Effect of message congruency on attention and recall in pictorial health warning labels

Lochbuehler, Kirsten; Mercincavage, Melissa; Tang, Kathy Z.; Tomlin, Carol; Cappella, Joseph N.; Strasser, Andrew A.

doi:10.1136/tobaccocontrol-2016-053615

Cited by 39 publications

(50 citation statements)

References 41 publications

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“…For DCE 2, no image type worked better than the others and only one, relatively weak general tendency of a particular imagery type (i.e., young woman) worked better than others for DCE 1. Significant interactions indicate a better fit between image types for some topics than for others, consistent with other research suggesting that the congruence between topic and imagery in pictorial warnings influences attention and recall [ 59 ].…”

Section: Discussionsupporting

confidence: 87%

Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment

Thrasher

Islam

Davis

et al. 2018

IJERPH

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This study assessed smokers’ responses to different smoking cessation topics and imagery for cigarette package inserts. Adult smokers from Canada (n = 1000) participated in three discrete choice experiments (DCEs): DCE 1 assessed five cessation benefit topics and five imagery types; DCE 2 assessed five messages with tips to improve cessation success and five imagery types; DCE 3 assessed four reproductive health benefits of cessation topics and four imagery types. In each DCE, participants evaluated four or five sets of four inserts, selecting the most and least motivating (DCEs 1 & 3) or helpful (DCE 2) for quitting. Linear mixed models regressed choices on insert and smoker characteristics. For DCE 1, the most motivating messages involved novel disease topics and imagery of younger women. For DCE 2, topics of social support, stress reduction and nicotine replacement therapy were selected as most helpful, with no differences by imagery type. For DCE 3, imagery influenced choices more than topic, with imagery of a family or a mom and baby selected as most motivating. Statistically significant interactions for all three experiments indicated that the influence of imagery type on choices depended on the message topic. Messages to promote smoking cessation through cigarette pack inserts should consider specific combinations of message topic and imagery.

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Section: Discussionsupporting

confidence: 87%

Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment

Thrasher

Islam

Davis

et al. 2018

IJERPH

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“…This study did not evaluate congruency between the text and pictures on the labels. Among the 9 FDA labels, some were more congruent than others, resulting in better recall of the content of the labels (Lochbuehler et al, 2018). Future research should investigate how congruency between text and pictures might affect adaptive and maladaptive responses to the warnings.…”

Section: Discussionmentioning

confidence: 98%

Reactions to tobacco warning labels: predictors and outcomes of adaptive and maladaptive responses

Owusu

Popova

2019

Addiction Research & Theory

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Background: The Extended Parallel Process Model (EPPM) responses have not been evaluated from verbal reactions to cigarette warning labels. We identified the EPPM responses in reactions to cigarette warning labels and evaluated their predictors and relationship with warning perceptions. Methods: U.S. adult current smokers, transitioning smokers (quit in the past two years or currently quitting) and never smokers (n=1,838) saw nine of 81 cigarette warning labels. Participants freely wrote their thoughts after viewing the first label and reported perceived informativeness, negative emotions, and denial for this label. Responses were coded for the presence of the EPPM response categories. Multivariable logistic regression models described adaptive and maladaptive respondent characteristics, and linear regression models assessed the relationship between the response categories and label perceptions. Results: Participants' responses contained adaptive (65.4%), maladaptive (16.5%), no response (14.7%), and mixed responses (both adaptive and maladaptive; 3.4%). Current smokers had decreased odds of adaptive response compared to never and transitioning smokers. Compared to text warnings, pictorial warnings were associated with increased odds of adaptive and decreased odds of maladaptive responses. Adaptive response was associated with increased odds of intentions to quit smoking. Adaptive respondents reported the highest levels of informativeness and negative emotions among the four response categories. Conclusions: The finding demonstrating predominantly adaptive (and few maladaptive) responses to warning labels supports the continued use of fear appeals in warning label design. The greater adaptive and lower maladaptive responses to pictorial warnings could serve as additional evidence for FDA to implement pictorial warning labels.

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“…An alternative explanation is that certain smoking diseases (eg, lung cancer, mouth cancer) may be easier to depict visually, evoke greater fear (as Table 2 indicates for lung disease), and are more congruent with text warning information than for other health risks, such as addiction. 39 Also, we find that relative exposure and risk modification claims (eg, less nicotine; less addicting) tend to undercut addiction warnings. Due to the emerging research on e-cigarettes, it is important to first know exactly what at-risk populations believe about different harmful consequences of use, and perceptions of GHW visuals, to better understand what type of warning might be most effective, especially in the presence of ad claims.…”

Section: Conclusion and Policy Implicationsmentioning

confidence: 74%

Effects of E-Cigarette Health Warnings and Modified Risk Ad Claims on Adolescent E-Cigarette Craving and Susceptibility

Andrews

Mays

Netemeyer

et al. 2018

Nicotine &Amp; Tobacco Research

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More than one type of e-cigarette warning may be necessary as e-cigarette research evolves. Our results show different warning type effects (e.g., text-only; GHW + text) on e-cigarette craving and future susceptibility for adolescent experimenters depending on the risk theme (e.g., addiction; lung disease) and presence of ad claims (e.g., exposure and risk reduction). As research emerges on risks associated with e-cigarette use, it is important to first know what at-risk populations (e.g., adolescents) believe about such risks. Such research will aid our understanding of what types of warnings might be most effective, especially in the presence of ad claims.

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Effect of message congruency on attention and recall in pictorial health warning labels

Cited by 39 publications

References 41 publications

Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment

Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment

Reactions to tobacco warning labels: predictors and outcomes of adaptive and maladaptive responses

Effects of E-Cigarette Health Warnings and Modified Risk Ad Claims on Adolescent E-Cigarette Craving and Susceptibility

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