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Introduction: Dissuasive cigarettes, cigarettes with an unappealing colour or displaying a health warning label, may deter young people from smoking uptake. Methods: Two online surveys were conducted with non-smokers aged 12–17 to explore perceptions of cigarette appeal, harm and product trial. Study 1 was a within-subject study which examined perceptions of four cigarettes with different coloured paper, and four cigarettes displaying a warning. Study 2 was a between-subject study (with limited power), in which respondents were randomized to one of four cigarettes: (1) regular cigarette; (2) least favourable warning from Study 1; (3) least favourable colour from Study 1; or (4) a combination of the least favourable warning and colour from Study 1. Warnings or colours were considered least favourable when they had lower scores on appeal, harm, and product trial. Results: In Study 1, a cigarette featuring the warning ‘cancer, heart disease, stroke’ and a drab dark brown cigarette were rated lowest on appeal and trial intentions, and highest on perceived harm. In Study 2, there were no significant differences in perceptions of appeal, harm or trial intentions between the regular and dissuasive cigarettes. Conclusions: Findings from our within-subject study suggest that a cigarette displaying the text ‘cancer, heart disease, stroke’ and a drab dark brown coloured cigarette are most dissuasive for Dutch non-smoking adolescents. Whether dissuasive cigarettes reduce appeal, reduce product trial, or increase perceptions of harm compared to a regular cigarette should be further examined in larger between-subject studies.

Background: A multitude of studies revealed that smoking is a behaviour learned and initiated during adolescence. Therefore, reducing the smoking initiation among adolescents has been recognised as one of the long term measures to reduce smoking-related health problems. The aim of this study is to investigate the effectiveness of a peer-based intervention in preventing smoking initiation among school-going male adolescents. Materials and Methods: This study use a quasi-experimental study design and involve school-going adolescents from selected secondary schools in the state of Negeri Sembilan. A total of 760 non-smoking adolescents per group will be recruited into the study based on a 50% of difference in the rate of smoking initiation between the control and intervention group. The outcome variable iss incidence rate of smoking initiation. Both intervention and control groups will receive health education materials on smoking, but for the intervention group, a peer-based intervention which also involve students who are elected by their peers, is introduced. Descriptive statistics will be used to illustrate the characteristics of respondents, Chi Square analysis will be perform to analyse differences in the incidence of smoking initiation at the end of the study. Statistical inferences were made using two-sided hypotheses and at alpha level of 0.05. Expected outcome: This study will be able to determine the effectiveness of the peer-based intervention, which can then be expanded and integrated with others interventional programmes in reducing the incidence rate of smoking initiation school-going adolescents in Malaysia. [ABSTRACT FROM AUTHOR]

Introduction: Dissuasive cigarettes, cigarettes with an unappealing colour or displaying a health warning label, may deter young people from smoking uptake., Methods: Two online surveys were conducted with non-smokers aged 12-17 to explore perceptions of cigarette appeal, harm and product trial. Study 1 was a within-subject study which examined perceptions of four cigarettes with different coloured paper, and four cigarettes displaying a warning. Study 2 was a between-subject study (with limited power), in which respondents were randomized to one of four cigarettes: (1) regular cigarette; (2) least favourable warning from Study 1; (3) least favourable colour from Study 1; or (4) a combination of the least favourable warning and colour from Study 1. Warnings or colours were considered least favourable when they had lower scores on appeal, harm, and product trial., Results: In Study 1, a cigarette featuring the warning 'cancer, heart disease, stroke' and a drab dark brown cigarette were rated lowest on appeal and trial intentions, and highest on perceived harm. In Study 2, there were no significant differences in perceptions of appeal, harm or trial intentions between the regular and dissuasive cigarettes., Conclusions: Findings from our within-subject study suggest that a cigarette displaying the text 'cancer, heart disease, stroke' and a drab dark brown coloured cigarette are most dissuasive for Dutch non-smoking adolescents. Whether dissuasive cigarettes reduce appeal, reduce product trial, or increase perceptions of harm compared to a regular cigarette should be further examined in larger between-subject studies., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)