Understanding how Graphic Pictorial Warnings Work on Cigarette Packaging

Abstract

The 2009 Family Smoking Prevention and Tobacco Control Act requires cigarette packages to contain stronger warnings in the form of color, graphic pictures depicting the negative health consequences of smoking. The authors present results from a between-subjects experiment with more than 500 smokers that test (1) the effectiveness of pictorial warnings that vary in their graphic depiction of the warning and (2) an underlying mechanism proposed to drive potential effects of the manipulation of the graphic depiction. The findings indicate that more graphic pictorial warning depictions strengthen smokers’ intentions to quit smoking. Recall of warning message statements is reduced by moderately or highly graphic pictures compared with a no-picture control or less graphic pictures. The results also show that the graphic warnings affect evoked fear, and in turn, fear mediates the effects of the graphic warning depiction on intentions to quit for the sample of smokers. This pattern of results indicates that though highly graphic pictures may reduce specific message recall and limit the direct effect of recall on intentions to quit, highly graphic pictures increase intentions to quit smoking through evoked fear (i.e., fear fully mediates the effect of the graphic depiction level). The authors discuss implications for consumer health and policy decisions.