Exposure to graphic warning labels on cigarette packages: Effects on implicit and explicit attitudes towards smoking among young adults

Abstract

Objective Test the effect of exposure to the U.S. Food and Drug Administration’s proposed graphic images with text warning statements for cigarette packages on implicit and explicit attitudes toward smoking. Design and methods A two-session web-based study was conducted with 2192 young adults 18–25 years old. During session one, demographics, smoking behavior, and baseline implicit and explicit attitudes were assessed. Session two, completed on average 18 days later, contained random assignment to viewing one of three sets of cigarette packages, graphic images with text warnings, text warnings only, or current U.S Surgeon General’s text warnings. Participants then completed post-exposure measures of implicit and explicit attitudes. ANCOVAs tested the effect of condition on the outcomes, controlling for baseline attitudes. Results Smokers who viewed packages with graphic images plus text warnings demonstrated more negative implicit attitudes compared to smokers in the other conditions (p=.004). For the entire sample, explicit attitudes were more negative for those who viewed graphic images plus text warnings compared to those who viewed current U.S. Surgeon General’s text warnings (p=.014), but there was no difference compared to those who viewed text-only warnings. Conclusion Graphic health warnings on cigarette packages can influence young adult smokers’ implicit attitudes toward smoking.

Graphic cigarette pack warnings do not produce more negative implicit evaluations of smoking compared to text-only warnings

“…It is possible that changes in implicit evaluations (and related changes in behavior) might be more positive after repeated (or longer) exposures to GWs. In line with this idea, a recent study found a (small) beneficial effect of GWs compared to text-only messages on implicit evaluations of smoking as measured with the IAT in a sample of young adult smokers [ 45 ]. Importantly, in that study, participants saw the nine FDA-proposed GWs four times each in a six minute time span.…”

Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions

“…Although we performed an a priori power analysis, it can be that this analysis was biased as it was not based on a meta-analysis (see also Albers and Lakens, 2018). Furthermore, prior research observed rather small effect sizes with much larger samples (Macy et al, 2015), and together, future research is needed to clarify whether the non-significant results in the present study reflect a non-existing effect or whether our actual effect size was too small to be detected with a possibly biased sample size.…”

Color Perception: a Smoking Cessation Experiment

“…Research on cigarette replacement products has also been carried out, Sheratt et al have conducted research in America about e-cigarettes which are considered as alternatives to quitting smoking still have limited health information constraints [10]. Previous research also uses a 'health and communication' perspective as a paradigm, such as Cho, Chun, & Choi, which states that graphic health warnings on cigarette packages do not get the attention of smokers who experience stress and believe that smoking can reduce their stress [11]. Graphic Health Warning, as one of the efforts of the anti-smoking campaign, apparently failed to reduce the number of smokers.…”