Are Graphic Cigarette Warning Labels an Effective Message Strategy? A Test of Psychological Reactance Theory and Source Appraisal

LaVoie, Nicole R.; Quick, Brian L.; Riles, Julius Matthew; Lambert, Natalie

doi:10.1177/0093650215609669

Cited by 105 publications

(81 citation statements)

References 52 publications

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“…However, with the exception of willingness to smoke, each of the observed differences was in the expected direction. Contrary to previous research demonstrating that pictorial warnings elicit reactance among adults [21,36,37], we did not find that reactance among adolescents differed between study arms. As reactance derives from a perceived threat to one's freedom [38], adolescents could have experienced greater reactance due to a newfound need for independence and autonomy [39].…”

Section: Discussioncontrasting

confidence: 99%

Adolescents' Responses to Pictorial Warnings on Their Parents' Cigarette Packs

Peebles

Hall

Pepper

et al. 2016

Journal of Adolescent Health

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Purpose Pictorial cigarette pack warnings are a promising policy solution to increase smoking cessation among adults. However, little is known regarding adolescents' responses to pictorial warnings, particularly in real-world settings. Methods Participants were 112 adolescent children, ages 13–17, whose parents received either text-only warnings on the side of their cigarette packs or pictorial warnings on the top half of the front and back of their cigarette packs for 4 weeks as part of a trial. We measured adolescents' recall and recognition of these warnings, negative emotional reactions to the warnings, perceived effectiveness of the warnings, social interactions about the warnings, and smoking risk beliefs. Results Adolescents accurately recalled pictorial warnings more often than text-only warnings (82% vs. 19%, p < .001). Recognition of warnings was also higher for pictorial than text-only warnings (82% vs. 34%, p < .001). Pictorial warnings drew greater attention (p < .001), elicited greater negative emotional reactions (p < .05), and sparked more social interactions (p < .01) than text-only warnings. Conclusions Pictorial warnings on cigarette packs may have important effects on adolescent children of smokers. Future research should further investigate the impact of such messages on adolescents' susceptibility to smoking initiation and interest in quitting smoking, particularly as the United States and other countries work to implement pictorial warning regulations.

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Section: Discussioncontrasting

confidence: 99%

Adolescents' Responses to Pictorial Warnings on Their Parents' Cigarette Packs

Peebles

Hall

Pepper

et al. 2016

Journal of Adolescent Health

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show abstract

“…Pictorial cigarette pack warnings cause greater message reactance than text warnings, as several studies and a recent meta-analysis have demonstrated (Erceg-Hurn & Steed, 2011; Hall et al, 2016; LaVoie et al, 2015; Noar et al, 2016). However, given the large body of research indicating the effectiveness of pictorial warnings, it would be unwise to conclude that pictorial warnings are counterproductive because they produce reactance, as others have asserted (LaVoie et al, 2015).…”

Section: Discussionmentioning

confidence: 98%

“…However, given the large body of research indicating the effectiveness of pictorial warnings, it would be unwise to conclude that pictorial warnings are counterproductive because they produce reactance, as others have asserted (LaVoie et al, 2015). Experimental and observational evidence supports the superiority of pictorial warnings over text warnings on numerous outcomes, including quit intentions (Noar et al, 2016), quit attempts (Brewer et al, 2016), knowledge about smoking risks (Brennan et al, 2011), and foregoing cigarettes (Yong et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

A brief measure of reactance to health warnings

Hall¹,

Sheeran

Noar³

et al. 2017

J Behav Med

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Reactance to persuasive messages involves perceived threat to freedom, anger, and counterarguing that may undermine the impact of health warnings. To understand reactance’s effects, reliable and valid assessment is critical. We sought to develop and validate a brief Reactance to Health Warnings Scale (RHWS). Two independent samples of US adults completed the brief RHWS in studies that presented warnings on cigarette packs that smokers carried with them for 4 weeks (Study 1; n = 2149) or as digital images of cigarette packs that participants viewed briefly (Study 2; n = 1413). The three-item Brief RHWS had good internal consistency and test–retest reliability. The scale correlated with higher trait reactance and exposure to pictorial warnings, supporting its convergent validity. With respect to predictive validity, the Brief RHWS predicted perceived message effectiveness, quit intentions, avoidance of the warnings, and number of cigarettes smoked per day. The Brief RHWS can serve as an efficient adjunct to the development of persuasive messages.

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“…The present research also highlights the promise of pictorial warnings as an effective tobacco control strategy, as pictorial warnings were viewed as more motivating than text warnings. Given the large body of research indicating the effectiveness of pictorial warnings, it would be unwise to conclude that pictorial warnings are counterproductive simply because they produce reactance, as others have done (20). However, our research suggests that reactance may partially weaken the impact of pictorial warnings on perceived effectiveness and the ability of the warning to motivate quitting, although text-only warnings performed worse overall.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, reactance may weaken the intended impact of the message (e.g., quitting smoking) or lead to boomerang effects (e.g., increased smoking). Experimental studies have focused on whether pictorial warnings increase reactance, but have not explored whether reactance undermines their positive effects (18–20). Thus, we explore the potential undermining effects of reactance through three additional hypotheses.…”

mentioning

confidence: 99%

Reactance to Health Warnings Scale: Development and Validation

et al. 2016

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Background Health warnings may be less effective if they elicit reactance, a motivation to resist a threat to freedom, yet we lack a standard measure of reactance. Purpose We sought to validate a new health warning reactance scale in the context of pictorial cigarette pack warnings. Methods A national sample of adults (n=1,413) responded to reactance survey questions while viewing randomly assigned pictorial or text warnings on images of cigarette packs. A separate longitudinal sample of adult smokers received the warnings on their own cigarette packs (n=46). Results Factor analyses identified a reliable and valid 27-item Reactance to Health Warnings Scale. In our experimental study, smokers rated pictorial warnings as being able to motivate quitting more than text warnings. However, five reactance scale factors weakened the warnings’ impact (anger, exaggeration, government, manipulation, and personal attack; all p<.05). Conclusions The Reactance to Health Warnings Scale had good psychometric properties. Reactance weakened the impact of pictorial warnings on smokers’ evaluation of the warning’s ability to motivate quitting.

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Are Graphic Cigarette Warning Labels an Effective Message Strategy? A Test of Psychological Reactance Theory and Source Appraisal

Cited by 105 publications

References 52 publications

Adolescents' Responses to Pictorial Warnings on Their Parents' Cigarette Packs

Adolescents' Responses to Pictorial Warnings on Their Parents' Cigarette Packs

A brief measure of reactance to health warnings

Reactance to Health Warnings Scale: Development and Validation

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