SHORT REPORT
Educating smokers about the risk of blindness – insights to improve tobacco product health warning labels
 
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1
Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Canada
2
Institute for Global Tobacco Control, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
3
School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
4
Faculty of Science, University of Waterloo, Waterloo, Canada
5
École d’optométrie, Université de Montréal, Montréal, Canada
6
Department of Psychology, University of Waterloo, Waterloo, Canada
7
Ontario Institute for Cancer Research, Toronto, Canada
8
College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
CORRESPONDING AUTHOR
Ryan David Kennedy   

Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Publish date: 2016-08-19
 
Tobacco Induced Diseases 2016;14(August):30
KEYWORDS
ABSTRACT
Background:
Health warning labels (HWL) on tobacco products help educate smokers about the health effects from smoking; however, there is a need to improve HWL content including images and text to increase effectiveness. In Canada, a HWL was created that communicates smoking’s causal association with “blindness” from age-related macular degeneration (AMD). This study surveyed Canadian optometrists about their opinions regarding the image and text used in the “blindness” HWL.

Methods:
An online survey was sent to all 4528 registered Canadian optometrists. Respondents were asked if the HWL conveyed important and believable information, and if the picture was appropriate. Optometrists were invited to make open-ended comments about the label which were analyzed using a qualitative analysis framework suitable for health policy evaluation. Frequency distributions were calculated for closed-ended questions.

Results:
The survey was completed by 850 respondents (19 %). Most respondents (90 %) reported the message was believable/somewhat believable; while 35 % felt the picture was “too graphic”. Some respondents reported in their open-ended comments that they were concerned the HWL was internally inconsistent because it reports there is “no effective treatment in most cases” for AMD but the image depicts someone undergoing surgery. There was concern that this may discourage patients from seeking needed treatment.

Conclusions:
The majority of Canadian optometrist respondents were in agreement that the new, “RISK OF BLINDNESS” pictorial HWL includes important, believable information. Some optometrists had concerns that the HWL included a confusing message or a message that may discourage some patients from pursuing treatment for AMD. Future development of blindness-related HWL should seek practitioner input.

 
REFERENCES (26)
1.
Institute for Global Tobacco Control. State of Evidence Review: Health Warning Labels on Tobacco Products. Baltimore: Johns Hopkins Bloomberg School of Public Health; 2013. http://globaltobaccocontrol.or.... Accessed 16 Aug 2016.
 
2.
Hammond D, Fong GT, McNeill A, Borland R, Cummings KM. Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: Findings from the International Tobacco Control (ITC) four country survey. Tob Control. 2006;15 Suppl 3:iii19–25.
 
3.
Canada H. Health Labels for Cigarettes and Little Cigars. 2012. http://www.hc-sc.gc.ca/hc-ps/t.... Accessed 16 Aug 2016.
 
4.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
 
5.
Velilla S, García-Medina JJ, García-Layana A, Dolz-Marco R, Pons-Vázquez S, Pinazo-Durán MD, et al. Smoking and age-related macular degeneration: review and update. J Ophthalmol. 2013;2013:895147.
 
6.
Mitchell P, Chapman S, Smith W. Smoking is a major cause of blindness. Med J Aust. 1999;171:173–4.
 
7.
Kelly SP, Thornton J, Lyratzopoulos G, Edwards R, Mitchell P. Smoking and Blindness. Br Med J. 2004;328:537–8.
 
8.
Canadian National Institute for the Blind. Your Guide to Age-Related Macular Degeneration. ND. http://www.cnib.ca/en/your-eye.... Accessed 16 Aug 2016.
 
9.
Carroll T, Rock B. Generating Quitline calls during Australia’s National Tobacco Campaign: effects of television advertisement execution and programme placement. Tob Control. 2003;12 Suppl 2:ii40–4.
 
10.
Wilson N, Thomson G, Grigg M, Afzal R. New smoke-free environments legislation stimulates calls to a national quitline. Tob Control. 2005;14(4):287–8.
 
11.
Moradi P, Thornton J, Edwards R, Harrison RA, Washington SJ, Kelly SP. Teenagers’ perceptions of blindness related to smoking: a novel message to a vulnerable group. Br J Ophthalmol. 2007;91(5):605–7.
 
12.
Kennedy RD, Spafford MM, Behm I, Hammond D, Fong GT, Borland R. Positive impact of Australian ‘blindness’ tobacco warning labels: findings from the ITC four country survey. Clin Exp Optom. 2012;95(6):590–8.
 
13.
Kennedy RD, Spafford MM, Parkinson CM, Fong GT. Knowledge about the relationship between smoking and blindness in Canada, the United States, the United Kingdom, and Australia: Results from the international tobacco control four-country project. Optometry. 2011;82(5):310–7.
 
14.
Shanahan P, Elliott D. Evaluation of the effectiveness of the graphic health warnings on tobacco product packaging 2008. Canberra: Australian Government Department of Health and Ageing; 2009.
 
15.
Kennedy RD, Spafford MM, Schultz AS, Iley MD, Zawada V. Smoking cessation referrals in optometric practice: a Canadian pilot study. Optom Vis Sci. 2011;88(6):766–71.
 
16.
Canadian Association of Optometrists. About Canadian Association of Optometrists. 2014. https://opto.ca/about. Accessed 16 Aug 2016.
 
17.
Canada S. French and the Francophonie in Canada. 2013. Available from: http://www12.statcan.gc.ca/cen.... Accessed 16 Aug 2016.
 
18.
Canada S. Optometrists – labour force distribution by gender. 2012. Available from: http://www.servicecanada.gc.ca.... Accessed 16 Aug 2016.
 
19.
Pope C, Ziebland S, Mays N. Qualitative research in health care- Analysing qualitative data. BMJ. 2000;320:8.
 
20.
Tremblay M, Cournoyer D, O’Loughlin J. Do the correlates of smoking cessation counseling differ across health professional groups? Nic Tob Res. 2009;11(11):1330–8.
 
21.
Program Training and Consultation Centre. Brief Counselling for Tobacco Use Cessation: A Guide for Health Professionals. Oct. 30, 2012. https://www.ptcc-cfc.on.ca/cms.... Accessed 12 Jan 2016.
 
22.
Kennedy RD, Spafford MM, Douglas O, Brûlé J, Hammond D, Fong GT, et al. Patient tobacco use in optometric practice: a Canada-wide study. Opt Vis Sci. 2014;91(7):1040–5488.
 
23.
Centre TLR. Health Warnings – Countries. 2014. http://www.tobaccolabels.ca/he.... Accessed 16 Aug 2016.
 
24.
World Health Organization. Guidelines for implementation of Article 11 of the WHO Framework Convention on Tobacco Control (Packaging and labelling of tobacco products). 2009. Decision FCTC/COP/3/DIV/3. http://www.who.int/fctc/guidel.... Accessed 16 Aug 2016.
 
25.
Swayampakala K, Thrasher JF, Hammond D, Yong H, Bansal-Travers M, Krugman D, et al. Pictorial health warning label content and smokers’ understanding of smoking-related risks—a cross-country comparison. Health Educ Res. 2015;30(1):35–45.
 
26.
Tobacco Labelling Resource Centre. Available from: http://www.tobaccolabels.ca/. Accessed 16 Aug 2016.
 
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