A new study has found that smokers who saw graphic warning labels that contained disturbing photos on every pack of cigarettes they smoked for four weeks had more negative feelings about smoking compared to those who saw just text warnings.
The photos led the smokers to look more closely at the warnings and put more credence into them, according to researchers at the Ohio State University.
This was linked to them thinking their habit was more dangerous, which made them more likely to consider quitting, according to the researchers. They also remembered more of the health risks of their habit.
“The graphic images motivated smokers to think more deeply about their habit and the risks associated with smoking,” said Ellen Peters, co-author of the study and a professor of psychology at The Ohio State University.
For the study, the researchers used graphic warning labels created by the U.S. Food and Drug Administration. One of the labels included an image of a man smoking through a hole in his throat, called a tracheostomy. A tracheostomy may be necessary as a result of some smoking-related cancers.
The use of graphic warning labels was mandated by law to appear on cigarette packs in the United States in 2009. The warnings proposed by the FDA were later invalidated by a federal appeals court. The court concluded the labels were unconstitutional in part because the images were “unabashed attempts to evoke emotion … and browbeat consumers into quitting.”
The new study suggests that the court was not correct in its assessment of how these images work to discourage smoking, Peters said.
“Smokers weren’t browbeaten by the images,” she said. “The images definitely did stir their emotions, but those emotions led them to think more carefully about the risks of smoking and how those risks affected them.”
“What the court is missing is that without emotions, we can’t make decisions,” she continued. “We require having feelings about information we collect in order to feel motivated to act. These graphic warnings helped people to think more carefully about the risks and to consider them more.”
The study involved 244 adults who smoked between five and 40 cigarettes each day.
Participants were provided with their preferred brand of cigarettes for four weeks, in modified packages. All packages had the same text messages, such as “Cigarettes cause fatal lung disease.”
Some participants received packs with only these messages. Others received packs with the text warnings plus one of nine graphic, somewhat disturbing images showing the dangers of smoking.
A third group received the simple text and the image, plus additional text detailing how every cigarette entails risk.
Participants returned to the lab each week to receive additional cigarettes and respond to surveys about their experiences with the new packaging.
Results showed that smokers who had the warning labels with the graphic labels were more likely than those who received only text warnings to report that the packaging made them feel worse about smoking. They were also more likely to read or look closely at the information on the warning labels and they better remembered what was on the labels, the researchers reported.
Smokers who had the graphic labels also saw the warnings as more credible, the researchers added.
“The feelings produced by the graphic images acted as a spotlight,” Peters said. “Smokers looked more carefully at the packages and, as a result, the health risks fell into the spotlight and led to more consideration of those risks.”
Smokers who viewed the graphic labels were also slightly more likely to say they intended to quit smoking, she added.
“The effect was small, but it was not unimportant,” she said. “For a health issue like smoking, which causes about a half-million deaths a year in the United States, even small effects can have a large impact in the population.”
The study, supported by grants from the National Cancer Institute and the FDA Center for Tobacco Products, was published in the journal PLOS ONE.