Graphic images of negative consequences of smoking have greatest impact on smokers

August 15, 2015

Participant responses indicated that pictorial warnings had a significantly positive effect on smokers' intentions to quit. Specifically, when compared to the moderate and low graphic levels, the highly graphic condition resulted in a significant increase in quit intentions. Moderate graphic levels also were associated with higher quit intentions than low graphic levels. Compared to the warning label with a written message only, the less graphic picture was not effective at strengthening smokers' intentions to quit.

The researchers found that participant recall of the written-message statement was reduced by the moderate and highly graphic pictorial warnings. Participants had greater recall of the written messages when they were packaged with "low" graphic pictorial warnings or with no image.

"However, it is worth noting here that recall of the stated warning is likely to be influenced by multiple exposures to the warnings," Kees said. "For instance, the graphic pictorial warnings may negatively affect recall initially because smokers are more 'shocked' by the warnings, but the stated message may be better remembered over time."

The researchers found that the graphic images evoked fear, which in turn served as the primary underlying mechanism explaining the effects of the pictorial warnings. As depictions of the consequences of smoking were presented more graphically, smokers reported higher levels of fear, Burton said. Also, the findings were consistent across variations in the amount of time participants were exposed to the packages, which suggested that even a relatively limited exposure to the warning label might achieve the desired effect to motivate smokers to quit.

"We believe our study provides some valuable implications for health policy," Burton said. "As public health officials and policy makers in the U.S. and around the world consider potential changes to warnings on cigarette packages, the addition of pictorial warnings, especially more graphic depictions of the consequences of smoking, to text-based messages appears beneficial. These data show that at least moderately graphic pictures should be used."

The researchers' study will be published in the fall issue of the Journal of Public Policy & Marketing.

SOURCE University of Arkansas, Villanova University and Marquette University