"' 1 .. ~
Environics Research Group Limited
ENVIRONICS
RESEARCH GROUP
W AVE 4 SUR VEYS
THE HEALTH EFFECTS OF TOBACCO AND HEALTH
W
ARNING MESSAGESON CIGARETTE PACKAGES
SURVEY OF YOUTH
Prepared for:
Health Canada
POR-01-18
Prepared by:
Environics Research Group Limited
March 2002
pn5069
33 Bloor Street East, Suite 900 Toronto, Ontario
Canada M4W 3H 1
tel: 416.9209010 fax: 416.920-3299 http://www.environics.net
... ' r
T ABLE OF CONTENTS
1.0 INTRODUCTION 3
2.0
SMOKING STATUS 4A. Smoking Behaviour and Brands 4
B. Quit Attempts and Potential Quitters. 6
3.0
HEALTH EFFECTS OF SMOKING 8A. General and Top-of-mind Effects 8
B. Sources of Information about Health Effects Il
c. Specifie Health Effects Caused by Smoking 12
D. Specifie Healrh Effects Caused by Second-hand Smoke 16
E. Health Effects Caused by Hydrogen Cyan ide 18
4.0
DEATHS FROM TOBACCO USE 195.0
QUITTIPS .' 216.0
HEALTHW
ARNING MESSAGES 23A. Recall and Reads Per Day 23
B. Impact of New Messages 29
c. Assessment of New Messages 30
D. Comparison of New and Old Messages 31
E. A voidance of New Messages 33
7.0
TOXIC SUBSTANCES3S
ApPENDICES Survey Methods Questionnaires
)
1.0 INTRODUCTION
Environics Research Group Limired was l,')
.Y l,
commissioned by Health Canada ro conduct a survey 1 of Canadian youth, including youth smokers and non-smokers, The main objective of the survey was
.1"." 1 to provide information ta assist in the evaluation of
,) 1
the impact of new health warning messages on tobacco packaging on youth knowledge and behaviours. The new health warning messages began appearing on the major tobacco brands in Canada on approxirnately J anuary l, 2001 and on aIl brands as of approximately June 30.The survey assessed sources of information about the effects of tobacco, awareness and knowledge of the healrh effects of robacco, the extent to which specifie diseases are believed ta be caused by tabacco and the number of deaths caused by smoking. The survey also measured awareness and recaIl of the new labels and their effect on knowledge and behaviours, including behaviours intended ta avoid the new labels, and perceptions of the effectiveness of the new labels compared to the old labels.
A survey of adulrs and adule smokers was conducted separately and is discussed under separate coyer.
One goal of the new surveys was ta conduct the sampling and questionnaire design ta aIlow comparison with three previous waves of surveys:
surveys conducted by Environics in] uly 2001 after the new labels had appeared on aIl brands, surveys conducted in March and April 2001, a few months afrer the new health warning messages were introduced into the marketplace, and baseline surveys, which were conducted in November and December 2000, prior to the introduction of the new health warning messages into the marketplace.
The survey of youth aged 12 ta 18, which included youth smokers and non-smokers, is based on a sample size of 1,001. This survey was conducted between December 6 and 20,2001.
A survey based on a sample of 1,001 has a margin of error of approximately 3.1 percentage points, 19 times in 20.
This report summarizes the findings of the research.
Appended to this report are copies of the English and French questionnaires and a description of the survey methods,
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 3
2.0 SMOKING STATUS
A.
Smoking Behaviour and Brands
From the survey, ten percent of youth smoke cigarettes every day and seven percent smoke
occasionally. Older youth, especially rhose aged 17 ta 18 years, are more Iikely than younger teens ta say they smoke cigarettes every day.
Among non-smoking youth, 36 percent say they have at sorne time cried cigarette smoking, which includes just having a few puffs. Among non- smoking youth who have never tried smoking, not even a few puffs, five percent say the y have seriously thoughr about trying smoking. Among non-smoking youth, two percent say they might cry smoking within the next rnonrh.
Of the youth sarnple, 17 percent are smokers and 83 percent are non-srnokers. Of all youth, 33 percent can be classified as potenrial smokers. Potential smokers include any yourh who say they have tried smoking, have seriously thoughr about smoking or think they might try smoking within the next month.
Cigarette Consumption
DEC MAR-ApR JULY Nov-DEC 2000 2001 2001 2001
Every day 11 7 10 10
Occasionally (Iess than
every day) 6 6 5 7
Not at ail 83 87 84 83
Q.l
At the present time, do you smoke cigarettes (manufactured or roll your oum) every day, occasionally or not at ail?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 4
Almost two in ten Canadian yourh (17%) report having smoked at least 100 cigarettes in their life.
This number is twice as high among older yourh, aged 17 to 18 years.
Among youth smokers who smoke every day, 22 percent report smoking more than 15 cigarettes per day, which includes two percent who say they smoke more than 25 cigarettes per day. Four in ten (39%) say they smoke between ten and 15 cigarettes per day, and a similar proportion (40%) report smoking fewer rhan ten cigarettes per day.
Among yourh smokers who smoke occasionally, 185 percent report smoking fewer than ten cigarettes per day on the days thar they smoke. Eleven percent smoke between ten ro 15 cigarettes per day and one percent report smoking more than 15 cigarettes per day.
Among youth smokers, Player's Light Regular Size (16%) is most often mentioned as their regular brand of cigarettes. Smaller proportions mention
DuMaurier Regular Size (13%), DuMaurier King Size (9%), Export "A" Medium Regular Size (6%) and DuMaurier Light King Size (5%). Fort y-four percent mention some other brand and six percent say they do not have a regular brand.
When yourh smokers are asked if they smoke any other brands of cigarettes, 57 percent say they do not smoke any ether brand.
Cigarette Consumption Per Day Every Day Smokers
DEG MAR-ApR JULY Nov-DEG 2000 2001 2001 2001 Less Ihan 10 cigarettes per day 31 35 25 40 10 ta 15 cigarettes per day 41 40 49 39
16 la 20 cigarettes per day 12 12 6 7
21 la 25 cigarettes per day 14 12 17 13
26 or more cigarettes per day 4 2
Q.6
On average, bou/ many cigarettes do you smoke per day?
Subsample: Smoke every day
Cigarette Consumption Per Day Occasional Smokers
DEG MAR-ApR JULY Nov-DEG
2000 2001 2001 2001
Less Ihan 10 cigarettes per day 92 89 89 85
1010 15 cigarettes per day 7 5 9 11
16 or more cigarettes per day 1
dk/na 4 2 2
Q.7
On tbe days tbat you smoke, about boio many cigarettes do you smoee?
Subsample: Smoke occasionally
l These numbers shouid be inrerprered wirh caution, because of small sample sizes.
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W AVE 4 5
B.
Quit Attempts and Potential Quitters
Three-quarters of yourh smokers (75 %) report having tried to quit smoking; one-quarter (25%) have not tried to quit.
Among youth smokers who have tried to quit smoking, just under nine in ten (87%) say they have sropped smoking for a period of 24 hours at least once in the past year, in an attempt ro quit. Thirteen percent say they have not arrernpred to quit smoking in the past year. -
More than six in ten yourh smokers (63%) report they are now seriously thinking of quitting smoking;
36 percent say they are not.
Among yourh smokers who are seriously thinking about quitting smoking.? more than six in ten (63%) say they will try to quit within the next 30 days.
Twenty-eight percent say they will try ro quit within the nexr six monrhs. Seven percent say they will not try within the next six months and two percent don't know when they will try ro quit.
Quit Attempts Smokers
OEe MAR-ApR JULY Nov-Dac
2000 2001 2001 2001
Yes 66 61 69 75
No 33 38 31 25
dk/na
Q.9
Have you euer triee( to quit smoking?
Subsample: Smokers
Number of Times Tried to Quit Smoking Smokers
OEe MAR-ApR JULY Nov-Dsc
2000 2001 2001 2001
Once 21 15 25 21
Twice 15 26 19 19
Three times 20 10 . 13 13
More than three times 27 37 32 34
Not in the past year 15 12 10 13
dk/na
Q.lO
In the past year, how many times have you stopped smoking/m' at least 24 hours because you u/ere trying to quit smoking?
Subsample: Smokers who have tried to quit smoking
2 These numbers should be inrerpreted with caution, because of small sample sizes.
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 6
The number of yourh smokers who have tried to quit is higher in the current survey than in previous surveys, as is the number who say they are seriously thinking of quitting. Although the sample size is small, the eurrent results also suggest an inerease in the number of potenrial quitters who think they will try to quit within 30 days.
Among youth smokers who are seriously thinking about quitting srnoking.t more than one-half say they will use will power or go eold turkey (53%) to
try ro quit smoking. About one in ten say the y would ehew gum/candy/food (11%), use the nicotine patch (9%), or use nicotine gum (9%). Smaller numbers say they would eut back gradually (8%), avoid ether srnokers/situarions involving smoking (8%), distract themselves (7 %) or do more exereise/ get physically fit (5%). Four percent mention sorne ether ways or methods and fourteen percent offer no opinion.
Potential Quitters Ways to Quit
Smokers Smokers
DEC MAR-ApR JULY Nov-DEC DEC MAR-ApR JULY Nov-DEC
2000 2001 2001 2001 2000 2001 2001 2001
Yes 57 50 56 63 Will power/cole turkey/just stop 54 46 54 53
No 42 49 44 36 Chew gum/candy/food 4 3 14 11
dk/na Nicotine patch 9 18 7 9
Nicotine gum 6 8 6 9
Cut back gradually 10 16 8 8
Q.l1a
Avoid other smokers/situations Are yo« now seriousiy thinking of quitting smoking?
involving smoking 5 2 5 8
Subsample: Smoeers
Distract yourself 9 3 7
More exercise/get physically fit 2 2 7 5
Zyban 6 2 2
Potential Quitters
Don't star! 2Smokers
HypnosisSelf-help program 2
DEC MAR-ApR JULY Nov-DEC Other 4 2 2 4
2000 2001 2001 2001
Within the next 30 days 56 41 37 63 None/nothing 1 2
Within the next 6 months 28 50 49 28 dk/na 11 5 5 14
Not withi n the next 6 months 12 6 7 7
dk/na 5 3 6 2 Q.l1c
If YOII u/ere ta quit smoking at some point in the future, what
Q.llb ways or methods do you think you would use?
U7hen do you think you will try to quit? Subsample: Smokers who are seriously thinking of quitting Subsample: Smoeers who are seriousiy thinking of quitting smoking
smoking
3 These numbers should be interprered wich caution, because of small sample sizes.
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 7
3.0 HEALTH EFFECTS OF SMOKING
..,
A.
General and Top-of-mind Effects
More than eight in ten youth (86%) think that cigarette smoking is a major health problem in Canada. Another 12 percent rhink ir is a minor problem. Only two percent think ir is not a healèh problem.
The results of the current survey are almost identical ro those found in
J
uly 2001, March-April 2001 and December 2000.The view thar smoking is a major health problem is lower among youth smokers. Among non-smoking youth, those identified as potential smokers are also less likely to say smoking is a major health problem.
When asked what specifie human healrh effects or diseases can be caused by smoking cigarettes, yourh are most likely to mention lung cancer (62%).
Smaller proportions mention cancer in general (37%), heart attack/disease/angina (19%), oral cancer - tongue, lips, mouth, rhroat (18%), lung disease (14%), emphysema (8%), gum disease/tcorh loss/
mouth disease (6%), respiratory problems/difficulty breathing/shortness of breath (5%) and asthma (4%).
Thirty-four percent mention other human health effects or diseases.
The results of the current survey are similar to those found in
J
uly 200 l. The results suggest an increase since December 2000 in mention of oral cancer.Older youth and youch smokers are more likely than ethers to mention heart attack/disease/angina, oral cancer and emphysema. Youth smokers and porential youth smokers are also more likely ta mention lung cancer. y outh smokers are also more likely ta mention respirarory problems/difficulty breathing/
shortness of breath. Older youth, aged 17 to 18, are more likely to mention cancer in general.
Smoking as a Health Problem
DEC MAR-ApR JULY Nov-Dtc 2000 2001 2001 2001
Major 84 87 85 86
Minor 13 Î Î 13 12
Not a problem 2 2
dk/na
Q.12
In general, do you think that cigarette smoking is a major health problem, a mtnor health problem 01' not a health problem in
Canada?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - W A VE 4 8
Health Effects of Smoking - Top-of-Mind
DEC
2000
Cancer -Iung Cancer in general Heart attackldisease/angina
Cancer - oral (tongue, lips, mouth, throat) Lung disease/lunqs (unspecified) Emphysema
Gum disease/tooth loss/rnoulh disease
Respiratory problems/difficulty breathing/shortness of breath Asthma
Yellow teeth/fingers/effect on appearance Stroke
Brain damage/disease Cancer - other
Blood circulation problems/blood clots Bronchitis/chronic bronchitis Bad breath
Impotence/sexual dysfunction Death/premature death Liver damage/disease
Poor physical condition/loss of energy Effect on the tetus/unborn child
Smaller babies/reduced growth of babies during pregnancy Preterm birth/premature birth
Second-hand smoke Cancer - breast Wrinkles/premature aging Eye disease/prohlerns Kidney disease/problems
Birth defects/problems with pregnancy Osteroporosis/problems with bones
60 35 17 13 16
9 4 5 5 2 2
• Less th an one percent
2
MAR-ApR JULY Nov-Dec
2001 2001 2001
68 61 62
34 37 37
21 19 19
14 15 18
13 14 14
10 10 8
6 5 6
5 5 5
4 5 4
4 5 3
4 2 3
3 2 3
2 2 3
2 2 2
2 2 2
2 2
2 2 2
2 1
2 2 2
2 1 2 2
Conlinued ..
Q.13
What specifie buman bealtb effects or diseases, if any, can you tbine of that can be caused by smoking cigarettes? Are there any otbers?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARN1NG MESSAGES - WAVE 4
9
y
Health Effects of Smoking - Top-of-Mind
Continued
OEC MAR-ApR JULY Nov-Dtc
2000 2001 2001 2001
Skin irritations/conditions Immune system problems Stomach problems Diabetes Allergies
Affect health ove rail Tumours
Dizziness/nausea High blood pressure
Air pollution/environmental damage Addiction
Throat disease/problerns Coughing
Multiple Sclerosis Headaches Fire accidents/burns Miscarriages/still births
Other 2 2 2
None/nothing 1
dk/na 3 4 3
. * Less than one percent.
Q.13
What specifie human beàltb effects or diseases,
if
any, ean yo« think of that ean be caused by smoking cigarettes? Are there any others?ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEAL TH W ARNING MESSAGES - W A VE 4 10
B. Sources of Information about Health Effects Sources of Information About Health Effects
When asked where they have recently seen or heard DEC MAR-ApR JULY Nov-DEC
information which ralks about the health effects of 2000 2001 2001 2001
smoking cigarettes, the Iargest proportions of yourh Television 49 56 48 53
mention television (53%) and schoo1/university School/university 48 44 40 49 (49%). This is followed by mention of cigarette Cigarette packages 13 29 32 30 packages (30%), word of mourh/family/friends (14%) Word of mouth/family/friends 11 10 14 14
and magazines (12%). Thirty-rhree percent mention Magazines 16 14 11 12
ether sources of information and four percent say Newspapers 6 7 6 5
nowhere.
Billboards 5 6 5 5
Radio 5 5 5 5
The results of the current survey find thar the
Public areas and builcinqs 2 2 4
number of yourh who have seen or heard information
InterneVwebsite 2 3 2 3
about the health effects of smoking cigarettes on
cigarette packages is similar to the numbers in. the Doctor/doctor's office 3 2 2 2
July and March-April surveys, but is 17 points Posters 2 2
higher than in December 2000. The number who Other tobacco product packages 1 1
mention school/universiry is nine points higher than News 2 2 3
in July 2001. Sin ce July, there has been an increase Advertising/media - general of five points in the number who mention television. Books/scientific journals
Bus/publie transportation Older youth, yourh smokers and potcnrial youth Pam ph 1 ets/bro chures/tlyers smokers are more likely to have seen this information Hospitals/medical clinics on cigarette packages and on television. Older yourh Workplace
are also more likely to mention magazines. Yourh
Health associations/agencies aged 12 to 16 are more likely ta mention schoo1/
Drug/health food stores/stores
university. in general
Other
Nowhere 8 5 6 4
dk/na 3 3 3 3
* Less th an one percent
Q.14
Thinking generally about information which talks about the health effects of smoking cigarettes, iohere have YOIi seen or beard any of this kind of information recently? A nyiohere else?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 1 1
r
c. Specifie Health Effects Caused by Smoking Specifie Health Effects Caused by Smoking
In this section of the survey, respondenrs were read a DEC MAR-ApR JULY Nov-DEC
list of health effects and diseases, and were asked the 2000 2001 2001 2001
extent ro which they agreed or disagreed thar each Lung cancer
can be caused by smoking cigarettes. Stronglyagree 95 97 95 95
Somewhat agree 4 2 4 4
An overwhelming majority of yourh strongly agree Somewhat disagree that lung cancer (95 %) can be caused by smoking Strongly disagree cigarettes. Large majorities strongly agree thar dl</na
smoking can cause heart disease (76%), throat cancer
(75%), gum or mouth diseases (73%), mouth cancer Heart disease
(71 %), asthma (66%) and premature dearh (64%). Stronglyagree 74 78 74 76 Smaller majorities strongly agree thar smoking can Somewhat agree 21 18 21 20 cause smaller babies or reduced growth of babies
Somewhat disagree 2 2 3 2
during pregnancy (53%) and chronic bronchitis
Strongly disagree 2 (51 %).
dl</na
Throat cancer
Stronglyagree 75 77 72 75
Somewhat agree 18 17 21 20
Somewhat disagree 3 3 3 2
Strongly disagree 1 2 1
dl</na 2 2
Gum or mouth diseases
Stronglyagree 66 73 72 73
Somewhat agree 23 19 19 20
Somewhat disagree 5 3 5 3
Strongly disagree 4 2 2 2
dl</na 3 2 2 2
Mouth cancer
Stronglyagree 66 69 66 71
Somewhat agree 21 21 24 22
Somewhat disagree 6 4 4 3
Strongly disagree 4 3 2 2
dl</na 3 3 3 2
* Less th an one percent
Q.15
1 am going to read you a !ist of buman health e!fects and diseases that may or may not be caused by smoking cigarettes. Based on what you know or beùeue, p!ease te!! me
if
you strongiy agree, somewhat agree, somewhat disagree or strong!y disagree that smoking cigarettes can cause each of the fo!!owing .ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 12
Fewer than half of youth strongly agree thar smoking can cause stroke (49%), wrinkles and premature aging (48%), premature birrh or preterm birrh (39%), blood clots (37%), emphysema (36%), miscarriages (35%), impotence in men (30%), stornach ulcers (22%), infertility (21 %) and bladder cancer (17%). Only about one in ten each strongly agree that smoking can cause multiple sclerosis (13%), acne (11 %), arthritis (11 %), Alzheirner's Disease (11 %), gangrene (9%) and hepatitis (9%).
The results of the current survey suggest thar there has been a slight increase from
J
uly 2001 survey in the proportion of youth who strongly agree that mouth cancer can be caused by smoking.Comparison wirh the baseline survey in December 2000 suggests that there have been increases in the numbers of Canadian youth who strongly agree thar impotence in men, gum or mou th diseases, stroke and mourh cancer can be caused by smoking.
Specifie Health Effects Caused by Smoking
DEC MAR-ApR JULY Nov-DEC
2000 2001 2001 2001
Asthma
Stronglyagree 67 70 67 66
Somewhat agree 22 21 21 23
Somewhat disagree 5 4 6 5
Strongly disagree 4 3 4 3
dl</na 2 2
Premature death
Stronglyagree 63 67 64 64
Somewhat agree 23 21 23 23
Somewhat disagree 7 5 7 6
Strongly disagree 4 4 2 3
dk/na 3 3 4 4
Smaller babies or reduced growth of babies during pregnancy
Strongly agree 51 55 54 53
Somewhat agree 29 29 29 31
Somewhat disagree 7 8 7 7
Strongly disagree 7 4 4 4
dl</na 6 4 6 6
Chronic bronchitis
Strongly agree 51 52 50 51
Somewhat agree 30 28 23 30
Somewhat disagree 7 5 7 5
Strongly disagree 2 3 2 2
dl</na 10 11 17 12
Stroke
Stronglyagree 44 51 49 49
Somewhat agree 30 26 27 27
Somewhat disagree 11 8 8 7
Strongly disagree 4 4 4 4
dl</na 11 12 13 13
Q.15
1 am going to read you a list of buman health effects and diseases that may 01' may not be caused by smoking cigarettes. Based on what you know or believe, please tell me if yo« strongly agree, somewhat agree, someu/hat disagree or strongly disagree that smoking cigarettes can cause each of the following , ..
ENVI RON les HEALTH EFFECTS OF TOBACCO AND HE AL TH W ARNING MESSAGES - W AVE 4 13
Among yourh, girls are more likely than boys tO
Specifie Health Effects Caused by Smoking
strongly agree thar smoking can cause miscarriages,
DEC MAR-ApR JULY Nov-DEC
smaller babies or reduced growrh of babies during 2000 2001 2001 2001
pregnancy, premature birth or prererrn birrh and
asthma. Boys are more likely rhan girls tO strongly Wrinkles and premature aging
agree thar smoking can cause heart disease, blood Stronglyagree 50 52 50 48 clots, arrhritis, impotence in men, bladder cancer, Somewhat agree 25 25 22 25 premature dcath, acne, Multiple Sclerosis and Somewhat disagree 12 12 13 12 Alzheirner's Disease. Olderyouth are more likely tO
Strongly disagree 9 9 10 9
strongly agree that smoking can cause emphysema,
dl</na 4 3 5 5
impotence in men, asthrna, mouth cancer, throar
cancer, wrinkles and premature aging, infertility,
Premature birth or preterm birth smaller babies or reduced growrh of babies during
pregnancy, premature birth or preterrn birth, chronic Strongly agree 42 41 42 39
bronchitis and premature dearh. Somewhat agree 30 34 33 33
Somewhat disagree 13 11 10 13 Those who have seen, read or heard about the new Strongly disagree 7 7 7 8
healrh warning messages on cigarette packages and dl</na 7 7 8 7
those who have seen rhese messages on cigarette
packages themselves are more likely than chose who Blood clots
have not tO strongly agree thar smoking can cause Stronglyagree 34 36 34 37 emphysema, impotence in men, mouth cancer, throat Somewhat agree 35 37 35 38 cancer, gum or ~outh diseases and chronic
Somewhat disagree 14 12 14 11
bronchicis. Those who have seen rhese messages on
Strongly disagree 7 5 6 5
cigarette packages themselves are also more likely tO
dl</na 10 9 11 8
srrongly agree chat smoking can cause smaller babies
or reduced growth of babies during pregnancy,
Emphysema premature birth or preterrn birth, and premature
death. Stronglyagree 37 42 38 36
Somewhat agree 24 21 20 21
Potential smokers among yourh are more likely to Somewhat disagree 7 8 9 8 srrongly agree thar smoking can cause asrhrna, but Strongly disagree 4 2 2 3
they are more likely to strongly disagree thar dl</na 27 28 30 32
smoking can cause arthriris, gangrene, stornach
ulcers, bladder cancer, hepatitis, acne and M iscarriages
Alzheimer's Disease. Youch smokers are more likely Strongly agree 34 35 35 35 chan ethers tO strongly agree thar smoking can cause
Somewhat agree 34 31 32 33
emphysema, impotence in men, asthma and throar
Somewhat disagree 14 13 12 13
cancer, but they are more likely to srrongly disagree
Strongly disagree 8 8 8 7
chat smoking can cause acne.
dl</na 10 12 14 12
Q.15
1 am going to read you a list of human health effects and diseases that may or may not be caused by smoking cigarettes. Based on what you know or believe, please tell me if you strongly agree, somewhat agree, somewhat disagree 01: strongiy disagree that smoking cigarettes can cause each of the following ...
ENVIRONICS HEALTH EFFECTS OF T08ACCO AND HEALTH WARNING MESSAGES - WAVE 4 14
Specifie Health Effects Caused by Smoking Specifie Health Effects Caused by Smoking
DEC MAR-ApR JULY Nov-DEC DEC MAR-ApR JULY Nov-DEC
2000 2001 2001 2001 2000 2001 2001 2001
Impotence in men Acne
Stronglyagree 14 27 27 30 Strongly agree 11 11 12 11
Somewhat agree 29 27 26 30 Somewhat agree 23 24 22 23
Somewhat disagree 18 16 15 14 Somewhat disagree 30 30 28 30
Strongly disagree 15 11 9 8 Strongly disagree 29 26 29 26
dk/na 24 19 23 18 dk/na 7 9 10 9
Stomach ulcers Arthritis
Stronglyagree 23 24 22 22 Stronglyagree 12 12 11 11
Somewhat agree 36 36 33 39 Somewhat agree 26 26 26 25
Somewhat disagree 19 19 18 18 Somewhat disagree 29 29 30 31
Strongly disagree 9 8 9 9 Strongly disagree 25 22 21 22
dk/na 13 13 17 13 dk/na 9 11 13 11
Infertility Alzheimer's Disease
Stronglyagree 18 23 22 21 Strongly agree 11 12 11 11
Somewhat agree 29 31 30 32 Somewhat agree 27 25 25 27
Somewhat disagree 17 18 14 15 Somewhat disagree 27 28 24 27
Strongly disagree 12 9 9 8 Strongly disagree 22 20 22 20
dk/na 23 20 25 23 dk/na 13 15 18 15
Bladder cancer Gangrene
Stronglyagree 18 19 16 17 Strongly agree 9 9 9 9
Somewhat agree 29 29 28 27 Somewhat agree 19 20 19 20
Somewhat disagree 26 25 26 29 Somewhat disagree 19 19 15 18
Strongly disagree 16 15 16 14 Strongly disagree 20 20 21 17
dk/na 11 13 14 13 dk/na 32 31 36 36
Multiple Sclerosis Hepatitis
Strongly agree 14 13 11 13 Stronglyagree 9 10 8 9
Somewhat agree 27 29 27 28 Somewhat agree 23 20 23 21
Somewhat disagree 21 21 18 20 Somewhat disagree 27 29 25 29
Strongly disagree 16 13 15 15 Strongly disagree 26 25 26 26
dk/na 22 24 29 24 dk/na 15 15 17 14
Q.15
l am going to read you a list of buman health effeas and diseases that may or may not be cazcsed by smoking cigarettes. Based on what YOIi
know or belieue, p!ease te!! me if you strongly agree, somewhat agree, somewhat disagree or strong!y disagree tbat smoking cigarettes can cause each of the Jo!!owing ..
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 15
.~ ...
D. Specifie Health Effects Caused by Second- Specifie Health Effects Caused by
hand Smoke Second-Hand Smoke
In this section of the survey, respondents were read a DEC MAR-ApR JULY Nov-DEC list of health effects in non-smokers, and were asked 2000 2001 2001 2001 about the extent to which they agreed or disagreed Asthma attacks in children
that each can be caused by second-hand srnoke. Strongly agree 64 64 62 61
Somewhat agree 25 27 27 31
Majorities of yourh strongly agree thar second-hand Somewhat disagree 6 4 6 4
smoke can cause asthrna attacks in children (61 %), Strongly disagree 3 3 3 3
lung cancer in non-smokers (54%) chest infections in dk/na 2 children (52%). Fewer than half srrongly agree thar
second-hand smoke can cause, bronchitis in children
Lung cancer in non-smokers (47%), heart disease in non-smoking adults (36%),
srrokes in non-smoking adults (23%) and SIDS Stronglyagree 56 60 52 54 (Sudden Infant Death Syndrome) or crib death Somewhat agree 31 28 33 33
(22%). Only about one in ten each strongly agree Somewhat disagree 7 6 9 8
thar second-hand smoke can cause ear infections in Strongly disagree 5 5 4 4
children (Ll %), or Multiple Sclerosis (9%), arrhritis dk/na 2
(8%) and Alzheirner's Disease (8%) in non-smoking
adules, Chest infections in children
Strongly agree 54 53 49 52
The resulrs of the current survey suggest thar there Somewhat agree 32 35 38 37 has been a slight increase from the] uly 2001 survey Somewhat disagree 7 6 6 6 in the number of yourh who strongly agree thar Strongly disagree 3 4 2 3 second-band smoke can cause SIDS. Comparison
dk/na 3 2 4 3
with the December 2000 baseline survey suggests thar there has been a slight decline in the number of
Bronchitis in children youth who srrongly agree thar second-hand smoke
can cause ear infections in children. Strongly agree 49 50 46 47
Somewhat agree 34 35 35 36
Among yourh, girls are more likely than boys to Somewhat disagree 7 7 7 8 strongly agree thar second-hand smoke can cause Strongly disagree 4 4 4 3
asthrna artacks, chest infections and bronchitis in dk/na 7 5 8 5
children. Boys are more likely than girls to strongly
agree thar second-hand smoke can cause strokes in Heart disease in non-smoking adults
non-smoking adults. Older yourh are more likely Stronglyagree 38 40 37 36 th an ethers to srrongly agree thar second-hand Somewhat agree 38 39 40 42 smoke can cause asthma attacks, chest infections and Somewhat disagree 13 12 14 12 bronchitis in children, heart disease in non-smoking
Strongly disagree 8 7 6 7
adulrs and lung cancer in non-smokers.
dk/na 3 2 4 2
Q.16
Here is a list
of
health effects and diseases ajfecting non-smokers that may or may not be caused by breathing in second-band smoke from cigarettes that other people are smoking. Based 011 what youknow or beùeue, please tell me ifyou strongly agree, somewhat agree, sometuhat disagree or strongly disagree that second-band smoke can cause each
of
the following ...ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W AVE 4 16
Those who have seen, read or heard about the new
Specific Health Effects Caused by
health warning messages on cigarette packages and
Second-Hand Smoke
chose who have seen rhese messages on cigarette
packages themselves are more likely to strongly agree DEC MAR-ApR JULY Nov-DEC 2000 2001 2001 2001 that second-band smoke can cause asthma attacks
and bronchitis in children, strokes in non-smoking SIDS (Sudden Infant Death Syndrome) or Crib Death
adules and lung cancer in non-smokers. Those who Stronglyagree 23 24 18 22
have seen these messages on cigarette packages Somewhat agree 31 30 33 33
themselves are also more likely to strongly agree that
Somewhat disagree 16 19 17 18
second-hand smoke can cause chest infections in
Strongly disagree 15 11 13 10
children.
dk/na 15 15 20 16
Y outh smokers are more likely than ethers to
Ear infections in children strongly disagree thar second-band smoke can cause
heart disease, arthritis, Multiple Sclerosis and Strongly agree 15 14 13 11
Alzhcimer's Disease in non-smoking adules, ear Somewhat agree 24 26 27 24
infections in children and SIDS or crib death. Somewhat disagree 28 30 26 33
Slrongly disagree 24 23 26 24
dk/na 9 7 8 8
Multiple Sclerosis in non-smoking adults
Strongly agree 9 10 8 9
Somewhat agree 25 26 26 25
Somewhat disagree 25 28 24 28
Strongly disagree 22 18 19 19
dk/na 19 18 23 19
Arthritis in non-smoking adults
Stronglyagree 7 8 10 8
Somewhat agree 20 21 21 22
Specific Health Effects Caused by
Somewhat disagree 34 31 31 32Second-Hand Smoke
Strongly disagree 31 32 2730
DEC MAR-ApR JULY Nov-DEC dk/na 7 9 11 9
2000 2001 2001 2001
Strokes in non-smoking adults Alzheimer's Disease in non-smoking adults
Stronglyagree 20 24 22 23 Stronglyagree 8 8 8 8
Somewhat agree 37 38 33 38 Somewhat agree 23 25 23 26
Somewhat disagree 21 19 22 19 Somewhat disagree 30 29 28 28
Strongly disagree 12 9 10 8 Strongly disagree 27 27 26 26
dk/na 10 10 13 12 dk/na 11 11 15 12
ç.i«
Here is a list of health effeas and diseases affecting non-smokers that may or may not be caused by breathing in second-band smoke from cigarettes that otber people are smoking. Based on what you know or belieue, please tell me
if
yOIi strongly agree, somewhat agree, somewhat disagree or strongly disagree that second-band smake can cause eacb of the following ...ENVI RON les HEAL TH EFFECTS OF TOBACCO AND HEAL TH W ARNING MESSAGES - W AVE 4 17
E.
Health Effects Caused by Hydrogen Cyan ide Health Effects Caused by Hydrogen Cyanide
When asked, top-of-rnind, seven in ten youth (69%) DEC MAR-ApR JULY Nov-DEC
offer no specifie health effects or diseases thar can be 2000 2001 2001 2001
caused by hydrogen cyanide. Anocher 17 percent say Lung disease/cancer 2 5 4 5 hydrogen cyanide does not cause any health effects or Cancer - general 2 2 2
diseases. Only 18 percent mention specifie healch Death 3 2 2 2
effects or diseases. Respiratory problerns/loss of breath 2 1 2
Heart disease/attack 2 2
The survey finds thar the number of youth who say Brain damage/memory loss/stroke 1 hydrogen cyan ide does not cause any health effects or Headache
diseases increased slighdy between December 2000 Throat cancer and March-April2001, declined considerably in July
Mouth cancer/disease 2001, and has now increased by five points. The
Pregnancy/complications survey also finds that the number who offer no
Liver cancer/disease opinion decreased slighdy between December 2000
and March-ApriI2001, increased in July 2001, but Damage to cells/arteries/bloud
has now decreased by seven points. Poisoning
Lung damage Burning in bcdy/orqans Dizziness
Nausea Vertigo Stomach aches
Damage to nervous system Weakness
Other
None 24 30 12 17
dk/na 66 59 76 69
* Less than one percent
Q.37
What specifie health effects or diseases,
If
any, can you name that can be caused by hydrogen cyan ide ?ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HE AL TH W ARNING MESSAGES - W A VE 4 18
..,
..
4.0 DEATHS FROM TOBACCO USE
Respondents were asked whether they believe thar
Causes of Death
tobacco use kills more or fewer numbers of Canadians
chan a number of ether causes of death, DEC MAR·ApR JULY Nov-Dsc
2000 2001 2001 2001
Between half and rwo-rhirds of yourh think tobacco Suicides
use kills more Canadians each year than do suicides More 61 64 67 64
(64%), murders (63%), alcohol (56%), AIDS (52%), Fewer 21 19 17 20
illegaldrugs (52%) and car accidents (50%). About the same number 15 14 15 13 Between one-third and one-half of youth believe thar dl<!na 3 3 2 2 tobacco use kills fewer or the same number of
Canadians each year as these other causes of death. Murders
More 57 60 60 63
The results of the current survey indicate no Fewer 25 23 22 20
significant change from
J
uly 200 l. Since December About the same number 16 16 16 15 2000, there have been slight increases in thedl<!na 2 2 2
numbers of yourh who think that tobacco use kills . more Canadians each year than car accidents, alcohol
Alcohol and murders.
More 51 57 55 56
Boys are more likely than girls ro think chat tobacco Fewer 20 15 18 17 use kills more Canadians each year th an do any of About the same number 27 27 26 26 these ether causes of death. Older youth are more dl<!na 2
likely than ethers to think tobacco use kills more
each year than do illegal drugs, suicides and murders. AlOS
Those who have seen, read or heard about the new More 50 51 54 52
health warning messages on cigarette packages and Fewer 26 24 22 24
chose who have seen these messages on cigarette About the same number 20 21 22 22 packages themselves are more likely to rhink thar dl<!na 4 3 2 3 tobacco use kills more Canadians each year than
most of these ether causes of deach.
Illegal drugs
Youth smokers are more likely ro chink thar tobacco More 52 59 52 52 kills more each year rhan do alcohol, car accidents, Fewer 23 20 21 21
suicides and murders. About the same number 23 20 25 25
dl<!na 2 1 2
Car accidents
More 46 50 50 50
Fewer 28 27 25 27
About the same number 25 23 23 22
dl<!na 1 2
Q.I7
Do you think that tobacco use kiffs more, fewer or about the same number
of
Canadians each year as each of the fo!!owiltg otber causesof
death ... ?ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W AVE 4 19
A total of 23 percent of youch correcdy believe that
Number of Canadians Who Die Each Year fram
approximately 45,000 Canadians die each year as a
Tobacco Use
result of tobacco use. Almost five in ren (46%) pick a
number lower than 45,000 and three in ten (27%) 2000 DEC MAR-ApR 2001 2001 JULY Noy-DEC 2001 choose a number higher than 45,000.
1,000 5 3 4 3
The survey finds thar the number of yourh who 5,000 8 7 8 8
correctly believe that approxirnately 45,000 10,000 1 1 1 1
Canadians die each year as a result of tobacco use has 15,000 11 11 15 14
not changed significantly from the
J
uly 2001 survey; 20,000 2it has increased by five points from the December 25,000 20 17 16 18
2000 survey. 45,000 18 23 22 23
50,000 2 2
75,000 15 15 15 14
100,000 15 15 13 13
Other 3 4 2 2
None
dk/na 2 2
* Less th an one percent
Q.18
Which of the folloioing do you tbine is the closest approximation of the number of Canadiam who die eacb year as a result of tobacco use? Is il closest to ... ?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 20
5.0 QUIT TIPS
When youth are asked what tips or advice they are aware of that might help someone quit smoking, the largest proportions mention medication/patch/
Nicoderm/Zyban/stop smoking pill (28%), warn of he al th effects (20%) and nicotine gum/Nicorette 09%). Smaller proportions mention will power or cold turkey 02%), chew gum/candy/food 00%), support .groups/counselling/associations/famiIy (8 %), avoid situations where you would normally smoke (6%), speak to a doctor (5%) and eut back gradually (5%). Thirty-eighr percent mention other tips or advice. Five percent say there is no way to help and 18 percent offer no opinion.
The current survey finds that there have been increases From the December 2000 survey in the numbers who mention nicotine gum/Nicorette (up 14 points) and medication/patch/Nicoderm/Zyban/
stop smoking pill (up five points).
Oider yourh and yourh smokers are more Iikely than orhers co mention will power or cold turkey and medication/patch/Nicoderm/Zyban/stop smoking pill. y outh smokers are aiso more Iikely ro mention nicotine gum/Nicorette and chew gum/candy/food.
Non-smoking youth and youth aged 12 to 16 years are more inclined to mention warn of health effects.
ENVIRONICS HEALTH EFFECTS Of TOBACCO AND HEAL TH W ARNING MESSAGES - W AVE 4 21
Quit Tips
DEC MAR-ApR JULY Nov-Dac
2000 2001 2001 2001
Medication/patch/Nicoderm/Zyban/stop-smoking pill 23 29 24 28
Warn of health effects 22 22 18 20
Nicotine gum/Nicorette 5 11 12 19
Will power/cold turkey/iust stop 14 14 11 12
Chew gum/candy/food 9 9 11 10
Support groups/co unsell i ng/associati 0 ns/ïarn i Iy 5 6 7 8
Cut back gradually 5 6 5 5
Avoid situations where you would normally smoke
(e.q., telephone/coffee/bar, etc.) 4 5 5 6
Speak to a doctor 5 5 4 5
Do something else/distract yourself 3 2 4 4
Don't start 2 3 3 4
Be aware that you're hurting olhers/your children 2 3 3 4
Keep active and busy 2 3 3 2
More education 3 2 2 2
Visualize negative ellects 2
Stop buying/get rid 01 cigarettes 2
Exercise 1 2
Waste 01 rnoney/costs too much 1 2
Have a plan 2
Drink water Keep trying
Alternatives to smoking Not cool
Adopt healthy lilestyle/reduce stress
Vou smell awlul!it tas tes awlul!cigarettes smell awlul 1
Advertising/media Hypnosis Must want to stop
Visit cancer/terminal hospital ward Smoke lighter brand/herbai cigarettes Avoid peer pressure/media influence Restrict access to children Acupuncture
Laser therapy Speak to a pharmacist Delay smoking lor ten minutes Tell others your quit date Write down reasons you are quitting Take a deep breath or Iwo Not attractive/yellow lingers/teeth Regulation
Speak to a nurse 1
Other 2 3 3 4
None/no way to help 7 8 4 5
dklna 16 12 17 18
* Less than one percent
Q.19
What tips or aduice,
if
any, are you aware of that might help someone quit smoking? Are tbere any otbers?ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEAL TH WARNING MESSAGES - W AVE 4 22
6.0
HEALTH W ARNING MESSAGES
A.
Recall and Reads Per Day
An overwhelming number of yourh (94%) say they have seen health warning messages on cigarette packages. Yourh smokers (99%) express almost unanimous recall.
The number of yourh who say they have seen health warning messages on cigarette packages is essentially unchanged from the July 2001, March-April2001 and the December 2000 surveys.
Six in ten youth (58%) say they have seen, read or heard about new health warning messages that are now on cigarette packages in Canada and another seven percent say they may have. One-third (33%) say they have not.
The number of youth who say they have seen, read or heard about new health warning messages has declined slightly (four points) from the J uly 2001 survey but is still considerably higher (by 30 points) than that found in December 2000.
Boys, older youth, especially those aged 17 co 18 years, youth smokers and potential youth smokers are more likely co be aware of new healch warning messages. Among yourh smokers, porential quitters are more likely to say they have seen, read or heard about new health warning messages.
Two-thirds of yourh (64%) say they have seen the new health warning messages on cigarette packages themselves. One-third (34%) have not.
The results of the current survey are similar to those found in the J uly 2001 survey.
Recall of Health Warning Messages on Cigarette Packages
DEC MAR-ApR JULY Nov-Drc 2000 2001 2001 2001
YES 91 93 93 94
No 9 7 6 5
Q.20
Have you ever seen hea/th warning messages on cigarette packages?
Awareness of New Health Warning Messages
DEC MAR-ApR JULY Nov-Dsc 2000 2001 2001 2001
Yes 28 70 62 58
Maybe 3 4 4 7
No 69 26 33 33
Q.21
Have yo« seen, read 01' heard anything about the new hea/th warning messages tbat are nou/ on some brands of cigarette packages in Canada?
*
December 2000 question referred to "health warning messages that might appear on cigarette packages in the near future"Have Seen New Health Warning Messages on Cigarette Packages
MAR-ApR JULY Nov-DEC
2001 2001 200l
Yes 66 67 64
No 33 32 34
dk/na 2 2
Older youth, particularly those aged 17 co 18 years, youth smokers and potential youth smokers are more likely to say they have seen the new health warning
messages on cigarette packages themselves. Q.22
Have you seen any of the new health warning messages on any cigarette packages themselves?
ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W AVE 4 23
(
Among youth smokers, more than eight in ten (85%) say they have seen the new health warning messages on their main brand of cigarettes. Fourteen percent have not.
The current survey finds an increase of seven points from July 2001 and a total of Il points from March- April in the number of youth smokers who say they have seen the new healrh warning messages on their main brand of cigarettes.
Twelve percent of yourh report that they look at or read health warning messages on cigarette packages several times a day and another 14 percent do this about once a day. Six in ten (60%) look at or read these health warning messages less frequendy, including 21 percent who say they do this less than once a week. Thirteen percent say they never look at or read rhese health warning messages.
The number who look at messages several times per day is four points lower in the current survey rhan in December 2000.
Youth aged 17 to 18 years, youth smokers and potcntial yourh smokers are more likely than others
to say they look at or read rhese health warning messages several times a clay. Those who have seen, heard or read about the new health warning messages, and those who have seen these messages on cigarette packages themselves are also more likely to say they look at or read these health warning messages several times a day.
Have Seen New Health Warning Messages on Main Brand of Cigarette Packages
Smokers
MAR-ApR JULY Nov-DEC 2001 2001 2001
Yes 74 78 85
No 23 21 14
dk/na 3 2
Q.23
Have you seen any of the new health u/arning messages on {main brand}?
Subsample: Respondents who smoke
Times Per Day Look at Health Warning Messages on Cigarette Packages
DEC MAR-ApR JULY Nov-DEC
2000 2001 2001 2001
Several times a day 16 15 15 12
About once a day 14 14 15 14
Once every Iwo or three days 14 18 16 16
About once a week 17 18 19 23
Less than once a week 25 22 22 21
Never 13 13 13 13
dk/na
* Less than one percent
Q.24a
About bou. often do you find yoursel] looking at, or reading health warning messages on cigarette packages? Would it be . ?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W AVE 4 24
When asked, top-of-mind, what the new health warning messages on cigarette packages in Canada look like (without looking at a cigarette package), the largest proportion of Canadian yourh say they have pictures (46%). Three in ten (29%) say they have more information than before or more information about the health effects of smoking.
Smaller numbers mention pictures of lungs (6%), mouth/teeth pictures/diseases (5%), tougher, srronger messages (5 %) and graphies that are gross (5%). Fort y-four percent sorne ether aspect and 26 percent offer .no opinion.
The results of the current survey suggest slight declines from] uly 200 l in the numbers of yourh offering general comments, such as mentioning thar the new health warnings have pictures, and a trend toward recall of specific elements of the new warning messages, such as pictures of lungs and mouth or teeth.
Older yourh, particularly those aged 17 to 18 years, yourh smokers and potential youth smokers are more likely to mention thar the new health warning messages on cigarette packages have pictures and thar they have more information than before or more information about the health effects of smoking.
Those who have seen, heard or read about the new health warning messages, those who have seen these messages on cigarette packages themselves and those who have seen these messages on their main brand of cigarettes are more likely than those who have not to mention pictures and more information rhan before or more information about the healrh effects of smoking.
Appearance of New Health Warning Messages on Cigarette Packages
MAR-ApR JULY Nov-Dtc 2001 2001 2001
Pietures 53 55 46
More info./specifie info about health
ettects of smoking 27 31 29
Pietures of lungs 6
Mouth/teeth (pietures/disease) 5
Tougher, stronger messages 5 4 5
Graphies are gross/disgusting/horrible 2 4 5
Black and white (texVbackground) 4
Pictures of pregant women/pregnancy 3
Covers more of the package/5D% of the
package 3 3 3
Colour/coloured 6 2 3
Info. about how to quit 3 2 3
Warnings/symbols in general 2 2 3
Impotence/drooped cigarette 3
Chi Idren/babies/kids 3
Box/rectangle 2 3
Writing/text in general 3 3 2
Info. on back of the slide portion 2 2
HearVheart disease 2
Brai n damage 2
Large lettering/fonVbold/block print More chemicals/ingredients listed Cigarettes in ashtray
Pictures of smoking in front of kids Surgeon General warnings Small writing/not too clear/
could be bigger Person with breathing machine Front portion of the pack Woman/man/people Advertising
Location on cigarette pack Ifs ridiculous/ioke/slupid
Other 2 4
None/nothing 1
dk/na 26 24 26
* Less th an one percent
Q.25
Without looking at a cigarette package, what do the new health warning messages on cigarette packages in Canada look like?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4 25
When asked, top-of-mind, what specifie new he al th warning messages they can remember seeing on cigarette packages in Canada (without looking at a cigarette package), the largest proportions of yourh recall messages such as causes lung cancer (2l %) and harmful to orhers/children (19%). Other recalled messages include impotence (16%), harmful during pregnancies, harmful to fetus or low birrh rate (16%), death or premature death (13%), cancer in general (8 %), heart disease (7 %), mouth or gum disease (6%) and lung disease (5%). Thirty percent mention sorne ether health warning message. A total of three in ten say none (18 %) or offer no opinion (12%).
SinceJuly 2001, there has been a four point increase in the number of youth who mention impotence.
Older youth, parricularly those aged 17 ro 18 years, and potential youth smokers are more likely ro recall specifie health warning messages, such as harmful ro others/children, harmful during pregnancies,
impotence and death or premature death, Older youth are also more likely ro recall causes lung cancer. y outh smokers are more likely to mention harmful to others/children and impotence. Boys are also more likely (û mention the message regarding impotence.
Those who have seen, read or heard about the new healrh warning messages on cigarette packages, those who have seen these messages on cigarette packages themselves and those who have seen rhese messages on their main brand of cigarettes are more likely to recall the message regarding impotence. Those who have seen, read or heard abolit the new health warning messages on cigarette packages and those who have seen rhese messages on cigarette packages themselves are also more likely ta recall messages such as causes lung cancer and harmful to ethers/
children.
Recall of Specifie Health Warning Messages on Cigarette Packages
MAR-ApR JULY Nov-DEC
2001 2001 2001
Causes lung cancer 17 19 21
Harmful to olhers/to children 15 16 19
Impotence 14 12 16
Harmful during pregnancies/
harmful to fetus/low birth rate 16 19 15
Death/premature death 14 12 13
Cancer - in general 10 10 8
Heart disease 8 8 7
Mouth/gum disease 4 5 7
Lung disease 7 7 5
Second-hand smoke is
harmful/dangerous 4
Premature birth/preterm birth 3 3 3
Stroke 3 1 3
Yellow teeth/gums/fingers 3 3
Cancer - other 3
Dangerous/bad for health 3 2 2
M outh cancer 2 2 2
Respiratory/breathing problems 1 2
Warnings/health warnings/stop smoking 1 1 2
Brain damage/disease 2 2
Addiction 3
Disease - in general 1
Emphysema
Throat problems/disease Must be 18/19 to smoke Don't starVhow to quit Graphies of cigarette package
Other 2 2
None 25 17 18
dk/na 8 13 12
Q.26
Without /ooking at a cigarette package, when it cornes to the new beaùb u/arning messages on cigarette packages, what specifie bealtb u/arning messages can yOU remember?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HE AL TH W ARNING MESSAGES - W A V;E 4 26
When asked, rop-of-mind, what pictures or images
Recall of Specifie Pictures, Images or Graphies
or graphies can they remember seeing on new health
on Cigarette Packages
warning messages on cigarette packages in Canada
(without looking at a cigarette package), the largest MAR-ApR JULY Nov-DEC
proportion of yourh recalliungs or diseased lungs 2001 2001 2001
(28%). Other recalled images include bad, rotren or
Lung/diseased lungs 27 32 28
big tee th (19%), pregnant women/with cigarettes
Bad/rotten/big teeth 16 21 19
(17%), heart or diseased heart (12%), limp, broken
Pregnant women/with cigarettes 9 13 17 or burning cigarette (l l %), mouth or diseased
HearVdiseased heart 11 13 12
mouth (10%), children, kids or babies (l 0%), brain
or diseased brain (8%), baby or premature baby (6%) Limp/broken/burning cigarettes 14 6 11
and gums or diseased gums (6%). Thirry-nine Chi ldren/kids/babies 19 18 10
percent recall other images or graphies. More than Mouth/diseased mouth 6 6 10 two in ten say none (14%) or offer no opinion (8%). Brain/diseased brain 11 8 8
Gums/diseased gums 5 5 6
The results of the current survey suggest thar there Baby/premature baby 6
have been slight increases from
J
uly 2001 in the Pictures of kids watching 5numbers of youth who recall images of pregnant Parents/mom/dad smoking 5 5 3 women/with cigarettes, limp, broken or burning Di rty/ful 1 ashtray 4 3 3 cigarettes, mouth or diseased mouth and baby or
Lung cancer 3 3 3
premature baby, and decreases in the numbers who
Lung pi ctures 3
mention images of children, kids or babies and
Respirators/people on breathing impotence.
rnachines 2 2 2
Impotence 3 8 2
Girls are more likely than boys to recall bad, rotten
Warnings/syrnbols 2 1 2
or big reerh and pregnant wornen/with cigarettes.
ThroaVthroat diseases 2 2
Boys are more likely than girls to recall heart or
diseased heart and limp, broken or burning cigarette. Mouth cancer 2
Older youth, particularly those aged 17 to 18 years, People sick/coughing/choking 2 are more likely ro recall bad, rotten or big tee th, AdulVwoman/man (gen) 2
heart or diseased heart, limp, broken or burning Bar charts/graphs/statistics 1 2 cigarette, children, kids or babies and mouth or Patients in bed/hospital bed 2
diseased mouth. Stroke
Deteriorating/diseased body parts Potential yourh smokers are more likely ro mention Arteries/clogged arteries/clot lungs or diseased lungs, children, kids or babies, bad, Cancer/tumour in general rotten or big teeth, pregnant women/wirh cigarettes Fetus/embryo and limp, broken or burning cigarette. Yourh
Cancer - other smokers, those who have seen, read or heard about
Graphies of cigarette package 2 the new health warning messages on cigarette
Other 2 3 2
packages, those who have seen these messages on
None/nothing 23 15 14
cigarette packages themselves and those who have
seen these messages on their main brand of cigarettes dk/na 5 8 8
are more likely to recall specifie images or graphies,
Q.27
such as limp, broken or burning cigarette, children, And without looking at a cigarette package, tohen it cornes to the kids or babies and baby or premature baby. Youth new health uurning messages on cigarette packages, what picteres smokers, those who have seen, read or heard about or images or graphies can you remember?
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEAL TH W ARN1NG MESSAGES - W A VE 4 27
the new health warning messages on cigarette packages and those who have seen these messages on cigarette packages themselves are also more likely ro recall heart or diseased heart and pregnant woman with cigarette. Yourh smokers and those who have seen rhese messages on cigarette packages themselves are also more likely ta mention mouch or diseased mouth and brain or diseased brain. y outh smokers, chose who have seen these messages on cigarette packages themselves and those who have seen these messages on their main brand of cigarettes are more likely tc recall bad, rotten or big teeth, y outh smokers and rhose who have seen these messages on rheir main brand of cigarettes are more likely ta recall patients in beds or hospital beds. Youth smokers are also more likely to mention respirators or people on breathing machines.
Those who have seen, read or heard about the new health warning messages on cigarette packages-and chose who have seen these messages on cigarette packages themselves are more likely ro recalllungs or diseased lungs. Those who have seen these messages on cigarette packages themselves and those who have seen thèse messages on rheir main brand of cigarettes are more likely to recall pictures ofkids watching.
Those who have seen these messages on their main brand of cigarettes are also more likely to mention gums or diseased gums.
ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEAL TH W ARNING MESSAGES - W AVE 4 28
.
{B.
Impact of New Messages
Among yourh smokers, five in ten (51 %) say that the new health warning messages they have seen on cigarerre packages have been very effective in informing them about the health effects of cigarette smoking. Between two and three in ten say thar these new messages have been very effective in gerring them to try co quit smoking (28%), increasing rheir desire co quit smoking (24%), getting them co smoke less around ethers rhan they used to (21 %) and getting them to smoke less (20%).
Combining the numbers who say very and somewhat effective, 84 percent of youth smokers say the new labels have been effective ove raIl in informing them about healrh effecrs and more than five in ten say they have been effective in increasing their desire co quit smoking (58%) and getting them ro try co quit smoking (55%). Half say they have been effective in gerring them ro smoke less around orhers than they used to (50%) and gerring them to smoke less (50%).
The current survey finds increases From March-April 2001 in the numbers of youth who say the new health warning messages have been very effective in informing them about the healrh effects of cigarette smoking (up 12 points) and in getting them ro cry to quit smoking (up Il points).
Impact of New Messages Smokers
MAR-APR JULY Nov-DEC
2001 2001 2001
Informing you about the health effects of cigarette smoking
Very effective 39 45 51
Somewhat effective 35 34 33
Not very effective 11 8 8
Not at ail effective 14 9 7
dk/na 3
Getting you to try to quit smoking
Very effective 17 16 28
Somewhat effective 33 35 27
Not very effective 18 23 19
Not at ail effective 31 25 26
dk/na
Increasing your desire to quit smoking
Very effective 27 21 24
Somewhat effective 29 34 34
Not very effective 19 17 21
Not at ail effective 24 25 20
dk/na 1 2
Getting you to smoke less around others than you used to
Very effective 17 22 21
Somewhat effective 27 30 29
Not very effective 19 25 15
Not at ail effective 36 23 34
dk/na
Getting you to smoke less
Very effective 19 17 20
Somewhat effective 28 32 30
Not very effective 25 26 21
Not at ail effective 28 26 28
dk/na
• Less th an one percent
Q.30
Thinking about the new health warning messages yot: have seen on cigarette packages, have these messages been very effective, sometobat effective, not very effective or not at at! effective in each of the following ways .. )
Subsample: Smokers
ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 4
