sample="quota" bates="2024964051" isource="pm" decade="1980" class="ni" date="19810722" TQQ V. SKR KSC 256250 SPOE CH 22/7 1542 JH WE HAVE A VERY LONG TELEX FOR YOU 986 RICHARD CORNER AND DON HOEL THE FOLLOWING TELEX WAS RECEIVED HERE TODAY FROM AXEL DOLLERIS RE ROTATIONAL WARNINGS - SWEDEN QUOTE TWO STUDIES HAVE BEEN MADE IN SWEDEN REGARDING THE ROTATIONAL WARNING LABELS ON CIGARETTE PACKS.: ONE IS MADE BY STUDENTS AT THE COMMERCIAL HIGHSCHOOL IN STOCKHOLM AND I BELIEVE THAT YOU ALREADY HAVE THIS REPORT. THE PRIMARY PURPOSE OF THAT STUDY IS TO SHOW THAT THE STUDENTS KNOW THEIR SUBJECT. IT IS VERY THEORETICAL BUT THE POPULATION IS VERY SMALL AND IT SEEMS A BIT FAR OUT TO DRAW ANY RELIABLE CONCLUSIONS FROM THIS MATERIAL. BUT IT MAY SERVE AS A MODEL AS TO HOW IT COULD BE DONE. HOWEVER THE REPORT IS MAINLY CONCERNED WITH THE REACTIONS TO THE CONTENTS OF THE SPECIFIC WARNING TESTS AND HAS NO BEARING ON THE AWARENESS AS SUCH. A PROPER STUDY WAS MADE BY NTS IN 1986 AND REPEATED IN 1977. THIS WAS A REPRESENTATIVE STUDY PLANNED BY NTS AND SUPPORTED BY THE DIRECTORATE OF HEALTH. THE INTERVIEWS WERE CARRIED OUT BY SIFO. THE POPULATION WAS 2000. A SUMMARY FOLLOWS AT THE END OF THIS TELEX. NONE OF THESE SURVEYS CAN SUPPORT DON HALLS CASE - ON THE CONTRARY THEY SEEM TO PROVE THAT THE WARNINGS ARE EFFECTIVE. I BELIEVE THAT AN IDENTICAL STUDY TODAY WOULD PRODUCE THE SAME RESULT. HOWEVER, I ALSO BELIEVE THAT IT WOULD BE POSSIBLE TO CONSTRUCT A SURVEY ON AWARENESS WHICH MIGHT SHOW THAT THE SMOKERS PAY LITTLE ATTENTION TO THE WARNINGS SIMPLY BECAUSE THEY HAVE STOPPED NOTICING THEM. AS TO THE EFFECT OF WARNING LABELS IT IS OF COURSE IMPOSSIBLE TO MEASURE IT BECAUSE THERE IS NO WAY TO SEPARATE IT FROM THE GENERAL ANTI SMOKING PROPAGANDA. IN ORDER TO OBTAIN CREDIBILITY I WOULD PREFER THAT SIFO DID THE INTERVIEWING BECAUSE THEY NORMALLY DO THIS FOR NTC, BUT IN ORDER TO BE ABLE TO BUILD UP THE QUESTIONNAIRE WE WOULD NEED ANOTHER RESEARCH INSTITUTE WHICH WILL UNDERSTAND OUR NEEDS. I HAVE CONTACTS WITH A FIRM THAT MIGHT COOPERATE WITH ME ON THIS BUT BEFORE GOING ANY FURTHER I WOULD LIKE TO HAVE AN APPROVAL FROM YOU OR DON HOEL. I LOOK FORWARD TO HEARING FROM YOU AND SEND MY BEST REGARDS. SUMMARY OF THE NTS STUDY ON THE FUNCTION OF THE SWEDISH TOBACCO LABELLING SYSTEM BY LARS M RAMSTROM PH D DIRECTOR GENERAL OF NTS THE STUDY HAS BEEN MADE BY INTERVIEWING A REPRESENTATIVE POPULATION SAMPLE OF 2 000 PEOPLE. THIS WAS DONE AT THE END OF 1976, IMMEDIATELY BEFORE THE INTRODUCTION OF THE LABELLING SYSTEM, AND ONE YEAR LATER, AT THE END OF 1977, WHEN THE LABELLING SYSTEM HAD BEEN EFFECTIVE ALMOST A YEAR. CERTAIN KNOWLEDGE, ATTITUDE AND BEHAVIORAL VARIABLES WERE MEASURED BY IDENTICAL QUESTIONS BOTH YEARS, AND, THE SECON SECOND YEAR, A NUMBER OF SPECIFIC QUESTIONS WERE ADDED CONCERNING EXPLICIT REACTIONS TO THE LABELLING SYSTEM. EXPLICIT REACTIONS BY MEANS OF MASS MEDIA PUBLICITY AND SIMILAR THINGS THE WARNING LABELS AS SUCH ARE GENERALLY, KNOWN BY MOST OF SWEDISH GROUPS PEOPLE. BUT THERE IS A STRIKING DIFFERENCE BETWEEN SMOKERS AND NON NON-SMOKERS, SO THAT SMOKERS HAVE A MUCH BETTER DETAILED KNOWLEDGE OF THE SHAPE OF THE SYSTEM. THIS SHOULD MOST PROBABLY BE INTERPRETED AS AN INDICATION THAT SMOKERS IN GENERAL HAVE REALLY STUDIED THE LABELS, NOTICING THEM RATHER THAN NEGLECTING THEM. AROUND HALF THE POPULATION BELIEVES THAT WARNING NOTICES DO HAVE A FAVOURABLE EFFECT. THE TWO MAJOR WAYS BY WHICH FAVOURABLE EFFECTS ARE BELIEVED TO OCCUR ARE: 1/ MAKING PEOPLE BETTER AWARE OF THE HEALTH HAZARD RELATED TO SMOKIN SMOKING, AND 2/ ENCOURAGING PEOPLE TO STOP SMOKING OR ENCOURAGING YOUNG PEOPLE TO REMAIN NON-SMOKERS. THE BELIEF THAT WARNING NOTICES MIGHT ENCOURAGE SMOKERS TO STOP IS HELD EQUALLY BY SMOKERS AND NON-SMOKERS, WHICH STRENGTHENS THE CREDIBILITY OF THESE ANSWERS. THE MAJORITY OF RESPONDENTS ALSO THINK THAT A ROTATION SYSTEM IS BETTER THAN HAVING A SINGLE WARNING STATEMENT. THE MAIN REASON FOR THAT IS STADE STATED AS THE ROTATION SYSTEM EVOKING CURIOSITY SO THAT THE NOTICE IS REALLY READ, NOT NEGLECTED. AGAIN, THIS IS AN OPINION HELD EQUALLY BY SMOKERS AND NON-SMOKERS, I E IT IS NOT JUST NON-SMOKERS' BELIEF BUT SMOKERS' ACTUAL, SELF-REPORTED REACTION. WHEN ASKING ABOUT THE DECLATION OF CONTENT WE GOT AN EQUALLY FAVOURABLE REACTION BY AROUND HALF THE RESPONDENTS STATING THAT THEY THINK IT REALLY DOES GOOD. EVEN MORE SMOKERS THAN NON-SMOKERS SAY SO. THEY GENERALLY INDICATE THAT THE WAY THE DECLARATION OF CONTENT IS USEFUL IS THAT IT FACILITATES CHOOSING A BRAND YIELDING SMALLER AMOUNTS OF HARMFUL SUBSTANCES. HERE AGAIN THERE IS A STRIKING DIFFERENCE SO THAT SMOKERS KNOW MUCH BETTER IN DETAIL HOW THE DECLARATION SYSTEM IS SHAPED, AND THIS GIVES FURTHER EVIDENCE THAT THE SMOKERS HAVE BOTH NOTICED AND UNDERSTOOD THE SYSTEM. CHANGES THAT SEEM RELATED TO THE LABELLING SYSTEM KNOWLEDGE BOTH 1976 AND 1977 THE RESPONDENTS WERE ASKED TO WHAT DEGREE THEY APPROVED OR DISAPPROVED TO STATEMENTS LIKE "SMOKERS ARE MORE SUSCEPTIBLE THAN NON-SMOKERS TO GENERAL AIR POLLUTION". THE CONTENT OF THIS STATEMENT COINCIDES WITH THE CONTENT OF ONE OF THE 16 WARNING NOTICES. AMONG THOSE WHO HAVE BEEN EXPOSED TO THE WARNING NOTICE, THAT IS THE SMOKERS, THERE IS A DEFINITE CHANGE TOWARDS INCREASED KNOWLEDGE OF THIS, WHILE THERE IS LESS SIGNIFICANT CHANGE IN NON-SMOKERS, WHICH SERVE AS A NON-EXPOSED "CONTROL GROUP". THIS PATTERN COULD BE INTERPRETED AS EVIDENCE FOR THE ATTRUBUTABILITY OF THE KNOWLEDGE CHANGE TO THE EXPOSURE TO THE WARNING LABELS. THIS MEANS THAT THE WARNING L LABELS HAVE NOT ONLY BEEN NOTICED AND UNDERSTOOD BUT HAVE ALSO MADE AN IMPACT ON PEOPLES KNOWLEDGE. BEHAVIOUR THE STUDY HAS ALSO REGISTERED THE CHOICE OF BRAND OF EVERYONE OF THE CIGARETTE SMOKERS. BOTH AMONG MEN AND WOMEN IN THE DIFFERENT AGE GROUPS THERE IS A CONSISTENT PATTERN OF SHIFT TOWARDS "WEAKER" BRANDS. THIS MIGHT OF COURSE BE, AT LEAST PARTLY, DUE TO OTHER INFLUENCES AS WELL, BUT AS STATED ABOVE, THE SMOKERS HAD EXPLICITLY STATED THAT THEY FELT THE DECLARATION BEING USEFUL JUST AS A TOOL FOR THAT SORT OF CHANGE AND THAT MAKES IT RATHER PROBABLE THAT THE ACTUAL CHANGE OF THAT KIND THAT HAS OCCURED HAS BEEN VERY MUCH AN EFFECT OF THE INTRODUCTION OF THE DECLARATION SYSTEM. IN SWEDEN SMOKING RATES AMONG MALES HAVE BEEN DECREASING SINCE 1969 AND RATHER CONSTANT AMONG WOMEN SINCE 1970. WHEN LOOKING AT FIGURES FOR 1977 COMPARED TO 1976 (THAT IS A COMPARISON BETWEEN THE LAST YEAR BEFORE AND THE FIRST YEAR AFTER THE INTRODUCTION OF THE LABELLING SYSTEM), WE FIND AN ACCELERATED DECREASE AMONG MEN AND A BEGINNING DECREASE AMONG WOMEN. NO DEFINITE CONCLUSIONS ABOUT TRENDS CAN BE DRAWN FROM FIGURES RELATING TO JUST TWO CONSECUTIVE YEARS. HOWEVER, SINCE A LOT OF SMOKERS HAVE INDICATED THAT THE WARNING NOTICES MIGHT INDUCE SMOKING CESSATION (SEE ABOVE) IT SEEMS PROBABLY THAT THE ACTUAL INCREASE IN SMOKING CESSAATION AT THE VERY TIME OF THE INTRODUCTION OF THE WARNING NOTICES COULD BE AT LEAST PARTLY ATTRIBUTABLE TO THESE LABELS. IN SUMMARY, THIS STUDY SUPPORTS THE IDEA THAT THE SWEDISH LABELLING SYSTEM HAS BENEFICIALLY INFLUENCED THE SMOKING BEHAVIOUR OF THE SWEDISH POPULATION BOTH BY CONTRIBUTING TO AN INCREASED NUMBER OF PEOPLE STOPPING SMOKING AND BY ENCOURAGING REMAINING SMOKERS TO CHANGE TO BRAND YIELDING LOWER AMOUNTS PER CIGARETTE OF HARMFUL SUBSTANCES. UNQUOTE BEST REGARDS TANA WELLS JM SHR KSC 250250 SPOL CH V