Cigarette Graphic Warning Labels Are Not Created Equal: They Can Increase or Decrease Smokers’ Quit Intentions Relative to Text-only Warnings

Evans, Abigail T.; Peters, Ellen; Shoben, Abigail B.; Meilleur, Louise; Klein, Elizabeth G.; Tompkins, Mary Kate; Römer, Daniel; Tusler, Martin

doi:10.1093/ntr/ntw389

Cited by 36 publications

(67 citation statements)

References 32 publications

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“…First, it indicates that arousal is an important emotional dimension for the perceived effectiveness of the warning labels. This result is in line with prior studies (Evans et al, 2017;Noar et al, 2016) and with the recent findings from Bekalu et al (2018) who concluded that beyond valence, arousal seems to be a strong factor to consider in labelling tobacco products. To make an evaluative judgment, people often rely on the intensity of their feelings and then use those feelings as an indicator of their judgment.…”

Section: Discussionsupporting

confidence: 92%

Emotional Impact and Perceived Effectiveness of Text-Only versus Graphic Health Warning Tobacco Labels on Adolescents

et al. 2019

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The study of smoking in adolescence is of major importance as nicotine dependence often begins in younger groups. Tobacco health warnings have been introduced to inform people of the negative consequences of smoking. This study assessed the emotions and perceived effectiveness of two formats of tobacco warnings on adolescents: Text-only versus graphic warning labels. In addition, we analyzed how emotions predicted their perceived effectiveness. In a cross-sectional study, 413 adolescents (131 smokers, 282 non-smokers) between 13–20 years of age rated their emotions (valence and arousal) and perceived effectiveness towards a set of tobacco warnings. Results showed that graphic warnings evoked higher arousal than text-only warning labels (p = .038). Most of the warning labels also evoked unpleasantness with smokers reporting higher unpleasantness regarding text-only warnings compared to non-smokers (p = .002). In contrast, perceived effectiveness of the warnings was lower in smokers than in non-smokers (p = .029). Finally, high arousal and being a non-smoker explained 14% of the variance of perceiving the warnings more effective. Given the role that warnings may play in increasing health awareness, these findings highlight how smoking status and emotions are important predictors of the way adolescents consider tobacco health labels to be effective.

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Section: Discussionsupporting

confidence: 92%

Emotional Impact and Perceived Effectiveness of Text-Only versus Graphic Health Warning Tobacco Labels on Adolescents

et al. 2019

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“…This allows cigarette stick warnings the potential to be as effective or more effective than current packaging warnings in reducing tobacco use . However, similar to graphic images on cigarette packaging, cigarette stick warnings would need to evoke a significant emotional response and ensure accurate perceptions of risk and increased quit intentions . Many pharmacists in the survey and interviews cited the health warnings on cigarette sticks as being ‘in your face’ and likely to attract the attention of the smoker and onlookers.…”

Section: Discussionmentioning

confidence: 99%

“…[14,17,37] However, similar to graphic images on cigarette packaging, cigarette stick warnings would need to evoke a significant emotional response and ensure accurate perceptions of risk and increased quit intentions. [38] Many pharmacists in the survey and interviews cited the health warnings on cigarette sticks as being 'in your face' and likely to attract the attention of the smoker and onlookers. However, including health warnings on cigarette sticks would likely be resisted by tobacco manufacturers, as has been the case for tobacco packaging warnings and plain packaging.…”

Section: Discussionmentioning

confidence: 99%

Australian community pharmacist experiences with smoking cessation and opinions of health warnings on individual cigarette sticks

Drovandi

Teague

Glass

et al. 2018

International Journal of Pharmacy Practice

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Pharmacists have considerable experience assisting smokers with quitting and based on these experiences believe that novel and tangible health warnings on cigarette sticks may be an effective future measure to combat tobacco use. Further research on the opinions of a more diverse range of health professionals and the general community will generate more robust findings regarding this method of intervention.

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“…Previous research suggests that highly severe HWLs increase smokers' intention to quit smoking as compared with less severe HWLs [5] and are more believable than symbolic warnings [6]. Furthermore, high emotion HWLs have been shown to elicit greater emotional reaction than lower-emotion HWLs, with emotional reaction to HWLs related to higher risk perceptions of smoking [7]. In contrast, other research on a range of different health outcomes indicates that highly severe warnings may result in defensive reactions [8][9][10].…”

Section: Introductionmentioning

confidence: 98%

Severity and susceptibility: measuring the perceived effectiveness and believability of tobacco health warnings

Maynard¹

2016

Preprint

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Background: Pictorial tobacco health warning labels (HWLs) have been shown to be more effective than text-only HWLs in changing smoking attitudes and intentions. However, there is contradictory evidence regarding how the severity of the content of HWLs influences responses to them. Methods: We examined the perceived believability and effectiveness of HWLs in an online study using a convenience sample of non-smokers (N = 437) and smokers (N = 436). HWLs were in one of three formats: (text-only, a moderately severe image or highly severe image) and focussed on three disease outcomes (lung cancer, blindness or tooth and gum disease). Participants rated the effectiveness and believability of each HWL and also rated their perceived susceptibility to each disease. Results: The most severe pictorial HWLs received the highest believability and effectiveness ratings and as expected, the text-only HWLs received the lowest. Lung cancer HWLs were rated most believable and effective, with the blindness HWLs receiving the lowest scores. Smokers considered themselves to be more susceptible to all three diseases, and among smokers, perceived susceptibility to the diseases was positively correlated with effectiveness and believability ratings of the HWLs.Conclusion: Our findings support previous evidence that pictorial HWLs are rated as more effective and believable than text-only warnings, and provide some support for the use of severe or ‘grotesque’ HWLs on tobacco products. Our data also suggest that HWLs should aim to increase perceived susceptibility to disease, as this was positively related to perceived message effectiveness and believability.

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Cigarette Graphic Warning Labels Are Not Created Equal: They Can Increase or Decrease Smokers’ Quit Intentions Relative to Text-only Warnings

Cited by 36 publications

References 32 publications

Emotional Impact and Perceived Effectiveness of Text-Only versus Graphic Health Warning Tobacco Labels on Adolescents

Emotional Impact and Perceived Effectiveness of Text-Only versus Graphic Health Warning Tobacco Labels on Adolescents

Australian community pharmacist experiences with smoking cessation and opinions of health warnings on individual cigarette sticks

Severity and susceptibility: measuring the perceived effectiveness and believability of tobacco health warnings

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