Smokers' reactions to cigarette package warnings with graphic imagery and with only text: a comparison between Mexico and Canada.

OBJECTIVE This comparison of population-based representative samples of adult smokers in Canada (n=1 751) and Mexico (n=1 081) aimed to determine whether cigarette packages with graphic warning labels in Canada had a stronger impact than the text-only warning labels in Mexico. MATERIALS AND METHODS Bivariate and multivariate adjusted models were used in this study. Results. Canadian smokers reported higher warning label salience (i.e., noticing labels & processing label messages) than Mexican smokers, and warning label salience independently predicted intention to quit. Moreover, Canadians had higher levels of knowledge about smoking-related health outcomes that were included as content on Canadian, but not Mexican, warning labels. Finally, a majority of Mexican smokers want their cigarette packs to contain more information than they currently contain. DISCUSSION These results are consistent with other studies that indicate that cigarette packages whose warning labels contain prominent graphic imagery are more likely than text-only warning labels to promote smoking-related knowledge and smoking cessation.