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Ethical Implications of Randomized Trial Design

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Ethical Implications of Randomized Trial Design

The subject of focus is research on the effects that exposure to retail store cigarette ads and product exhibits have on school children. The study’s objective was to examine the impact of cigarette exhibits and advertisements at retail stores on the attitudes, beliefs, and intentions related to smoking among students. The study used earlier research to hypothesize that exposure to cigarette pack displays and retail tobacco advertising would influence students’ perceptions. This perception includes normative beliefs about smoking, ease of access to cigarettes, perceived cigarette brand popularity, future smoking intentions, and perceived smoking harms (Wakefield, 2006). The study was carried out in five high schools in Victoria, Australia, using a group of 605 students in the ninth grade of ages 13–15 years. These students came from one Catholic girls’ school, a co-educational private school, two Catholic boys’ schools, and a public high school.  Two of the schools were situated in locations with low socio-economic benefits, while the other four were located in areas with high socio-economic benefits. Although the randomized design helped obtain vital information, it posed concerning matters in terms of exposing underage persons to cigarettes.

The research was conducted in late 2003 to early 2004. The study used experimental research design between subjects similar to that undertaken by Henriksen et al. using the pretext of pre-evaluating a news article designed for teenagers; participants were randomly subjected to one of the testing conditions (Henriksen et al., 2002). Such conditions include the point-of-sale area of retail stores with no noticeable tobacco presence, a retail store with a show of a cigarette pack, but no cigarette advertisements, and a retail store with cigarette advertisements and cigarette pack shows (Wakefield, 2006). Trained investigative apprentices visited the study areas to conduct the study.

Prior to the experimental study, all students were engaged in a dialogue that aimed at increasing the importance of general aspects of brand promotion and display. After the discussion, students were randomly selected to view images of any of the three testing conditions. While an investigative apprentice proceeded to narrate a fictitious news article about teenage patterns and retail store visits, the subjects were asked to look at the image they were given and to imagine wandering in the tore and shopping (Wakefield, 2006). After the activity, the students completed a short questionnaire. The entire session took 45 minutes.

The group of 605 students comprised 51% females and 49% males. The study showed that students subjected to either the cigarette show or the conditions of cigarette ads considered that purchasing tobacco wouldn’t be stressful for than their counterparts who saw the image containing no tobacco. However, the subjects who viewed the tobacco advertisement situation reported that they wouldn’t be asked for evidence of age if they wanted to buy cigarettes than respondents in the no cigarettes scenario. All in all, most respondents agreed that cigarette use has adverse health effects. Consumption of fewer than 15 cigarettes per day was regarded as very unsafe by over half of the students (Wakefield, 2006).    However, only 20 percent of students thought that the consumption of one to two cigarettes was very unsafe. In comparison, about 55 percent thought it was a little risky to smoke, and 25 percent thought it was not dangerous. Concerning potential smoking intentions, students who viewed cigarette advertisements reported that they would try smoking a cigarette at some point during the coming year relative to those who viewed the cigarette displays.

Generally, the results illustrate that the existence of cigarettes at retail stores, whether only tobacco displays or tobacco exhibits plus promotion, increased the respondents’ expectations about the simplicity of buying tobacco. Furthermore, the existence of tobacco advertisements reduced the anticipated chance of students being asked for evidence of age (Wakefield, 2006). This pattern of results suggests that displaying cigarettes in retail stores form the impression among respondents that cigarettes are within reach in their community. In contrast, tobacco advertisements further fortify the illusion of cigarette accessibility.

The legal concerns raised in the research were high school students’ access to tobacco-related matters. The thought of exposing underage children to cigarette advertising and shows of cigarettes seems immoral because it can lead to increased cigarette use. The study was carried out independently of other common influences of cigarette use such as sex, sensitivity to smoking, and family exposure through randomized design. This efficiency was achieved by analyzing data through GEEs, where the study area was regarded as a random effect.

References

Henriksen, L., Flora, J., Feighery, E., & Fortmann, S. (2002). Effects on Youth of Exposure to Retail Tobacco Advertising1. Journal Of Applied Social Psychology, 32(9), 1771-1789. doi: 10.1111/j.1559-1816.2002.tb00258.x

Wakefield, M. (2006). An experimental study of effects on schoolchildren of exposure to point-of-sale cigarette advertising and pack displays. Health Education Research, 21(3), 338-347. doi: 10.1093/her/cyl005

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