Severity and susceptibility: measuring the perceived effectiveness and believability of tobacco health warnings

Maynard, Olivia

doi:10.31234/osf.io/7ukmr

Cited by 5 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that highly-severe warnings increase self-reported avoidance, reactance and motivation to quit smoking compared to moderately-severe warnings. This finding supports our previous online study using the same warnings, which found that the highly-severe warnings were perceived as more effective and believable by both non-smokers and current smokers (48).…”

Section: Discussionsupporting

confidence: 90%

“…We next examined the extent to which these loss-framed messages focusing on the long-term consequences of smoking should be severe. Previous research has found that highly-severe warnings increase intentions to quit (42) are rated as more believable and effective (43) and increase perceived effectiveness of the warnings to discourage smoking (44).…”

Section: Warning Severitymentioning

confidence: 99%

See 1 more Smart Citation

Avoidance of tobacco health warnings? An eye-tracking approach

Sillero‐Rejon¹,

Leonards²,

Munafò³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Aims: Across three eye-tracking studies, we examined how the location, framing, immediacy, and severity of health warnings on branded cigarette packs affected visual attention and self-reported avoidance of and reactance to warnings. Design: Study 1: smoking status × warning immediacy (short-term vs. long-term) × warning location (top of back vs. bottom of pack). Study 2: smoking status × warning framing (gain-framed vs. loss-framed) × warning format (text-only vs. pictorial). Study 3: smoking status × warning severity (highly-severe vs. moderately-severe). Setting: University of Bristol, UK, eye-tracking laboratory. Participants Study 1: non-smokers (n=25), weekly smokers (n=25), and daily smokers (n=25). Study 2: non-smokers (n=37), smokers contemplating quitting (n=37) and smokers not contemplating quitting (n=43). Study 3: non-smokers (n=27), weekly smokers (n=26) and daily smokers (n=26). Measurements: For all studies: relative number of fixations to the warning vs. the brand, self-reported avoidance of and reactance to warnings and for Study 3: effect of warning on quitting motivation. Findings: Study 1: Greater self-reported avoidance (p<0.001) and greater visual attention (p=0.03) to long-term warnings, but no difference for reactance (p=0.12). Increased visual attention to warnings on the upper- versus lower-half of the pack (p=0.02). Study 2: Higher self-reported avoidance of (p<0.001) and reactance to (p<0.001) loss-framed warnings but little evidence of a difference for visual attention (p=0.30). Greater visual attention, avoidance and reactance to pictorial versus text-only warnings (all ps>0.001). Study 3: Greater self-reported avoidance of (p<0.001) and reactance (p=0.003) to highly-severe warnings but no clear difference in visual attention (p=0.24). Conclusions: Subjective (self-report) and objective (eye-tracking) measures of warning avoidance produced different outcomes, suggesting these capture different constructs. Visual avoidance of warnings indicates low-level disengagement with warnings, while self-reported avoidance reflects higher-level cognitive awareness and engagement with warnings. We suggest that loss-framed, long-term, highly-severe images are likely to be most effective in communicating harm.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Warning Severitymentioning

confidence: 99%

Avoidance of tobacco health warnings? An eye-tracking approach

Sillero‐Rejon¹,

Leonards²,

Munafò³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…With regard to image‐and‐text HWLs, uncertainty also remains around the types of images that may exert the greatest effect. Warnings including shocking or explicit pictures are most likely to be believed and are rated as more effective than those with less severe pictures [29]. The former, however, may also increase reactance and avoidance behaviours [28] and may be less acceptable [30].…”

Section: Introductionmentioning

confidence: 99%

Impact of health warning labels communicating the risk of cancer on alcohol selection: an online experimental study

et al. 2020

View full text Add to dashboard Cite

Aims Evidence from tobacco research suggests that health warning labels (HWLs) depicting the adverse consequences of consumption change smoking behaviours, with image‐and‐text (also known as ‘pictorial’ or ‘graphic’) HWLs most effective. There is an absence of evidence concerning the potential impact of HWLs placed on alcohol products on selection of those products. This study aimed to obtain a preliminary assessment of the possible impact of (i) image‐and‐text, (ii) text‐only, and (iii) image‐only HWLs on selection of alcoholic versus non‐alcoholic drinks. Design A between‐subjects randomised experiment with a 2 (image: present versus absent) × 2 (text: present versus absent) factorial design. Setting The study was conducted on the online survey platform Qualtrics. Participants Participants (n = 6024) were adults over the age of 18 who consumed beer or wine regularly (i.e. at least once a week), recruited through a market research agency. Interventions Participants were randomised to one of four groups varying in the HWL displayed on the packaging of alcoholic drinks: (i) image‐and‐text HWL; (ii) text‐only HWL; (iii) image‐only HWL; and (iv) no HWL. HWLs depicted bowel cancer, breast cancer and liver cancer, which were each displayed twice across six alcoholic drinks. Each group viewed six alcoholic and six non‐alcoholic drinks and selected one drink that they would like to consume. Measurements The primary outcome was the proportion of participants selecting an alcoholic versus a non‐alcoholic drink. Findings Alcoholic drink selection was lower for all HWL types compared with no HWL (image‐and‐text: 56%; image‐only: 49%; text‐only: 61%; no HWL: 77%), with selection lowest for HWLs that included an image. Image‐and‐text HWLs reduced the odds of selecting an alcoholic drink compared with text‐only HWLs (OR = 0.80, 95% CI = 0.69, 0.92), but increased the odds of selecting an alcoholic drink compared with image‐only HWLs (OR = 1.34, 95% CI = 1.16, 1.55). Conclusions Health warning labels communicating the increased risk of cancers associated with alcohol consumption reduced selection of alcoholic versus non‐alcoholic drinks in a hypothetical choice task in an online setting; labels displaying images had the largest effect. Their impact in laboratory and real‐world field settings using physical products awaits investigation.

show abstract

“…We suggest this may be due to the pictorial used, with the pancreatic cancer warning displaying a close-up of a yellow eye, which is arguably novel and memorable, while the anxiety warning depicted a man pulling at his hair. Previous research has suggested that more ‘severe’ or grotesque warnings increase smokers’ intentions to quit and are rated as more believable and effective than less severe warnings 21 22…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional online survey of the impact of new tobacco health warnings in Colombia

et al. 2022

View full text Add to dashboard Cite

ObjectivesThis study aimed to explore the impact of a new set of six pictorial warnings introduced in 2018.Design and settingUsing a cross-sectional design, we examined awareness of the new warnings among Colombian smokers across two time points of data collection.ParticipantsAdult smokers (≥18 years of age), defined as having smoked at least 100 cigarettes in their lifetime and currently smoking at least one cigarette per week participated at time 1, prior to the introduction of the new health warnings in Colombia in 2018 (n=1985, 72% male), and at time 2, 12 months post introduction (n=1572, 69% male).Primary outcomesAt each time, we examined smokers’ responses to warnings on packs (negative affect, thinking about warning messages and cognitive elaboration), attitudes toward smoking (perceived likelihood and severity of harm, self-efficacy, response efficacy and quit intentions), knowledge of the health risks of smoking and responses to the new warnings (negative affect, believability, thinking about the harms, reactance and perceived message effectiveness).ResultsAwareness of the warnings was low, with only 59% of smokers reporting having seen them at time 2. Between times, we observed a reduction in negative affect toward current warnings (p<0.001), reduced thinking about (p<0.001) and cognitive elaboration of the warning message (p<0.001), and an increase in perceived severity of warnings (p<0.001). When asked about the six new health warnings, we found a reduction in negative affect (p<0.07), cognitions related to harm (p<0.01), believability (p<0.03), reactance (p<0.01) and perceived message effectiveness (p<0.02) between times.ConclusionsOur data indicate that effectiveness was low prior to the introduction of the new health warnings and at 12 months post introduction. Tobacco control policy should seek to improve exposure to and noticeability of tobacco health warnings in Colombia.

show abstract

Severity and susceptibility: measuring the perceived effectiveness and believability of tobacco health warnings

Cited by 5 publications

References 21 publications

Avoidance of tobacco health warnings? An eye-tracking approach

Avoidance of tobacco health warnings? An eye-tracking approach

Impact of health warning labels communicating the risk of cancer on alcohol selection: an online experimental study

Cross-sectional online survey of the impact of new tobacco health warnings in Colombia

Contact Info

Product

Resources

About