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Which Images and Features in Graphic Cigarette Warnings Predict Their Perceived Effectiveness? Findings from an Online Survey of Residents in the UK

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Many countries are implementing graphic warnings for cigarettes. Which graphic features influence their effectiveness remains unclear.

Purpose

To identify features of graphic warnings predicting their perceived effectiveness in discouraging smoking.

Method

Guided by the Common-Sense Model of responses to health threats, we content-analyzed 42 graphic warnings for attributes of illness risk representations and media features (e.g., photographs, metaphors). Using data from 15,536 survey participants, we conducted stratified logistic regressions testing which attributes predict participant selections of warnings as effective.

Results

Images of diseased body parts predicted greater perceived effectiveness; OR = 6.53–12.45 across smoking status (smoker, ex-smoker, young non-smoker) groups. Features increasing perceived effectiveness included images of dead or sick persons, children, and medical technology; focus on cancer; and photographs. Attributes decreasing perceived effectiveness included infertility/impotence, addictiveness, cigarette chemicals, cosmetic appearance, quitting self-efficacy, and metaphors.

Conclusions

These findings on representational and media attributes predicting perceived effectiveness can inform strategies for generating graphic warnings.

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Statement of Conflict of Interest and Adherence to Ethical Standards

Linda D. Cameron and Brian Williams declare that they have no conflict of interest. All procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Authors and Affiliations

  1. University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA

    Linda D. Cameron Ph.D

  2. University of Stirling, Stirling, UK

    Brian Williams Ph.D

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  1. Linda D. Cameron Ph.D
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  2. Brian Williams Ph.D
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Correspondence to Linda D. Cameron Ph.D.

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Cameron, L.D., Williams, B. Which Images and Features in Graphic Cigarette Warnings Predict Their Perceived Effectiveness? Findings from an Online Survey of Residents in the UK. ann. behav. med. 49, 639–649 (2015). https://doi.org/10.1007/s12160-015-9693-4

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  • DOI: https://doi.org/10.1007/s12160-015-9693-4

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