Reactions to the FDA proposed graphic warning labels among smokers in addiction treatment centers

Aims:We evaluate knowledge and attitudes of cigarette health risks and smoking behaviors with respect to the FDA proposed graphic warning labels (GWLs) among smokers in the addiction treatment centers where smoking prevalence is 3-4 times higher than in the general population. Methods:376 clients from8addiction treatment centers inNew York were surveyed from May to September, 2013. Participants were asked about cigarette use harms and attitudes about quitting smoking after exposing to current warning labels. The GWLs were introduced to participants and the same set of questions was repeated. Participants were also asked questions related to smoking behaviors, intention to quit and attitudes towards cessation program. Signed tests were used to compare how participants responded to the same set of questions for current warning labels and the GWLs. The association between levels of perceiving health risk from the GWLs and smoking behaviors were examined by t tests and chi-square tests. Results: 67% of participants (n = 252)were current smokers. The GWLs consistently have the higher impact than the current warning labels on: knowledge of cigarette use harms (55.8% vs 35.9%, p<0.001), positive attitudes about quitting smoking (53.7%vs 34.6%, p<0.001), staying quitting (50.0% vs 34.2%, p<0.001), and stopping from having a cigarette (34.6% vs 6.5%, p<0.001) Among smokers who thought “somewhat/a lot” about the health risks of smoking after exposing to the GWLs, they were more likely to attempt quitting (66.7% vs 48.6%, p=0.019), have intention to quit in the next 6 months (68.2% vs 46.1%, p<0.001), and also have positive attitudes towards smoking cessation programs (3.29 vs 3.00, p=0.002). Conclusions: The GWLs have greater impacts than the current warning labels in term of conveying health risks of smoking and promoting quitting among this high prevalence smoking population. Perceiving greater health risks from smoking are also more likely to increase the quit attempts, intention to quit and positive attitudes towards smoking cessation. Financial support: NIDA (P50DA009253).