Protocol for creating new warnings on cigarette packs and evaluating their efficacy in a randomised experimental setting.

INTRODUCTION: Tobacco smoking is one of the leading causes of preventable death. This is not inevitable as tobacco control tools have become more powerful and more effective. Among these, warnings on cigarette packs have proven to be somewhat effective. Our objective is to increase the efficacy of antismoking warnings by using innovative psychological approaches and to create an experimental setting for the evaluation of these new warnings based on behavioural indicators. METHODS AND ANALYSIS: First, we created new warnings based on three categories of motivational leverage and on harm reduction. New warnings with innovative texts and pictures were designed for each category and inserted on plain packs. We will then use standard indicators to compare their effect to that of control packs: plain pack without warning, plain pack with conventional warning and branded pack with conventional warning. Second, the novelty of our approach will consist in designing an experimental protocol that uses monetary incentives to evaluate the effect of warnings. Subjects will be able to 'sacrifice' part of their participation defrayal to purchase a good whose subjective value is related to one's attitude towards smoking. These monetarily incentivised measures are designed to assess smokers' immediate/mid-term intention to quit and non-smokers' aversion to smoking. In both cases, the monetary amounts individuals accept to sacrifice may be a more reliable measure than declarative responses, which may be distorted by several hypothetical biases. In the end, we should be able to robustly measure the impact of our new warnings between intervention and control groups by using both traditional indicators and our new monetarily incentivised measure. ETHICS AND DISSEMINATION: The ethics committee of the Groupement des Hôpitaux de l'Institut Catholique de Lille approved the research protocol on 5 July 2019 (CIER 2019-22). Results will be presented at scientific meetings and published.

Do supine position and deprivation of visual environment influence spatial neglect?

It has been suggested that in spatial neglect, placing the patient in a supine position and performing tasks in the dark would reduce the rightward bias in line bisection and cancellation tasks. However, these findings remain debated and have not been extended to other tasks such as reading or visual exploration. Here, in the same study, we examined the effect of body position (BP) and visual environment (VE) on relatively ecological tests of spatial neglect. Among 17 patients with right-hemisphere stroke, 12 were neglect and five were non-neglect in clinical tests. They were compared with 12 healthy control participants in four tasks: line bisection, text reading, number reading, and visual exploration. Tasks were performed on a computer screen in two BP (sitting and supine) and two VE (light and dark) conditions. We found that placing patients in darkness reduced contralesional omissions in the visual exploratory task and, to a smaller extent, in number reading. Conversely, the supine position did not influence performance, and even resulted in cognitive slowing, especially in reading. In conclusion, we confirmed that reducing visual information can improve performance, but only to a limited extent. This justifies strict control of peripheral visual information when exploring neglect patients. Conversely, positioning neglect patients in the supine position can have a discrete negative effect on cognitive functioning, and this effect must be taken into account during therapy.