguno-Aguilar SE, Dorantes-Alonso AC, Thrasher JF, Villalobos V, Besley JC Análisis de la cobertura del tema de tabaco en medios impresos mexicanos [Analysis of the coverage of tobacco in Mexican print media]. Salud Pública de México. 30 (Sup 3): S348-S354. 2008

Hassan LM, Shiu E, Thrasher JF, Fong GT, Hastings G. Exploring the effectiveness of cigarette warning labels: Findings from the United States and United Kingdom arms of the International Tobacco Control Four Country Survey. International Journal of Nonprofit and Voluntary Sector Marketing. 13(3): 263-274. 2008. DOI:10.1002/nvsm.328

Thrasher JF, Rousu MC, Anaya-Ocampo R, Reynales-Shigematsu LM, Arillo-Santillán E, Hernández- Ávila M. Estimating the impact of cigarette package warning label policies: The auction method. Addictive Behaviors, 32(12) 2916-2915. 2007. DOI: 10.1016/j.addbeh.2007.05.018

Thrasher JF, Hammond D, Fong G, Arillo-Santillán E. Smokers’ reactions to cigarette package warnings with graphic imagery and with only text: A comparison of Mexico and Canada. Salud Pública de México, 49(SuppI): S233-S240. 2007

Arillo-Santillán E, Thrasher JF, Rodríguez-Bolaños R, Chávez-Ayala R, Ruiz Velazco S, Lazcano-Ponce E. Susceptibilidad al consumo de tabaco en estudiantes no fumadores de 10 ciudades mexicanas. [Susceptibility to tobacco use among nonsmoking students in 10 Mexican cities] Salud Pública de México, 49(SuppI): S170-S181. 2007. DOI: 10.1590/S0036-36342007000800007

Thrasher JF, Jackson C. Mistrusting companies, mistrusting the tobacco industry: Clarifying the context of tobacco prevention efforts that focus on the tobacco industry. Journal of Health & Social Behavior. 47(4): 406-422. 2006. DOI: 10.1177/002214650604700407

Thrasher JF, Bentley ME. The meanings and context of smoking among Mexican university students. Public Health Reports. 121(5): 578-585. 2006.

Hammond D, Fong G, Zanna M, Thrasher JF, Borland R. Tobacco denormalization, anti-industry beliefs, and cessation behavior among smokers from four countries. American Journal of Preventive Medicine. 31(3): 225-232. 2006. DOI: 10.1016/j.amepre.2006.04.004

Thrasher JF, Niederdeppe JD, Jackson C, Farrelly MC. Using anti-tobacco industry messages to prevent smoking among high-risk youth. Health Education Research, 21(3): 325-337. 2006. DOI: 10.1093/her/cyl001

Thrasher JF, Chaloupka FJ, Hammond D, Fong G, Borland R, Hastings G, Cummings KM. Evaluación de las políticas contra el tabaquismo en países latinoamericanos en la era del Convenio Marco para el Control del Tabaco [Evaluation of tobacco control policies in Latin American countries during

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the Framework Convention on Tobacco Control era]. Salud Pública de México, 48(SuppI): S155-S166. 2006.

Thrasher JF, Allen B, Anaya-Ocampo R, Reynales LM. Análisis del impacto en fumadores mexicanos de las advertencias gráficas en las cajetillas de cigarros [Analysis of the impact of pictorial warning labels on cigarette packs among Mexican smokers]. Salud Pública de México, 48(SuppI): S65-S74. 2006

Valdés-Salgado R, Thrasher JF, Sanchez-Zamorano LM, Lazcano-Ponce E, Reynales-Shigematsu LM, Meneses-González F, Hernández-Ávila M. Los retos del Convenio Marco para el Control del Tabaco en México: un diagnóstico a partir de la Encuesta sobre Tabaquismo en Jóvenes [Challenges to the Framework Convention on Tobacco Control in Mexico: A diagnosis using the Global Youth Tobaco Survey]. Salud Pública de México, 48(SuppI): S5-S16. 2006

Rivera-Rivera L, Allen B, Thrasher JF, Chavez R, Fernandez-Ortega C, Galal O, Lazcano-Ponce EC, Hernández-Avila M. The prevalence and correlates of intra-familial violence among Mexican and Egyptian youth. Revista de Saude Publica, 39(5): 709-715. 2005. DOI: 10.1016/j.ypmed.2007.02.020

Thrasher JF, Niederdeppe J, Farrelly MC, Davis KC, Ribisl K, Haviland L. The impact of anti-tobacco industry prevention messages in tobacco producing regions: Evidence from the US truth® campaign. Tobacco Control, 13 (3): 283-288. 2004. DOI: 10.1136/tc.2003.006403

Thrasher JF, Campbell M, Oates V, Hudson M, Jackson E. Behavior-specific social support and risk behavior among African-American church members: Applying optimal matching theory. Health Education & Behavior, 31(2): 193-205. 2004. DOI: 10.1177/1090198103259184

Thrasher JF, Cummings KM, Michalek A, Mahoney M, Moysich K, Pillitere D. Colorectal cancer screening among people with and without a family history. Journal of Public Health Management and Practice, 8(2): 1-9. 2002

Beskow LM, Khoury MJ, Baker T, Thrasher JF. The integration of genomics into public health research, policy, and practice in the United States. Community Genetics, 4(1): 2-11. 2001. DOI: 10.1159/000051150

Khoury MJ, Thrasher JF, Burke W, Gettig E, Fridinger F, Jackson R. Challenges in communicating about genetics: A public health approach. Genetics in Medicine, 2(3): 185-190. 2000. DOI: 10.1097/00125817-200005000-00007

MANUSCRIPTS UNDER PEER-REVIEW (UNDERLINED = STUDENT/ADVISEE)

Murdoch M, Irmak C, Thrasher JF. The effect of political ideology on reactions to warning labels and consumption regulations. Journal of Consumer Research.

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Newman-Norlund RD, Thrasher JF, Fridrikson J, Brixius W, Froeliger BE, Hammond D, Cummings KM. Neural biomarkers for assessing the effects of different types of imagery in pictorial health warning labels on cigarette packaging.

Huang L, Thrasher JF, Friedman DB. Which types of anti-smoking television advertisements work better in Taiwan? Health Promotion International. Under review.

Swift E, Borland R, Cummings KM, Fong GT, McNeill A, Hammond , Thrasher JF, Partos TR, Yong H-H. Australian smokers’ support for plain or standardized packs before and after implementation: Findings from the ITC Four Country Survey. Tobacco Control.

Mejia R, Kollath-Cattano C, Braun S, Ahuja R, Perez-Stable EJ, Alderete E, Sargent JD, Thrasher JF. Comparison of tobacco and alcohol imagery in films produced in Argentina and the United States. Substance Use & Misuse. Revised & resubmitted.

Li L, Borland R, Fong GT, Jiang Y, Yang Y, Wang L, Partos TR, Thrasher JF. Smoking-related thoughts and microbehaviours and their predictive power for quitting: Findings from the International Tobacco Control (ITC) China Survey. Tobacco Control. Under review.

Salloum RG, Thrasher JF, Kates FR, Masiak W. Waterpipe tobacco smoking in the United States: Findings from the National Adult Tobacco Survey. Under review.

Thrasher JF, Price AE, Thompson M, Borland R, Yong H, Fong G, Hammond D, Cummings KM. A latent growth curve analysis of cigarette warning label wear out: Findings from the ITC Four Country Survey. Under review.

Villalobos V, Thrasher JF, Sansores R, Pérez-Hernández R, Reynales-Shigematsu LM. Consejo médico y el dejar de fumar, prevalencia e impacto: Hallazgos de un estudio longitudinal en México. [Prevalence and impact of doctors’ smoking cessation advice: Results from a longitudinal study in Mexico]. Revista de Investigación Clínica. Revised & resubmitted.

Pressgrove G, Thrasher JF, Besley JC. Who attends public meetings about indoor smoking bans? Journal of Public Health Management & Practice. Under review

Osman A, Thrasher JF, Arillo-Santillán E, Reglado-Piñeda J. Cigarette-pack warnings, knowledge about tobacco constituents and quit behavior: A population-based longitudinal study of Mexican smokers. Under review.

Osman A, Thrasher JF, Froliger BE, Cayir E, Pérez-Hernández R. Depressive symptoms and responses to cigarette pack warning labels among Mexican smokers. Under review. Health Psychology

Chu YH, Jones SJ, Frongillo EA, DiPietro RB, Thrasher JF. Modifying placement and simplifying menu labels in a foodservice operation reduces the energy content purchased by patrons. Under review.

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Mutti S, Hammond D, Reid JL, White CM, Thrasher JF. Perceptions of branded and plain cigarette packaging among Mexican youth. Health Promotion International. Revised & resubmitted.

Blake CE, Childers C, Thrasher JF, Lenkerd AA. Parental balancing of competing influences in the selection of children’s beverages and the impact of front-of-package labels on choice. Journal of Nutrition, Education & Behavior. Under review.

Williams LR, Annang L, Spencer SM, Thrasher JF, Lindley LL. Exploring body image and sexual risk behaviors among heterosexual and sexual minority college females: A qualitative approach. Perspectives on Sexual and Reproductive Health. Under review.

Mutti S, Hammond D, Thrasher JF, Fong GT. A critical review of the effectiveness of personal testimonials in anti-tobacco mass media campaigns: implications for low and middle-income countries.

Thrasher JF, Osman A, Abad-Vivero EN, Hammond D, Bansal-Travers M, Cummings KM, Hardin J, Moodie C. Are cigarette package inserts to supplement pictorial health warnings effective?: An evaluation of the Canadian policy.

Bansal-Travers M, Cummings KM, O’Connor RJ, Hammond D, Thrasher JF, Tworek C, McDermott N. Influence of product size and shape on consumer risk perceptions.

O’Connor RJ, Travers-Bansal M, Cummings KM, Hammond D, Thrasher JF, Tworek C, McDermott N. How do cigarette filters influence consumer perceptions of product harm?

Gravely S, Fong GT, Cummings KM, Yan, Quah ACK, Borland R, Yong H, Hitchman S, McNeill A, Hammond D, Thrasher JF, Willemsen M, Seo A, Jiang J, Cavalcante T, Perez C, Omar A, Hummel. Awareness, trial, and use of electronic cigarettes among 10 Countries: Findings from the ITC Project. International Journal of Environmental Research in Public Health.

Salloum R, Goma F, Chelwa G, Cheng X, Zulu R, Kaai SC, Quah ACK, Thrasher JF, Fong GT. Cigarette price and brand loyalty in Zambia: Findings from the ITC Zambia Survey. Tobacco Control.

COMMENTARIES & NON PEER-REVIEWED ARTICLES (**STUDENT/ADVISEE)

Thrasher JF, Osman A, Anshari D. Images in cigarette warning labels: How should they warn? Virtual Mentor: American Medical Association Journal of Ethics. 15:704-712. 2013

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Barrientos-Gutierrez T, Gimeno D, Delclos GL, Thrasher JF, Knudson P. Meeting our ends by our means: Protecting children from SHS in research. Tobacco Control. 21: 383-384. 2012

Barrientos-Gutierrez T, Barrientos-Gutierrez I, Lazcano-Ponce E, Thrasher JF. Tobacco content in video games: 1994-2011. Lancet Oncology. 13(3): 237-238. 2012. doi:10.1016/S1470- 2045(12)70099-2

Thrasher JF, Reynales LM, Pérez-Padilla R, Lazcano-Ponce, E. Introducción: El control de la epidemia del tabaco en América Latina: avances en investigación, acción y evaluación del Convenio Marco para el Control de Tabaco [Introduction: Controling the tobacco epidemic in Latin America: Advances in research, action and evaluation of the Framework Convention on Tobacco Control] Salud Pública de México. 52(sup 2): S96-97. 2010. (Guest Editor Introduction to special issue)

Thrasher JF, Hammond D, Arillo-Santillán E. The alchemy of Marlboro: Transforming “Light” into “Gold” in Mexico. Tobacco Control. Aug;19(4):342-3. 2010. (Commentary)

BOOKS, BOOK CHAPTERS & BOOK REVIEWS

Thrasher JF, Reynales-Shigematsu LM, Lazcano-Ponce E, Hernández-Ávila M, Editors. Salud pública y tabaquismo, Volumen II. Advertencias sanitarias en América Latina y el Caribe [Public health & tobacco, Volume 2: Warning labels in Latin America and the Caribbean]. Cuernavaca, México: Instituto Nacional de Salud Pública, 2013. ISBN: 978-607-511-044-8 http://www.insp.mx/images/stories/Produccion/pdf/130226 reporteTabacoVol2.pdf

Reynales-Shigematsu LM, Thrasher JF, Lazcano-Ponce E, Hernández-Ávila M, Editors. Salud pública y tabaquismo, Volumen I. Políticas públicas para el control del tabaco en México [Public health & tobacco, Volume 1: Tobacco control policy in Mexico]. Cuernavaca, México: Instituto Nacional de Salud Pública, 2013. ISBN: 978-607-511-043-1 http://www.insp.mx/images/stories/Produccion/pdf/130206 reporteTabacoVol1.pdf

Thrasher JF, Pérez-Hernández R, Arillo-Santillán E, Barrientos-Gutiérrez I. Evaluación del impacto de la primera ronda de advertencias sanitarias con pictogramas en México: resultados de dos encuestas en población fumadora. In Salud pública y tabaquismo, Volumen II. Advertencias sanitarias en América Latina y el Caribe. Pp. 109-127. 2013.

Reid J, Hammond D, Thrasher JF, Driezen P, Boudreau C, Arillo-Santillán E. Impacto de estrategias visuales en las advertencias sanitarias: un experimento de campo en adultos fumadores y adolescentes mexicanos. In Salud pública y tabaquismo, Volumen II. Advertencias sanitarias en América Latina y el Caribe Pp. 128-142. 2013

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Thrasher JF, Arillo-Santillán E, Villalobos V, Pérez-Hernández R, Hammond D, Sansores RH, Valdemar F, Regalado-Pineda J. Impacto de los contenidos en las advertencias sanitarias con pictogramas: un experimento de campo en adultos fumadores y adolescentes mexicanos. In Salud pública y tabaquismo, Volumen II. Advertencias sanitarias en América Latina y el Caribe Pp. 144-161. 2013

Regalado-Pineda J, Hernández- Flores LA, Cárdenas León MG, Robles-Jara AM, Thrasher JF, Arillo-Santillán E, Pérez Hernández R. Reacción de fumadores y no fumadores hacia las advertencias sanitarias más impactantes en el Distrito Federal, Guadalajara y Monterrey. In Salud pública y tabaquismo, Volumen II. Advertencias sanitarias en América Latina y el Caribe Pp. 162-173. 2013.

Co-author and working group member. IARC. IARC Handbooks of Cancer Prevention: Tobacco Control. Volume 12. Methods for Evaluating Tobacco Control Policies. Lyon, France: International Agency for Research on Cancer, 2008.

Thrasher JF and Johnson T. “Developing and assessing comparable questions in cross-cultural survey research on tobacco” in IARC Handbooks of Cancer Prevention: Tobacco Control. Volume 12. Methods for Evaluating Tobacco Control Policies. Lyon, France: International Agency for Research on Cancer, 2008.

Thrasher JF. Book review of “Women and Alcohol in a Highland Maya Town” by Christine Eber, American Anthropologist, 98: 664-5. 1996

TECHNICAL REPORTS & UNPUBLISHED MANUSCRIPTS

Arillo-Santillán E, Barrientos I, Pérez-Hernández R, Kollath-Cattano C, Sargent JD, Thrasher JF. Tabaquismo y cine en México: Análisis de las películas más taquilleras del 2004 al 2012. Cuernavaca, Mexico: Instituto Nacional de Salud Pública. 2014

Mejia R, Braun S, Morello P, Peña L, Kollath-Cattano C, Sargent JD, Thrasher JF. El cine y tabaquismo en Argentina: Análisis de las películas más taquilleras del 2004 al 2012. Buenos Aires, Argentina: Centro de Estudios de Estado y Sociedad. 2014

Arillo-Santillán E, Pérez-Hernández R, Barrientos-Gutiérrez I, Thrasher JF, Reynales-Shigematsu LM. Efectividad de diferentes tipos de contenidos para las advertencias sanitarias de las cajetillas de cigarros . [Effectiveness of different health warning label content on cigarette packs: Scientific evidence among Mexicans and best international practices]. Cuernavaca, Mexico: Instituto Nacional de Salud Pública. 2013.

Omodior O, Huang L, Thrasher JF. Evaluation of the South Carolina Department of Health & Environmental Control smoking cessation mass media campaigns, 2010-2012. Office of Public Health Practice, Arnold School of Public Health, University of South Carolina. 2013.

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Lazcano-Ponce EC, Reynales-Shigematsu LM, Guerrero-López CM, Vallejo-Mateos AA, Muños- Hernández JA, Sáenz de Miera-Juárez B, Barrientos-Gutiérrez T, Thrasher JF, Arillo-Santillán EJ, Pérez-Hernández R. Encuesta Nacional de Adicciones, 2011 – Tabaco. [National Survey on Addictions, 2011 – Tobacco]. Cuernavaca, Mexico: Instituto Nacional de Salud Pública. 2012.

Thrasher JF, Arillo-Santillán E, Pérez-Hernández R, Sansores R, Regalado-Piñeda J. Evaluación de advertencias sanitarias de las cajetillas de tabaco: Cuatro investigaciones del impacto y recomendaciones para la Segunda Ronda de Pictogramas en México. [Cigarette package warning labels: Four studies of impact and recommendations for the second round of pictorial warning labels in Mexico.] A report prepared for the Minister of Health. Secretaría de Salud, Instituto Nacional de Salud Pública, México. March 2011.

Hammond D, Thrasher JF, Reid JL, Daniel S, Driezen P, Boudreau C. United States health warning study: International packaging study, preliminary results. Waterloo, Canada: University of Waterloo. 2011.

Thrasher JF, Huang L, Haq Z. Focus group pretesting of smoking cessation ads for low-income populations: Results and recommendations. Office of Public Health Practice, Arnold School of Public Health, University of South Carolina. October 2010.

Thrasher JF. Clarifying how anti-tobacco industry messages prevent youth smoking in the United States and Mexico: A focus on mistrust. PhD Thesis, Health Behavior & Health Education. UNC, Chapel Hill. 2005

Thrasher JF. Family history of colorectal cancer and fecal occult blood test return in a mass screening campaign. MS Thesis, Epidemiology & Community Health. SUNY, Buffalo. 2000

Thrasher JF. Tourism and the Semi(ex)otics of Mayan Shamanism. MA Thesis, Cultural Anthropology. SUNY, Buffalo. 1994

INVITED PRESENTATIONS (OTHER PRESENTATIONS PROVIDED UPON REQUEST)

Thrasher JF. Publicidad del tabaco, sus impactos y las respuestas de salud pública. [Tobacco marketing, its impacts, and public health responses] 4th National Congress of Tobacco Researchers. National Institute of Respiratory Diseases, Mexico City, Mexico. May 27, 2014. Invited presentation.

Thrasher JF. Producción y clasificación de los medios de entretenimiento y sus impactos en el consumo de tabaco en jóvenes [Production and rating of entertainment media and their impact on tobacco use among youth] World Health Organization, Pan American Health Organization, workshop with activists and Ministry of Health officials from around Latin America and the Caribbean. Panama City, Panama. May 15, 2014. Invited presentation.

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Thrasher JF. Investigación sobre el empaquetado de los productos de tabaco [Research on tobacco product packaging] World Health Organization, Pan American Health Organization, workshop with activists and Ministry of Health officials from around Latin America and the Caribbean. Panama City, Panama. May 15, 2014. Invited presentation.

Thrasher JF. ¿Qué se sabe sobre los impactos de PPP en puntos de venta? [What do we know about tobacco advertising and promotions at point of sale?] World Health Organization, Pan American Health Organization, workshop with activists and Ministry of Health officials from around Latin America and the Caribbean. Panama City, Panama. May 14, 2014. Invited presentation.

Thrasher JF. Using the cigarette package for public health communications: Warning label impacts & innovations around the world. Innovations in Tobacco Control Lecture Series. Johns Hopkins University, Baltimore, MD. April 10, 2014. Invited presentation.

Thrasher JF. Making the tobacco industry visible: A social marketing approach. Corporate Accountability International. Bogotá, Colombia. December 4, 2013. Invited presentation.

Thrasher JF. Tobacco advertising, promotion & sponsorship: Global trends, regional trends and the next frontiers for tobacco control. Corporate Accountability International. Bogotá, Colombia. December 3, 2013. Invited presentation.

Thrasher JF. Regulation of tobacco marketing: Global trends and the next frontier. World No Tobacco Day: Banning Tobacco Advertising, Promotion and Sponsorship. Sponsored by the Pan-American Health Organization and the Brazilian Ministry of Health. Brasilia, Brazil. March 29, 2013. Invited plenary presentation.

Thrasher JF. Mejores prácticas de empaquetado y etiquetado de productos de tabaco en México [Best practices for tobacco packaging and labeling in Mexico]. 15th Public Health Research Conference. Instituto Nacional de Salud Pública, Cuernavaca, México. March 8, 2013. Invited presentation.

Thrasher JF. How to develop health warnings for tobacco products. World Health Organization, Pan American Health Organization, workshop with regulators and Ministry of Health officials from around Latin America and the Caribbean. Panama City, Panama. March 5, 2013. Invited presentation.

Thrasher JF. Pictogramas en las cajetillas de cigarro: Un ejemplo del sector salud versus la industria tabacalera [Pictorial warnings on cigarette packages: An example of the health sector versus the tobacco industry]. National Conference of Tobacco Researchers. National Institute of Respiratory Diseases. Mexico City. May 28, 2012. Invited Plenary.

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Thrasher JF. Health warning labels on cigarette packaging: A cost-effective population-based intervention. The Future of Tobacco Control: Implications for the Prevention of Youth Tobacco Use in Virginia. Richmond, Virginia. April 3, 2012. Invited Plenary.

Thrasher JF. Plain packaging: The next frontier. Third Latin American Conference on Tobacco or Health. Lima, Peru. October 18, 2011. Invited Plenary.

Thrasher JF. Cigarette health warning labels in Latin America and the Caribbean. Third Latin American Conference on Tobacco or Health. Lima, Peru. October 18, 2011 Invited Plenary.

Thrasher JF. Advertencias sanitarias con pictogramas para el control de tabaco en México: a 6 meses de su implementación [Pictorial warning labels for tobacco control in Mexico: 6 months post- implementation]. Congreso de Investigación en Salud Pública. Instituto Nacional de Salud Pública. Cuernavaca, México. March 3, 2011.

Thrasher JF. Evidencia para el control de tabaco en México, a través de estrategias de comunicación: el caso de los pictogramas [Communication and tobacco control strategies in Mexico: The case of pictorial warning labels]. Intrainstitutional Seminar, Center for Health Systems Research, National Institute of Public Health, México. January 23, 2011.

Thrasher JF. Smoking & entertainment media: Perspectives from Mexico & Latin America. Tobacco Research Network on Disparities conference on Movies, Entertainment and Tobacco-Related Disparities. National Cancer Institute / American Legacy Foundation. Harvard University, Cambridge, MA, USA. October 14, 2010.

Thrasher JF. Advertencias sanitarias con pictogramas: Hacia el cumplimiento con el derecho a la información [Pictorial warning lables: Towards compliance with the right to information]. Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Guadalajara, México. September 24, 2010.

Thrasher JF. La mercadotecnia de tabaco: impactos en las mujeres [Tobacco marketing: impacts on women]. Feria del Día Mundial sin Tabaco: Mujeres libres de tabaco. Instituto Nacional de Enfermedades Respiratorias, Mexico City, México. May 31, 2010.

Thrasher JF. Advancing smoke-free policy: Struggles, successes and future prospects in Mexico. Center for Tobacco Control Research & Education, University of California, San Francisco. April 1, 2010.

Thrasher JF. Translating tobacco control policies and communication strategies: A view from Latin America and beyond. Distinguished Visiting Scholar. University of Kansas, School of Medicine, Kansas City, KS. July 9, 2009

Thrasher JF. Impactos sociales de los espacios libres de humo de tabaco. Avances y retos a un año de aprobación de la Ley de Protección a no Fumadores [Advances and challenges one year

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after the approval of the Law to Protect Non Smokers]. Mexican National Academy of Medicine, Mexico City, México. May 27, 2009

Thrasher JF. Campañas sociales para apoyar los espacios libres de humo de tabaco [Campaigns to support smoke-free places]. Feria del Día Mundial sin Tabaco. Secretaría de Salud, Mexico City, México. May 31, 2008.

TEACHING

Instructor Public Health Policy and Advocacy Spring ’12, ’13, School of Public Health, USC, Columbia, SC ‘14

Instructor Measurement Development in Health Research Fall ’07-‘11 School of Public Health, USC, Columbia, SC

Co-Instructor Health Communication Spring ’07-‘11 Instituto Nacional de Salud Pública, México

Instructor Research Methods Spring ‘09 School of Public Health, USC, Columbia, SC

Instructor Tobacco Prevention and Control in Public Health Spring ’08, School of Public Health, USC, Columbia, SC ‘10

Co-Instructor Contemporary Issues in Tobacco Control Aug ‘03, ‘04 Instituto Nacional de Salud Pública, México ’06-‘13

Co-Instructor Public Health Policy and Advocacy July ‘10, ’11, ‘12 Instituto Nacional de Salud Pública, México ‘13

Co-Instructor Fundamentos teóricos de salud pública Aug ‘10 Instituto Nacional de Salud Pública, México

Assistant Instructor Social and Behavioral Sciences in Public Health Summer ‘05 School of Public Health, UNC, Chapel Hill

Assistant Instructor Research Methods Fall ‘01 Dept. of Health Behavior, UNC, Chapel Hill

Co-Instructor Epidemiology and Biostatistics Spring ‘99 Dept. of Social and Preventive Medicine SUNY, Buffalo, NY

Instructor Introduction to Cultural Anthropology Fall ‘96 & Dept. of Anthropology, SUNY, Buffalo, NY Spring ‘97

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ACADEMIC COMMITTEES – PHD AND DRPH Dien Anshari. Effects of different health warning label characteristics on adult smokers and youth in Indonesia. Fulbright scholar. DrPH. Health Promotion, Education and Behavior. USC. Committee Chair. In process. Rosaura Pérez-Hernández. Movie smoking and youth smoking in Mexico. PhD. Epidemiology. National Institute of Public Health, Mexico. Committee Chair. In Process. Yoojin Cho. Tobacco policy effects among older smokers in South Korea. PhD. Health Promotion, Education and Behavior. USC. Committee Chair. In process. Amira Osman. Discrimination and smoking among Arabs in Israel. Fulbright scholar. DrPH. Health Promotion, Education and Behavior. USC. Committee Co-Chair. In process. Kamala Swayampakala. Impact of tobacco policies and communications among light smokers. PhD. Epidemiology and Biostatistics. Committee Co-Chair. In process. Seema Mutti. Evaluation of smokeless tobacco warning labels in Bangladesh. PhD. Public Health & Health Systems. University of Waterloo, Canada. Committee member. In process. Tessa Swigart. A mass media social marketing campaign to promote exclusive breast feeding among a low income population: A case in Mexico. PhD. Population Nutrition. National Institute of Public Health, Mexico. Committee Member. In Process. Genevieve Sansone. Acceptability of female smoking and smokeless tobacco use in Bangladesh and India. PhD. Psychology. University of Waterloo, Canada. Committee member. In process. Salima Kasymova. Gender-based norms, attitudes, and paternity policies in three countries. PhD. Health Promotion, Education and Behavior. USC. Committee member. In process. Heather Ranhoffer. Pastoral eating identity and the informational and physical environment in African-American churches - Implications for health promotion programming. PhD. Health Promotion, Education and Behavior. USC. Committee member. In process Casey Childers. Media coverage of food systems policy and media advocacy to change it. PhD. Health Promotion, Education and Behavior. USC. Committee member. In process SeulKi Choi. Implementation and evaluation of a healthy food access policy in South Korean schools. PhD. Health Promotion, Education and Behavior. USC. Committee member. In process.

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María Cristina Ortiz León. Uso de tecnología móvil en estudiantes universitarios para dejar de fumar. [Mobile technologies to help university students quit smoking]. PhD. Health Sciences. Universidad Veracruzana, México. Committee Members. In process. Edna Judith Arillo Santillán. Impacto de las advertencias sanitarias de cigarros en una cohorte mexicana [Impact of cigarette warning labels in a cohort of Mexican smokers]. PhD. Psychology. Universidad de Complutense, Madrid, Spain. Committee Member. In process. Zaeem Haq. Promoting early childhood development through community health worker interventions: Implementation and measurement issues in rural Pakistan. Fulbright scholar. PhD. Health Promotion, Education and Behavior. USC. Committee Chair. 2013. Liling Huang. Evaluation of mass media campaigns to change smokers’ knowledge, attitudes and behaviors in China and Taiwan: Does cultural context matter? PhD. Health Promotion, Education and Behavior. USC. Committee Chair. 2013. Stacey Smallwood. Understanding the relationships between religiosity, spirituality, internalized homonegativity, and sexual risk behaviors among African-American men who have sex with men. PhD. Health Promotion, Education and Behavior. USC. Committee member. 2013. Mary Jean Costello. An evaluation of the potential effectiveness of tobacco-related health messages among Inuit in Nunavut, Canada: What types of messages work best at promoting smoking cessation among Inuit smokers?. PhD. Public Health & Health Systems. University of Waterloo, Canada. Committee member. 2013. Wendy González. Understanding the early stages of development of a Global Health Partnership. PhD. Health Promotion, Education and Behavior. USC. Committee member. 2013. Leith Soledad León Maldonado. Identificación de necesidades de información y apoyo de las mujeres mexicanas al realizarse la prueba del VPH [Needs assessment for Mexican women who screen for HPV]. PhD. Escuela de Salud Pública, INSP, Cuernavaca, México. Committee member. 2013. Leah Williams. A mixed-methods approach to understanding the association between body image and sexual risk behaviors among female college students. PhD. Health Promotion, Education and Behavior. USC. Committee member. 2012. Megan Weiss. Back at work, now what? Exploring home organizational climate and professional networks in applying leadership skills for public health systems change. DrPH. Health Promotion, Education and Behavior. USC. Committee member. 2012. Yong Hong. Investigating content, format and placement of point-of-selection nutrition labels in a foodservice setting and its impact on patrons’ purchasing behavior. PhD. Health

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Promotion, Education and Behavior. USC. Committee member. 2012. Brook Harmon. Pastoral eating identity and the informational and physical environment in African-American churches - Implications for health promotion programming. PhD. Health Promotion, Education and Behavior. USC. Committee member. 2012. Sarah Hitchman. The relation between number of smoking friends and adult smoking cessation: Findings from the International Tobacco Control Policy Evaluation Project Four Country Survey. PhD. Department of Psychology, University of Waterloo, Canada. Committee member. 2012.

ACADEMIC COMMITTEES – MASTERS & UNDERGRADUATE HONOR´S THESES LaQuenta Weldon. Smoking cessation in pregnancy is associated with excessive gestational weight gain, SC Mothers, 2009-2011. MSPH. Epidemiology. Committee member. 2013. Bimla Mousla. Effects of the World Lung Foundation’s ‘Sponge’ media campaign in Mauritius. University of Pretoria, Pretoria, South Africa. MPH. Committee member. 2013. Rahoul Ahuja. Movies, smoking and tobacco control policy in Argentina. BS. Honors Thesis. University of South Carolina. Director of Thesis. 2013. Johann Fridriksen. Neurological responses to graphic warning labels on cigarette packages. Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina. MSPH. Committee chair. 2013. Nancy Nolasco Alonso. La consulta médica y el dejar de fumar en México. [The medical encounter and smoking cessation in Mexico]. Department of Epidemiology, School of Public Health. Mexican National Institute of Public Health. MSc. Committee chair. 2012. Peter Sae Yang. Impact of cartoon characters and nutrition claims on parental perceptions of children´s food products. Department of Health Studies, University of Waterloo, Canada. Committee member. MSc. 2011. Christine White. The impact of cigarette package design on female youth in Brazil: Brand appeal and health-related perceptions. Department of Health Studies, University of Waterloo, Canada. MSc. Committee member. 2011. Victor Montalvo Díaz. Los pictogramas en las cajetillas de cigarro como mensaje de salud para promover la intención de dejar de fumar en adultos de Guadalajara, 2010. [Pictorial warning labels on cigarette packages as a stop-smoking message for adults in Guadalajara, 2010]. Dept. Health Behavior, Mexican National Institute of Public Health. MPH. Committee member. 2011.

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Alejandra Gutiérrez Cárdenas. La educación en salud para la prevención del tabaquismo en las escuelas: Un análisis cualitativo desde la perspectiva de los profesores [Health education to prevent tobacco in schools: A qualitative analysis of the teacher perspective]. MPH. Escuela de Salud Pública, INSP, Cuernavaca, México. Committee member. 2010. Jessica Steele. Vaccine introduction in Latin America and the Caribbean: Developing learning modules for evidence-based decision making. BA. Honors Thesis. University of South Carolina. Director of Thesis. 2010. Francisco Javier Arellano Ayala. Significados relacionados con el riesgo y el placer de las prácticas sexuales anales penetrativas en un grupo de hombres que tienen sexo con hombres (HSH) [Meanings of risk and pleasure around anal penetrative sex among men who have sex with men]. MSc. Área de concentración en salud reproductiva, Escuela de Salud Pública, INSP, Cuernavaca, México. Committee member. 2009. Rosaura Pérez Hernández. Factores familiares en el inicio del consumo de tabaco [Family factors associated with smoking initiation]. MPH, Epidemiology, Escuela de Salud Pública, INSP, Cuernavaca, Mexico. Committee member. 2009. Nidia Guadalupe Sosa Delgado. Violencia de género, un problema de salud pública: un taller de empoderamiento en la colonia “Los Reyes” del municipio Axochiapan, Morelos . [Gender- based violence, a public health problema: An empowerment workshop in the Kings neighborhood of Axochipan, Mexico]. MPH, Ciencias Sociales y del Comportamiento, Escuela de Salud Pública, INSP, Cuernavaca, Morelos, México. Committee member. 2007. Dra. Rosa Gricelda Huerta Flores. Obesidad un problema de salud pública: Promoción de un estilo de vida saludable en “Los Reyes,” Axochiapan, Morelos [Obisity as a public health problema: Promotion of health lifestyles in the Kings neighborhood of Axochiapan, Mexico]. MPH, Epidemiología, Escuela de Salud Pública, INSP, Cuernavaca, Morelos, México. Committee member. 2007. Epifania González Baza. Salud y género: una intervención educativa con madres de niñas menores de 5 años de edad en la Colonia Los Reyes del municipio Axochiapan, Morelos [Health and gender: An educational intervention among mothers of children younger than 5]. MPH, Ciencias Sociales y del Comportamiento, Escuela de Salud Pública, INSP, Cuernavaca, Morelos, México. Committee member. 2007. Dr. Oscar Murillo. Intervenciones educativas contra el tabaquismo en adolescentes en diversos países [Educational interventions to prevent tobacco use among youth from different countries]. MPH, Sistemas de Salud, Escuela de Salud Pública, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. Committee member. 2003.

PRACTICUM ADVISOR

JF THRASHER

Marissa Hall. Validation of an instrument to assess tobacco marketing at points of sale in Mexico. PhD Research Practicum. Department of Health Behavior, University of North Carolina. 2013.

Ashlee Navarro. Media coverage and media advocacy around tobacco control policy in Mexico. MPH Practicum. Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina. 2010.

Janaki Jayanthan. Civil society coalition building to advance smoke-free policy in Mexico. MPH practicum. Department of Global Health. Simon Frasier University, Canada. 2009.

Lauren . Analysis of media coverage around smoke free policy initiatives in South Carolina. MPH Practicum. Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina. 2010.

UNIVERSITY & DEPARTMENTAL SERVICE Chair, Doctoral Committee 2012-present Department of Health Promotion, Education & Behavior University of South Carolina Member, Research Advisory Council 2011-present Arnold School of Public Health University of South Carolina Member, South Carolina Public Health Consortium 2010-present Office of Public Health Practice, Arnold School of Public Health University of South Carolina & South Carolina Department of Health & Environmental Control Member, Departmental Chair Search Committee 2013-present Department of Health Promotion, Education & Behavior University of South Carolina Member, Steering Committee 2013-present Center for Research in Nutrition & Health Disparities University of South Carolina Member, Tobacco Free Task Force 2012-present Healthy Carolina, University of South Carolina. Member, Faculty Search Committee – Latino Health Disparities 2013-2014 Department of Health Promotion, Education & Behavior University of South Carolina Member, Information Technology and Resources Committee 2008-2013

JF THRASHER

Arnold School of Public Health, University of South Carolina Chair, Faculty Search Committee – Cancer Research Cluster 2012-2013 Arnold School of Public Health, University of South Carolina Member, Review Committee 2013 Magellan Scholarship for Undergraduate Research University of South Carolina Member, Faculty Search Committee 2011-2012 Department of Health Services Policy & Management University of South Carolina Member, Endowed Chair Search Committee – Information Technology 2011-2012 Arnold School of Public Health, University of South Carolina Member, Doctoral Committee 2007-2012 Department of Health Promotion, Education & Behavior University of South Carolina Member, Fulbright Evaluation Committee 2010 University of South Carolina

HONORS & AWARDS Faculty Research Excellence Award, Arnold School of Public Health, 2014 University of South Carolina, Columbia Delta Omega, Honorary Public Health Society 2005 Selected participant, Career Development Institute on Health Disparities, 2005 Center for Minority Health, U Pittsburgh Ambassador, The Graduate School, University of North Carolina, 2003-2005 Chapel Hill Winner, Spicer Award, Society for Applied Anthropology, Washington, DC 2004 Winner, Travel Award Competition, School of Public Health, 2004 University of North Carolina, Chapel Hill Stipend Award, Fulbright New Century Scholars Program 2003 La globalización y los retos de salud en Latinoamérica

Winner, Graduate Student Abstract Competition 2003 Public Health Education and Health Promotion Section, American Public Health Association Winner, Photography Competition, Center for International Studies 2002

35 JF THRASHER

University of North Carolina, Chapel Hill Winner, Graduate Student Research Award 2000 New York State Public Health Association Phi Beta Kappa 1989

AD HOC REVIEWER Addiction (2011, 2013) Addictive Behaviors (2007, 2010) American Anthropologist (1995-1996) American Journal of Public Health (2012) American Journal of Preventive Medicine (2013) BMC Public Health (2011, 2012) British Medical Journal Open (2013) Bulletin of the World Health Organization (2010) Archives of Pediatric and Adolescent Medicine (2004-2005) Cancer Causes & Control (2010) Cancer, Epidemiology, Biomarkers & Prevention (2009) Ethnography (2010) Field Methods (2005; 2011) Global Public Health (2006) Global Health Promotion (2011) Health Education and Behavior (2010, 2011) Health Education Research (2004, 2010, 2011) Health Policy (2011) Health Policy & Planning (2013) Health Psychology (2011, 2013) Health Services Research (2007) Human Organization (2007) International Journal of Public Health (2010) International Journal of Environmental Research and Public Health (2011) Journal of Addiction (2013) Journal of Adolescent Health (2009) Journal of Health and Social Behavior (2003) Journal of Health Communication (2011) Journal of Rural Health (2007) Lancet (2013)

JF THRASHER

Nicotine and Tobacco Research (2007, 2009, 2011, 2012, 2013) Preventive Medicine (2006-2008) Salud Pública de México (2005-2007, 2010, 2012) Social Science & Medicine (2011-2013) Tobacco Control (2003-2004, 2009-2013)

PROFESSIONAL ASSOCIATIONS American Public Health Association Mexican Society of Public Health Society for Applied Anthropology Society for Medical Anthropology Society for Research on Nicotine and Tobacco

PROFESSIONAL SERVICE Associate Editor, Nicotine & Tobacco Research, Journal of the Society for Research on Nicotine & Tobacco. 2013 – present. Associate Editor, Tobacco Regulatory Science: Research to Inform Tobacco Control Policy. 2014 – present. Chair, Global Health Network, Society for Research on Nicotine & Tobacco. March 2013 – present. Board of Directors, South Carolina Tobacco-Free Collaborative, a coalition of organizations that provide resources and information on tobacco-related policies to advocates, lawmakers and concerned citizens of South Carolina. Scientific Chair, Latin American Conference on Tobacco or Health. San José, Costa Rica. March 2013 – April 2014. Peer reviewer, National Cancer Institute Monograph, A Socio-ecological Approach to Addressing Tobacco-related Health Disparities. Department of Health and Human Services, National Cancer Institute. 2014. Review Committee Member, American Cancer Society-Institutional Research Grant, University of South Carolina. Review seed grant applications among Junior USC faculty. January 2013 – present. Steering Committee, South Carolina Tobacco Research Interest Group (SCTRIG), an interinstitutional collaboration to foster tobacco-related research in South Carolina. February 2011-present. Abstract Reviewer, Society for Behavioral Medicine, Annual Conference, October 2013 Scientific Reviewer, Cancer Research UK. March 2013.

JF THRASHER

Working group member, Consorcio Interinstitucional sobre Comunicación y Política Pública para el Control de Tabaco [Interinstitutional Consortium on Tobacco control Communications and Policy], Mexican Ministry of Health. March 2010 - December 2012. Project Advisory Council. Pasos, a Robert Wood Johnson Foundation project to develop leadership and advocacy to address reproductive health issues among Latinos in South Carolina. November 2010 – 2012. Scientific Co-Chair, Latin American Conference on Tobacco or Health. Lima, Peru. February - October 2011. Panelist, Movies, Entertainment Media and Tobacco-Related Disparities, Tobacco Research Network on Disparities, National Cancer Institute and American Legacy Foundation. Harvard University. Oct 14-15, 2010. Advisory Council, Consejo de impacto para dejar de fumar, an online course for public health professionals and medical personnel on tobacco and tobacco cessation. Instituto Nacional de Enfermedades Respiratorias, México. August-September 2010. Guest Editor, special issue of the Mexican Journal of Public Health, “El control de la epidemia del tabaco en América Latina: avances en investigación, acción y evaluación del Convenio Marco para el Control del Tabaco,” September 2010. Peer reviewer, Surgeon General’s Report on Preventing Youth Smoking, Department of Health and Human Services, Centers for Disease Control and Prevention, March 2010. Advisory Workshop, Cigarette Warning Labels, Packaging, and Product Labeling to inform Food and Drug Administration regulations. National Cancer Institute, National Institutes of Health, Oct 20-12, 2009. External advisory board, University of Illinois, Chicago, P25 training grant from National Cancer Institute, September 2008-2010. Advisory Committee, Mexican National Council against Addictions, inform regulations around health warning labels for cigarette packaging, Mexico, Oct 4-5, 2008. Scientific Committee, Society for Research on Nicotine and Tobacco, 2nd Latin American Conference, Mexico City, Mexico. 14-16 October, 2009. Organizer, Pre-conference workshop “Promoting and Evaluating Effective Tobacco Control Policies”, Society for Research on Nicotine and Tobacco, 2nd Latin American Conference, Mexico City, Mexico. 13 October, 2009. Consultant, Centers for Disease Control and Prevention, School Health Guidelines on Tobacco Prevention. Atlanta, GA, USA. 20-21 August, 2007. Consultant, World Health Organization, Protocol on Cross-border Tobacco Advertising, Promotion, and Sponsorship. Agra, India. 16-18 November, 2006. Consultant, World Health Organization, Protocol on Cross-border Tobacco Advertising, Promotion, and Sponsorship. 13-15 September, 2006. Geneva, Switzerland.

JF THRASHER

LANGUAGES SPOKEN & WRITTEN English & Spanish (written and spoken fluency)

REFERENCES FURNISHED UPON REQUEST

Appendix 2

List of Annexes

Beaglehole R, Bonita R, Horton R, et al. Priority actions for the non-communicable disease JT-001 crisis. The Lancet 2011; 377(9775): 1438-47.

Oppeltz R, Jatoi I. Tobacco and the escalating global cancer burden. Journal of Oncology JT-002 2011: 408104.

Swayampakala K, Thrasher J, Hammond D, et al. Pictorial health warning label content and JT-003 smokers’ understanding of smoking-related risks – A cross-country comparison. Health Education Research in press.

Weinstein ND, Slovic P, Waters E, G G. Public understanding of the illnesses caused by JT-004 cigarette smoking. Nicotine & Tobacco Research 2004; 6(2): 349-55.

Jamieson P, Romer D. What do young people think they know about the risks of smoking? In: JT-005 Slovic P, ed. Smoking: Risk, Perception, and Policy. Thousand Oaks, CA: Sage; 2001: 51-63.

Weinstein N, Marcus S, Moser R. Smokers’ unrealistic optimism about their risk. Tobacco JT-006 Control 2005; 14(55-59).

Hyland A, Li Q, Bauer J, et al. Predictors of cessation in a cohort of current and former JT-007 smokers followed over 13 years. Nicotine & Tobacco Research 2004; 6(Supp 3): S363–69.

Arnett J. Optimistic bias in adolescent and adult smokers and nonsmokers. Addictive JT-008 Behaviors 2000; 25(4): 625-32.

Johnston L, O’Malley P, Bachman J, Schulenberg J. Monitoring the Future national results on JT-009 adolescent drug use: Overview of key findings, 2004. Bethesda, MD: National Institute on Drug Abuse, 2005. Winder C, Azzi R, Wagner D. The development of the globally harmonized system (GHS) of JT-010 classification and labelling of hazardous chemicals. Journal of Hazardous Materials 2005; (A125 ): 29-44.

Wogalter MS, Conzola VC, Smith-Jackson TL. Research based guidelines for warning design JT-011 and evaluation. Applied Economics 2002; 33(3): 219-30.

Wogalter M, DeJoy D, Laughery K, editors. Warnings and Risk Communication. London: JT-012 Taylor and Francis; 1999.

Sojourner R, Wogalter M. The influence of pictorials on the comprehension of and recall of JT-013 pharmaceutical safety and warning information. International Journal of Cognitive Ergonomics 1998; 2: 93-106.

Michael S. Wogalter, Sandra S. Godfrey, Gail A. Fontenelle, David R. Desaulniers, Rothstein JT-014 PR, Kenneth R. Laughery. Effectiveness of warnings. Human Factors: The Journal of the Human Factors and Ergonomics Society 1987; 29: 599-612.

Curt C. Braun, Paul B. Kline, N. Clayton Silver. The influence of color on warning label JT-015 perceptions. International Journal of Industrial Ergonomics 1995; 15: 179-87.

Michael J. Kalsher, Michael S. Wogalter, Bernadette M. Racicot. Pharmaceutical container JT-016 labels: Enhancing preference perceptions with alternative designs and pictorials. International Journal of Industrial Ergonomics 1996; 18

Wogalter M, DeJoy D, Laughery K. Organizing theoretical framework: A consolidated JT-017 communication human information processing (C-HIP) model. In: Wogalter M, DeJoy D, Laughery K, eds. Warnings and Risk Communication. London: Taylor and Francis; 1999: 30-8.

Laughery K, Wogalter M. Designing effective warnings. In: Williges R, ed. Human Factors in Ergonomics Reviews. Santa Monica, CA: Human Factors and Ergonomics Society; 2006: 241- JT-018 71.

JT-019 Rice RE, Atkin CK, editors. Public communication campaigns. Thousand Oaks, CA: Sage; 2001.

Lee NR, Kotler PA. Social Marketing: Influencing Behaviors for Good Thousand Oaks: Sage; JT-020 2011. Wogalter M, Leonard S. Attention and maintenance. In: Wogalter M, DeJoy D, Laughery K, JT-021 eds. Warnings and risk communication. London: Taylor & Francis; 1999: 130-55.

Petty RE, Barden J, Wheeler SC. The Elaboration Likelihood Model of persuasion: Health promotions that yield sustained behavioral change. In: DiClemente RJ, Crosby RA, Kegler MC, JT-022 eds. Emerging theories in health promotion practice and research. San Francisco, CA: Jossey- Bass; 2002: 71-99.

Petty RE, Cacioppo J. The effect of involvement on response to argument quantity and JT-023 quality: Central and peripheral routes to processing. Journal of Personality and Social Psychology 1984; 46: 69-81.

Czoli C, Hammond D. Cigarette packaging: Youth perceptions of “natural” cigarettes, filter JT-024 references, and contraband tobacco. Journal of Adolescent Health 2013; 54(1): 33-9

JT-025 Harris B. The intractable cigarette ‘filter problem’. Tobacco Control 2011; 20(Supp 1): 10i-i6.

Kotnowski K, Hammond D. The impact of cigarette pack shape, size and opening: evidence JT-026 from tobacco company documents. Addiction 2013; 108(9): 1658-68

West R, Sohal T. “Catastrophic” pathways to smoking cessation: findings from national JT-027 survey. British Medical Journal 2006; 332(7539): 458-60.

Moodie C, MacKintosh AM, Hammond D. Adolescents’ response to text-only tobacco health JT-028 warnings: Results from the 2008 UK Youth Tobacco Policy Survey. European Journal of Public Health 2010; 20(4): 463-9.

Li J, Grigg M. New Zealand: new graphic warnings encourage registrations with the quitline. JT-029 Tobacco Control 2009; 18(1): 72.

Cantrell J, Vallone D, Thrasher J, et al. Impact of tobacco-related health warning labels across JT-030 socioeconomic, race and ethnic groups: Results from a randomized web-based experiment. PLoS One 2013; 8(1): e52206

Veer E, Rank T. Warning! The following packet contains shocking images: The impact of JT-031 mortality salience on the effectiveness of graphic cigarette warning labels. Journal of Consumer Behaviour 2012; 11: 225-33. Thrasher J, Carpenter M, Andrews J, et al. Cigarette warning label policy alternatives and JT-032 smoking-related health disparities. American Journal of Preventive Medicine 2012; 43(6): 590–600

Thrasher J, Arillo-Santillán E, Villalobos V, et al. Can pictorial warning labels on cigarette JT-033 packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content. Cancer Causes and Control 2012; 23: 69–80.

Peters E, Romer D, Slovic P, et al. The impact and acceptability of Canadian-style cigarette JT-034 warning labels among US smokers and nonsmokers. Nicotine & Tobacco Research 2007; 9(4): 473-81.

Kees J, Burton S, Andrews J, Kozup J. Tests of graphic visuals and cigarette package warning JT-035 combinations: Implications for the Framework Convention on Tobacco Control. Journal of Public Policy Marketing 2006; 25(212-23).

Kees J, Burton S, Andrews JC. Understanding how graphic pictorial warnings work on JT-036 cigarette packaging. Journal of Public Policy and Marketing 2010; 29: 115-26.

Cameron LD, Pepper JK, Brewer NT. Responses of young adults to graphic warning labels for JT-037 cigarette packages. Tobacco Control in press (available online)

Emery LF, Romer D, Sheerin KM, Jamieson KH, Peters E. Affective and cognitive mediators of JT-038 the impact of cigarette warning labels. Nicotine & Tobacco Research 2014; 16(3): 263-9.

Hammond D, Thrasher J, Reid J, Driezen P, Boudreau C, Arillo-Santillán E. Perceived effectiveness of pictorial health warnings among Mexican youth and adults: a population- JT-039 level intervention with potential to reduce tobacco-related inequities. Cancer Causes and Control 2012; 23: 57-67

Volchan E, David I, Tavares G, et al. Implicit motivational impact of pictorial health warning JT-040 on cigarette packs. PLoS One 2013; 15(8): e72117. Nan X, Zhao X, Yang B, Iles I. Effectiveness of cigarette warning labels: Examining the impact JT-041 of graphics, message framing, and temporal framing. Health Communication in press (available online)

Fong GT, Hammond D, Jiang Y, et al. Perceptions of tobacco health warnings in China JT-042 compared with picture and text-only health warnings from other countries: an experimental study. Tobacco Control 2010; 19(Suppl 2): i69-i77

Thrasher JF, Allen B, Anaya-Ocampo R, Reynales LM, Lazcano-Ponce EC, Hernández-Avila M. Análisis del impacto en fumadores Mexicanos de los avisos gráficos en las cajetillas de JT-043 cigarros [Analysis of the impact of cigarette package warning labels with graphic images among Mexican smokers]. Salud Pública de México 2006; 48: S65-S75

Fathelrahman A, Omar M, Awang R, Cummings K, Borland R, Bin Mohd Samin A. Impact of the new Malaysian cigarette pack warnings on smokers’ awareness of health risks and JT-044 interest in quitting smoking. International Journal of Environmental Research in Pubilc Health 2010; 7: 4089-99.

Thrasher JF, Rousu MC, Hammond D, Navarro A, Corrigan J. Estimating the impact of pictorial JT-045 health warnings and "plain" cigarette packaging: Evidence from experimental auctions among adult smokers in the United States. Health Policy 2011; 102: 41- 8

Thrasher JF, Rousu MC, Anaya-Ocampo R, Reynales-Shigematsu LM, Arillo-Santillán E, JT-046 Hernández-Ávila M. Estimating the impact of graphic warning labels on cigarette packs: The auction method. Addictive Behaviors 2007; 32(12): 2916-5

Reid J, Hammond D, Thrasher J, Driezen P, Boudreau C, Arillo-Santillán E. Impacto de estrategias visuales en las advertencias sanitarias: un experimento de campo en adultos JT-047 fumadores y adolescentes mexicanos. In Pp. . 2013. In: Thrasher J, Reynales-Shigematsu L, Lazcano-Ponce E, Hernández-Ávila M, eds. Salud pública y tabaquismo, Volumen II Advertencias sanitarias en América Latina y el Caribe; 2013: 128-42. Thrasher J, Pérez-Hernández R, Arillo-Santillán E, Barrientos-Gutierrez I. Hacia el consumo informado de tabaco en México: Efecto de las advertencias en población fumadora [Towards JT-048 informed tobacco consumption in Mexico: Effects of pictorial warning labels among smokers]. Revista de Salud Pública de México 2012; 54: 242-53

Kennedy RD, Spafford MM, Behm I, Hammond D, Fong GT, Borland R. Positive impact of JT-049 Australian ‘blindness’ tobacco warning labels: findings from the ITC four country survey. Clinical and Experimental Optometry 2012; 95(6): 590-8.

Hammond D. Tobacco packaging and labeling policies under the U.S. Tobacco Control Act: JT-050 research needs and priorities. Nicotine & Tobacco Research 2012; 14(1): 62-74.

Nilsson T. Legibility and visual effectiveness of some proposed and current health warnings JT-051 on cigarette packages. Prepared for Bureau of Tobacco Control, Health Canada, 1999

Argo JJ, Main KJ. Meta-analyses of the effectiveness of warning labels. Journal of Public Policy JT-052 and Marketing 2004; 23: 193-208.

Hassan L, Shiu E, Thrasher JF, Fong GT, Hastings G. Exploring the effectiveness of cigarette warning labels: Findings from the United States and United Kingdom arms of the JT-053 International Tobacco Control Four Country Survey. International Journal of Nonprofit and Voluntary Sector Marketing 2008; 15.

BRC Marketing & Social Research. Smoking health warnings study, Stage 2: Optimising JT-054 smoking health warnings - text, graphics, size and colour testing.: prepared for Ministry of Health, New Zealand, 2004.

Borland R, Yong H-H, Wilson N, et al. How reactions to cigarette packet health warnings JT-055 influence quitting: Findings from the ITC 4 country survey. Addiction 2009; 104: 669-75.

Fathelrahman AI, Li L, Borland R, et al. Stronger pack warnings predict quitting more than JT-056 weaker ones: finding from the ITC Malaysia and Thailand surveys. Tobacco Induced Diseases 2013; 11: 20.

Yong H-H, Borland R, Thrasher J, et al. Mediational pathways of the impact of cigarette JT-057 warning labels on quit attempts. Health Psychology in press. JT-058 Wegner D. Ironic process of mental thought. Psychology Review 1994; 101(34-52).

Environics Research Group. Testing the size of cigarette package health warnings: An online JT-059 survey of Canadians, Study 2. Toronto: Prepared for Health Canada, 2011.

Wakefield M, Germain D, Durkin S, Hammond D, Goldberg M, Borland R. Do larger pictorial JT-060 health warnings diminish the need for plain packaging of cigarettes? Addiction 2012; 107: 1159–67.

Hammond D, White C, Anderson W, Arnott D, Dockrell M. The perceptions of UK youth of JT-061 branded and standardized, ‘plain’ cigarette packaging. European Journal of Public Health 2014; online(24): 4.

Witte K, Allen M. A meta-analysis of fear appeals: Implications for effective public health JT-062 campaigns. Health Education & Behavior 2000; 27: 608-32.

Durkin S, Brennan E, Wakefield M. Mass media campaigns to promote smoking cessation JT-063 among adults: an integrative review. Tobacco Control 2012; 21(2): 127-38

Borland R, Hill D. Initial impact of the new Australian tobacco health warnings on knowledge JT-064 and beliefs. Tobacco Control 1997; 6: 317-25

Durkin S, Wakefield M. Maximising the impact of emotive anti-tobacco advertising: Effects of JT-065 interpersonal discussion and program placement. Social Marketing Quarterly 2006; 12(3): 3- 14.

Southwell BG, Yzer MC. The roles of interpersonal communication in mass media campaigns. JT-066 In: Beck CS, ed. Communication Yearbook 31 New York: Erlbaum; 2007: 419–62

Van den Puttte B, Yzer MC, Southwell BG, De Bruijn G-J, Willemsen MC. Interpersonal JT-067 communication as an indirect pthway for the effect of antismoking media content on smoking cessation. Journal of Health Communication 2011; 16: 470-85

Environics Research Group. Testing the size of cigarette package health warnings: An online JT-068 survey of Canadians, Study 1. Toronto: Prepared for Health Canada, 2011 Environics Research Group. Testing the size of cigarette package health warnings: An online JT-069 survey of Canadians, Study 3. Toronto: Prepared for Health Canada, 2011

Czuka D, Bhatti F. Canada’s implementation of graphic health warning labels. North JT-070 American Consortium of Quitlines Conference; 2012

Huang J, Chaloupka F, Fong G. Cigarette graphic warning labels and smoking prevalence in JT-071 Canada: a critical examination and reformulation of the FDA regulatory impact analysis. Tobacco Control in press

Azagba S, Sharaf M. The effect of graphic cigarette warning labels on smoking behavior: JT-072 Evidence from the Canadian experience. Nicotine & Tobacco Research 2013; 15(3): 708-17

Gospodinov N, Irvine I. Global health warnings on tobacco packaging: Evidence from the JT-073 Canadian experiment. Topics in Economic Analysis & Policy 2004; 4(1): 1-23.

O'Hegarty M, Pederson LL, Yenokyan G, Nelson DE, Wortley P. Young adults' perceptions of JT-074 cigarette warning labels in the United States and Canada. Preventing Chronic Disease 2007; 4(2): A27

IOM. Speaking of health: Assessing health communication strategies for diverse populations. JT-075 Washington DC: National Academy of Sciences, Institute of Medicine; 2002.

Swinehart JW. Health behavior research and communication campaigns. In: Gochman DS, ed. JT-076 Handbook of Health Behavior Research, IV: Relevance for professionals and issues for the future. New York: Plenum Press; 1997: 351-73

Hornik R, editor. Public health communication: Evidence for behavior change. Mahwah, NJ: JT-077 Lawrence Erlbaum; 2002

JT-078 McQuail D. McQuail's mass communication theory. 5th ed. London: Sage; 2005

Hawkins D, Best R, Coney K. Consumer behavior: Building marketing strategy. Boston, MA: JT-079 McGraw-Hill; 2001

Brandt AM. The cigarette century: The rise, fall, and deadly persistence of the product that JT-080 defined America. New York: Basic Books; 2007 Anderson S. Marketing of menthol cigarettes and consumer perceptions: A review of tobacco JT-081 industry documents. Tobacco Control 2011; 20(S2): ii20-ii8