Graphic Warning Labels in Cigarette Advertisements

Abstract

Background The Family Smoking Prevention and Control Act gave the U.S. Food and Drug Administration (FDA) legal authority to mandate graphic warning labels on cigarette advertising and packaging. The FDA requires that these graphic warning labels be embedded into cigarette advertising and packaging by September 2012. Purpose The aim of this study was to examine differences in recall and viewing patterns of text-only versus graphic cigarette warning labels; and, the association between viewing patterns and recall. Methods Participants (current daily smokers; N=200) were randomized to view a cigarette advertisement with either text-only or graphic warning labels. Viewing patterns were measured using eye-tracking, and recall was later assessed. Sessions were conducted between November 2008 and November 2009. Data analysis was conducted between March 2011 and July 2011. Results There was a significant difference in percentage correct recall of the warning label between those in the text-only versus graphic warning label condition, 50% versus 83% (χ2 =23.74, p=0.0001). Time to first view of the graphic warning label text, and dwell time duration (i.e., time spent looking) on the graphic image were significantly associated with correct recall. Warning labels that drew attention more quickly and resulted in longer dwell times were associated with better recall. Conclusions Graphic warning labels improve smokers’ recall of warning and health risks; they do so by drawing and holding attention.

Government Efforts to Aid Consumer Well-Being

“…A strong positive relationship was then observed between a measure of cognitive processing and smokers' intentions to quit and later cessation behavior. Eye-tracking studies have shown positive effects on viewing of the graphic warning text and dwell time in cigarette ads (Strasser et al, 2012). Other GHW eye-tracking research shows greater attention toward health warnings compared to brand information when shown on plain packs (i.e., without the colored logo associated with the brand name) versus regular branded packs, with effects observed among nonsmokers and weekly smokers, but not daily smokers (Munafo, Roberts, Bauld, & Leonards, 2011).…”

Reactions of Nepali Adults to Warning Labels on Cigarette Packages: A Survey with Employee and Medical Students of a Tertiary Care Medical College of Western Region of Nepal

“…This study did not test whether remembering health warnings more accurately translated into the desired effect of making a person quit smoking. Therefore, this study alone cannot justify whether graphic warning labels on cigarette packs really "work better" than written warnings when it comes to quit rates [29].…”

Reducing Smoking Among Distracted Individuals: A Preliminary Investigation

“…By contrast, the use of a warning label alone resulted in smoking levels that did not differ from baseline. In other research, graphic warning labels have been shown to increase recall for the relevant warning (Strasser, Tang, Romer, Jepson, & Cappella, 2012), enhance knowledge of smoking risks (Borland & Hill, 1997), reduce the likelihood of former smokers lighting up again (Hammond, McDonald, Fong, Brown, & Cameron, 2004), discourage current smokers from wanting to smoke (Cameron, Pepper, & Brewer, 2013), and reduce cigarette use among active smokers (Willemsen, 2005). But efforts to implement such warnings in the United States are currently stalled, and the evidence to date suggests that less prominent text-only warnings found on U.S. cigarette packs are much less likely to produce any of the those effects (Hammond, 2011).…”