Testing competing explanations for graphic warning label effects among adult smokers and non-smoking youth

Abstract

Rationale The U.S. courts have blocked the implementation of graphic warning labels on cigarette packages (GWLs). This decision was based, in part, on the premise that GWLs are unnecessarily emotional and are meant to scare rather than inform consumers about smoking’s health effects. However, research in judgment and decision-making suggests these relationships are more complex. Objective In this paper, we drew on several theoretical frameworks that lead to competing hypotheses about the relationships between negative affect, health risk beliefs, and quit intentions (among adult smokers) or susceptibility to start smoking (among non-smoking youth). Method We tested these competing mediation models using data from two experiments with two populations each—adult smokers (N=313, 238) and primarily non-smoking middle-school youth (N=340, 237). Using mobile recruitment methods, we focused specifically on individuals from socioeconomically disadvantaged communities in rural and urban areas of the Northeastern U.S. Results The best fitting model across all four datasets was one in which label-induced negative affect (a) directly predicted intentions/susceptibility but also (b) indirectly predicted intentions/susceptibility via risk beliefs. Although mediation analyses did not demonstrate significant serial mediation effects of GWL exposure on intentions/susceptibility through negative affect then risk beliefs, there was some evidence that GWL exposure indirectly promoted adults’ quit intentions through negative affect. Additionally, negative affect consistently mediated the indirect effect of GWL exposure on strengthened risk beliefs among adults and youth. Conclusions These results speak to the importance of negative affect in directly motivating adult smokers’ quit intentions but also serving an informational function, directing adult smokers and non-smoking youth to accept the health risks of smoking.

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“…Therefore, contradictory warning labels are more meaningful, if targeted at current smokers, and it also prevents youth from starting the behavior [28]. However, this is an important thing to consider while initiating a program to this effect as it is supported by a previous study, which illustrated the importance of negative affect indirectly motivating the desire to stop smoking -hence, serving as a source of information to influence adult smokers and non-smoking adolescents to accept health the risks [29].…”

Indonesian adolescents’ perspectives on smoking habits as a reference for a prevention program: a qualitative study

“…However, this is an important issue to consider when initiating a program. A previous study illustrated the importance of negative affect indirectly motivating the desire to stop smoking, hence, serving as a source of information to influence adult smokers and non-smoking adolescents to accept the health risks [30].…”

Warning labels and messaging for youth gamblers

“…Youth did not seem to care about the credibility of the graphic warning labels; the importance was using imagery that elicited negative emotions. 35,36 Negative emotions or reactance to the graphic warning labels were associated with a greater likelihood of negative attitudes towards the behaviour, and therefore higher chances of taking on cessation attempts. 37,38 Graphic warning labels in youth ages 13 to 20 years evoked higher arousal than text-only warning labels.…”