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

Abstract

Graphic warnings (GWs) on cigarette packs are widely used internationally with the aim of reducing smoking behavior. In the current study, we investigated whether GWs influence implicit evaluations of smoking, a potential moderator of smoking behavior, as measured with an Implicit Association Test (IAT). Results showed that viewing a GW did not produce more negative implicit evaluations of smoking for daily smokers, occasional smokers, or non-smokers, compared to viewing a text-only warning. If anything, effects were in the direction of evaluations of smoking being more positive after certain participants (i.e., daily and occasional smokers) viewed a GW. We also did not find any beneficial effects of GWs on explicit evaluations of smoking. These results contrast with the observation that non-smokers and occasional smokers (but not daily smokers) believed that GWs would be more effective than the text-only warnings. We discuss implications and limitations of these findings and provide recommendations for improving the effectiveness of cigarette pack warnings on implicit evaluations.

The association between new graphic health warning labels on tobacco products and attitudes toward smoking among south Korean adolescents: a national cross-sectional study

“…Continuous exposure to secondhand smoke may lead to underestimation of the risk of using tobacco products and to familiarity with them. As a result, GHWLs alone are insufficient to change the perceptions and attitudes of tobacco-friendly adolescents [43], such as current smokers who are familiar with tobacco products and those exposed to secondhand smoke. These results suggest that a single policy is inadequate for the prevention of smoking by adolescents and underscore the need for multiple integrated approaches.…”

Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions

“…These null findings might be a lack of power in the adult smoker group. However, very recent work comparing graphical warning labels with text-only warning labels with a much larger sample ( N = 7757) also found no significant effects on implicit associations measured with an IAT, and no effects on explicit evaluations (van Dessel et al, 2018) in an adult population of smokers, occasional smokers, and non-smokers. Our null-findings are in line with this work.…”

“…Although this could be interpreted as a first support for using social warning labels and even health warning labels to convince smokers to stop smoking, given that this effect was not found in Study 1a, future research should replicate this finding before strong conclusions can be drawn. Previous research demonstrates mixed results of graphical warning labels on explicit evaluations, with on the one hand research showing an influence of warning labels on explicit attitudes (Süssenbach et al, 2013), while more recent work (van Dessel et al, 2018) on the other hand showing no beneficial effects of graphical warning labels compared to text-only warning labels on explicit evaluations.…”

“…Furthermore, warning labels formulated as questions (Glock et al, 2013b) or labels which contradict common smoking-related positive outcome expectancies (e.g., smoking reduces stress), do not elicit defensive responses, and thus result in higher smoking-related risk perception (Glock et al, 2013b). It is further supported by research that less aversive warning labels do not induce threat, and therefore no defensive responses are elicited, which makes them more effective than fear-inducing warning labels [Süssenbach et al, 2013; but see van Dessel et al (2018) for null findings of graphical warning labels].…”

Message Pretesting Using Perceived Persuasiveness Measures: Reconsidering the Correlational Evidence

“…Biener, Ji, Gilpin, and Albers (2004) found that adolescents who owned a tobacco promotional item, compared to those who did not, rated antismoking ads as significantly less effective. In a number of studies, smokers with higher PME scores for antismoking ads, compared to those with lower PME scores, have been found to be significantly more likely to have made a previous quit attempt, to smoke fewer cigarettes, to have a greater desire or readiness to quit, to already have plans to quit, and so on (Bigsby et al, 2013;Brennan et al, 2014;Davis et al, 2017;Hitchman et al, 2012;Van Dessel, Smith, & De Houwer, 2018;Willemsen, 2005). And several studies have found antismoking messages to be rated higher in perceived effectiveness by nonsmokers than by smokers (Biener, McCallum-Keeler, & Nyman, 2000;Lingwall et al, 2018;Sidhu, 2011;Sobani, Nizami, Raza, Ul Ain Baloch, & Khan, 2010).…”