Effects of emotional arousal on the neural impact and behavioral efficacy of cigarette graphic warning labels.

Autor: Shi Z; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Wang AL; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Fairchild VP; Department of Psychology, Queens College, City University of New York, New York, NY, USA., Aronowitz CA; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Padley JH; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Lynch KG; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Loughead J; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Langleben DD; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Addiction (Abingdon, England) [Addiction] 2023 May; Vol. 118 (5), pp. 914-924. Date of Electronic Publication: 2023 Jan 20.
DOI: 10.1111/add.16112
Abstrakt: Background and Aims: Graphic warning labels (GWLs) on cigarette packs have been adopted by many jurisdictions world-wide. In the United States, the introduction of GWLs has been delayed by claims that their high level of negative emotional arousal unnecessarily infringed upon the tobacco manufacturers' free speech. This study aimed to provide experimental data on the contribution of emotional arousal to GWL efficacy.
Design: Observational study using long-term naturalistic exposure and functional magnetic resonance imaging.
Setting: Research university in Philadelphia, PA, USA.
Participants: A total of 168 adult smokers.
Measurements: For 4 weeks, participants received cigarettes in packs that carried either high-arousal or low-arousal GWLs (n = 84 versus 84). Smoking behavior, quitting-related cognitions and GWL-induced brain response were measured before and after the 4-week exposure. The amygdala and medial prefrontal cortex served as regions of interest.
Findings: Compared with the high-arousal group, the low-arousal group smoked fewer cigarettes [log 10 -transformed, 1.076 versus 1.019; difference = 0.056, 95% confidence interval (CI) = 0.027, 0.085, χ 2 (1)  = 14.21, P < 0.001] and showed stronger intention to quit (2.527 versus 2.810; difference = -0.283, 95% CI = -0.468, -0.098, χ 2 (1)  = 8.921, P = 0.007) and endorsement of the GWLs' textual component (4.805 versus 5.503; difference = -0.698, 95% CI = -1.016, -0.380, χ 2 (1)  = 18.47, P < 0.001). High-arousal GWLs induced greater amygdala response than low-arousal GWLs (0.157 versus 0.052; difference = 0.105, 95% CI = 0.049, 0.161, χ 2 (1)  = 23.52, P < 0.001), although the response to high-arousal GWLs declined over time (slope = -0.087 versus 0.016; difference = -0.103, 95% CI = -0.198, -0.009, χ 2 (1)  = 6.370, P = 0.046). Greater baseline amygdala response was associated with more smoking at 4 weeks in the high-arousal group, but less smoking in the low-arousal group (slope = 0.179 versus -0.122; difference = 0.287, 95% CI = 0.076, 0.498, χ 2 (1)  = 7.086, P = 0.008). Medial prefrontal response did not differ significantly between groups.
Conclusions: High-arousal cigarette graphic warning labels (GWLs) appear to be less efficacious than low-arousal GWLs. The high emotional reaction that high-arousal GWLs elicit wanes over time. Baseline amygdala response negatively predicts efficacy of high-arousal GWLs and positively predicts efficacy of low-arousal GWLs. High emotional arousal may not be required for sustained GWL efficacy.
(© 2023 Society for the Study of Addiction.)
Databáze: MEDLINE
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