College student reactions to health warning labels: Sociodemographic and psychosocial factors related to perceived effectiveness of different approaches

Abstract

Objective To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students. Method We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analyses from 2,600. Results Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused on differences between those endorsing gruesome images or testimonials as most effective. Factors related to ranking testimonials versus gruesome images as most effective included being female (p<0.01), White (p<0.01), and nonsmokers (p=0.04), lower perceived smoking prevalence (p<0.01), and greater receptivity to laws/restrictions around smoking (p<0.01) and tobacco marketing (p=0.01). Among smokers, factors related to ranking testimonials as most effective versus gruesome images included being female (p=0.03), being White (p=0.03), higher autonomous motivation (p=0.03), and greater extrinsic self-efficacy (p=0.02). Conclusions Understanding factors related to perceived effectiveness of different pictorial warnings among subpopulations should inform health warning labels released by the FDA.

Responses of young adults to graphic warning labels for cigarette packages

“…Third, labels with the greatest effects on discouragement from wanting to smoke generally included photographs of diseased body parts, suffering or dead people or children or babies, whereas labels with minimal effects generally included images consisting of art graphics, metaphors or depictions of unpleasant smoking experiences. These latter findings converge with evidence that labels with graphic depictions of disease have stronger effects on emotional reactions and smoking motivations than do images of human suffering or symbolic images 15 17…”

Framing Pictorial Cigarette Warning Labels to Motivate Young Smokers to Quit

“…The overall response rate among eligible young adults was 19%, similar to other young adult internet-based smoking studies. 24 …”

“…In response to each of the pack images, participants answered a question assessing how much the pack motivated them to quit smoking using a 1-("Not at all") to 7-("A lot") response scale. 24 For bivariate analyses, we averaged participants' reported motivation to quit for the four pack images to assess associations with variables of interest (M = 4.82, SD = 1.83, Cronbach's α = 0.92). For multivariable analyses, we analyzed participants' responses to each item individually using methods to account for the within-participant correlated nature of the data (see statistical analysis description).…”

Review of hookah tobacco smoking among college students: policy implications and research recommendations

“…However, the research on cigarette warning labels shows that labels are effective in deterring cigarette smoking among college students (23)(24)(25). This research has also shown that the type of cigarette warning labels used (graphic images of disease, images of suffering with testimonials, or emotional tone) affects students differently depending on their smoking status (25).…”

“…College students are receptive to different antismoking messages depending on their smoking status (25,79). Accordingly, smoking status should be considered when antismoking messages for college-age adults are developed.…”