Message frames in health warnings and plain packaging. What effects do they have on non-smokers?

Abstract

Objective: The key to controlling tobacco use lies in preventing new smokers. Graphic health warnings and plain packaging are policy interventions to discourage cigarette consumption. This study examined the effect of the warning message frame (gain vs loss) and cigarette packaging (branded vs plain) in non-smokers. Methods: Young adult non-smokers aged 18–22 years ( n = 282) were recruited online and randomised to one of four experimental conditions, in a 2 (Package, plain vs branded) × 2 (Frame, gain vs loss) between-subjects experimental design. Each participant was exposed to four images of cigarette packs. After observing each image, participants reported the perceived message effectiveness, perceived risks (or benefit) of smoking (or not), decision not to smoke, and attention to image. Results: Separate two-way analyses of covariance (ANCOVAs) that examined the main effects of frame and package were used for each measure. A loss-framed warning was perceived as more effective, increased risk perception, enhanced awareness of the health benefits of not smoking, produced less desire to smoke, and strengthened the decision not to smoke. Plain packaging had no significant effect on any of the outcomes. No significant differences were found in visual attention. Conclusions: The results suggest that loss-framed warnings were more effective in preventing non-smokers from starting, compared with gain-framed warnings. Plain packaging did not seem to enhance the effect of health warnings in our sample of non-smokers.