Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content

Abstract

Objective This study aimed to determine the most effective content of pictorial health warning labels (HWLs) and whether educational attainment moderates these effects. Methods Field experiments were conducted with 529 adult smokers and 530 young adults (258 nonsmokers; 271 smokers), wherein participants reported responses to different HWLs printed on cigarette packages. One experiment involved manipulating textual form (testimonial narrative vs didactic) and the other involved manipulating imagery type (diseased organs vs human suffering). Results Tests of mean ratings and rankings indicated that HWLs with didactic textual forms had equivalent or significantly higher credibility, relevance, and impact than HWLs with testimonial forms. Results from mixed-effects models confirmed these results. However, responses differed by participant educational attainment: didactic forms were consistently rated higher than testimonials among participants with higher education, whereas the difference between didactic and testimonial narrative forms was weaker or not statistically significant among participants with lower education. In the second experiment, with textual content held constant, greater credibility, relevance and impact was found for graphic imagery of diseased organs than imagery of human suffering. Conclusions Pictorial HWLs with didactic textual forms appear to work better than with testimonial narratives. Future research should determine which pictorial HWL content has the greatest real-world impact among consumers from disadvantaged groups, including assessment of how HWL content should change to maintain its impact as tobacco control environments strengthen and consumer awareness of smoking-related risks increases.

Socioeconomically disadvantaged smokers’ ratings of plain and branded cigarette packaging: an experimental study

“…Use of a wider range of brands for comparison is recommended for research in countries considering implementing plain packaging. Although the study employed a computer image instead of actual packs, previous packaging research demonstrates that results are generally consistent regardless of stimulus presentation modality 22 35 36. The outcome measures used in this study pose an additional limitation.…”

How Does Packaging Influence Consumer Behavior? A Multidisciplinary Bibliometric Study

“…In the cluster -communication‖, Thrasher et al (2012) found that the warning labels on cigarette packages worked most effectively at getting a message across. In the group called -tuxedo‖, Zacher et al (2014) also discussed the issue of information and warnings on cigarette packages.…”

Respuestas faciales ante imágenes de advertencia de tabaco

“…Las imágenes de advertencia muestran el impacto negativo del consumo de tabaco mediante imágenes impactantes, y pretenden promover conductas de rechazo hacia el consumo (Farrelly et al, 2008). Esta estrategia ha demostrado ser efectiva para un amplio grupo de personas (Borland et al, 2009;Hammond, Reid, Driezen y Boudreau, 2013;Hammond et al, 2012;Thrasher et al, 2012), particularmente aquellas que han iniciado recientemente la conducta de fumar y aquellas que están interesadas en abandonarlo, especialmente cuando las imágenes de advertencia son muy visibles y señalan los efectos negativos del consumo de tabaco (Hammond, Fong, McNeill, Borland y Cummings, 2006). El estudio de la respuesta emocional hacia las imágenes de advertencia se ha limitado, por lo general, al uso de encuestas y grupos focales (Hammond, 2011), los resultados de estas investigaciones muestran que las imágenes son más efectivas para comunicar el mensaje de daño y peligro en comparación a cuando sólo se usa el mensaje en texto (Vardavas, Connolly, Karamanolis y Kafatos, 2009) y que los fumadores reportan algún grado de miedo, asco o ira ante las imágenes de advertencia, y que las emociones de miedo y asco se asocian a la disminución del consumo de tabaco posteriormente (Hammond, Fong, McDonald, Brown y Cameron, 2004).…”