Does the effect go up in smoke? A randomized controlled trial of pictorial warnings on cigarette packaging

The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies

“…That is, after Australia implemented pictorial warnings, beliefs that getting gangrene, emphysema, and clogged arteries would be one of the worst things that could happen increased (Miller, Quester, Hill, & Hiller, 2011). These findings are similar to an experimental study of pictorial warnings conducted in Germany, which also demonstrated impact on perceived severity but not perceived likelihood (Schneider, Gadinger, & Fischer, 2012). The proposition that warnings may impact perceived severity but not perceived likelihood is consistent with the nature of many pictorial warnings, which provide gruesome images of serious harm but do not give objective or implied information on frequency of harm.…”

Characteristics of warning labels for drug containers and their effects on perceived hazardousness

“…These results are generally consistent with research pertaining to the effects of pictorial warnings on smokers' cognitive responses and attitude change (Andrews et al, 2014;Munoz et al, 2013;Schneider et al, 2012). One conclusion to be drawn from this body of research is that pictorial fear-arousing messages are perceived by subjects as particularly effective, and they have been associated with increased thinking about health risks (Hammond et al, 2004), suggesting that fear mediates the efficacy of health warnings (Sweet et al, 2003).…”

“…Another limitation is that the context in which participants evaluated the warning stimuli, i.e., after viewing them on paper, does not correspond with the repeated exposure to drug containers that occurs in real life. However, the paper presentation of stimuli in our study yielded similar results to the screen presentation of stimuli used by Blanton et al (2014) and Schneider et al (2012). Furthermore, it is important to keep in mind that explicit judgments of the perceived effectiveness of warning do not necessarily predict responses to warning labels on drug containers.…”

“…Feras et al (2011) demonstrated that images are more easily noticed and understood by smokers than is text and that messages that use images are more effective at eliciting fear and stimulating intentions to quit smoking. Similarly, Schneider et al (2012) conducted an experiment to compare the effects of pictorial and written warnings on the intensity of resulting fearful emotions and on participant's motivation to quit smoking; 44 adult smokers viewed written warnings, while another 44 adult smokers viewed corresponding pictorial warnings. The authors concluded that pictorial warnings may be effective in increasing motivation to quit among heavy smokers.…”

The Argument in Favor of Graphic Warning Labels on Cigarette Packages

“…Two randomized controlled trials performed in adult and youth smokers in the United States and Mexico revealed that graphic warnings added to a telephone quit line number were more effective (e.g., increase concern about health risk, motivate smokers to quit, prevent youths from smoking, and overall effectiveness) than nongraphic warnings or symbolic images (14,15). A German study demonstrated that pictorial warnings were associated with a significantly higher motivation to quit and higher fear intensity to effects of smoking independent of nicotine dependence and self-affirmation (16).…”