A Review on the Effects of Health Warnings Printed on Cigarette Packages on Smokers

Abstract

SUMMARYPrinting warning messages on cigarette packages is one of the policies against smoking. Millions of people are exposed to these warning messages every day. Therefore, it is essential to improve the effectiveness of these messages and evaluate their effects on individuals. This study aims to discuss the studies investigating health warnings on cigarette packages. In this context, studies about the design of warning messages (e.g. Should we use combined warnings which contain pictorials and texts together or should they contain only pictorials or only texts?; Do we need to return to plain packages?) on cigarette packages were reviewed. Then, studies related to the content of the messages were reviewed since the content of the messages (i.e. message framing) could also be effective on smoking just as the package design. Graphic warning labels on cigarette packages may generate defensive reactions. In this regard, these defensive reactions against graphic warning labels were addressed within the frameworks of psychological reactance theory (1), cognitive dissonance theory (2), terror management theory (3) and self-affirmation theory (4). Finally, how these defensive reactions could be reduced (e.g. framing sentences as questions instead of affirmative sentences) was reviewed on the basis of related literature.