The hypothesis
In addition to the above said strategies, packet covers could also be used to give
additional messages destined to spur also screening and therefore smoke-induced
disease prevention. Cigarette packaging is the perfect means to address smokers directly
especially if more specific text-messages appeared on cigarette packets together with the
above said shocking warning pictures. This might give the opportunity to make prevention
especially on smokers who are more at risk for pulmonary diseases and who more easily
get the prevention message as they have the opportunity to read such warnings every time
they decide to smoke a cigarette. Such messages, might include, for example:" If you are
over forty, perform an annual spirometry as you could suffer from emphysema!” or: "If you
suffer from breathlessness/cough/phlegm, perform a spirometry as you could have
emphysema”). In fact, these text messages may, first of all, stimulate smokers (in case
they do not know) to find out what “spirometry” and “emphysema (COPD)” are and also to
associate them to possible symptoms. Other prevention messages might appear on
cigarette packaging warning smokers about the risk of developing lung cancer (LC). In
fact, by writing, for example, “If you are over 50, perform an annual chest x-ray as you
might have lung cancer", smokers could be awoken on LC and, above all, it might be a
proposal for a further prevention diagnostic test. As LC screening is unfortunately
nonexistent nowadays, if we motivated smokers to perform a chest-x ray, they might be
induced to undergo an LC screening. In fact, a chest-x ray abnormality might suggest to
perform a lung CT. The above said text-messages could induce smokers to take the
advice as they are not just scary warnings. In fact, they clearly indicate how to find out
whether they have smoke-related respiratory diseases.