DESCRIPTION (provided by applicant): Tobacco use is the leading preventable cause of death in the United States. Legislation empowers the FDA to regulate the manufacture, marketing, and distribution of tobacco products, and requires new warnings on cigarette packs to communicate the risks of smoking. In this supplement to an existing P30 research grant, we seek to synthesize the literature and expand the ecological validity of the controlled laboratory experiments examining the warnings' impacts. To accomplish this, we will conduct a meta-analysis of the existing experimental literature on cigarette pack warnings (Aim 1). In addition, we will conduct a large-scale RCT in which we label cigarette packs that smokers use every day with text or graphic warnings to examine the impact on smoking behavior (Aim 2). This new approach combines the strengths of laboratory experiments and field studies in evaluating warnings to achieve strong generalizability and internal validity. Participants will be 2,250 adult smokers ages 18-65 from North Carolina and California. The proposed studies will additionally examine whether the impact of cigarette pack warnings on smoking behavior differs for low-income versus higher-income smokers.

PUBLIC HEALTH RELEVANCE: Warnings on cigarette packs may reduce smoking. We will summarize prior studies of how well the warnings work. We will also test warnings on the cigarette packs smokers use every day.