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Erschienen in: Annals of Behavioral Medicine 5/2015

01.10.2015 | Original Article

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

verfasst von: Linda D. Cameron, Ph.D, Brian Williams, Ph.D

Erschienen in: Annals of Behavioral Medicine | Ausgabe 5/2015

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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.
Literatur
2.
Zurück zum Zitat World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization; 2003. World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization; 2003.
4.
Zurück zum Zitat Canadian Cancer Society. Cigarette Package Health Warnings: International Status Report. 3rd ed. Toronto: Framework Convention Alliance; 2012. Canadian Cancer Society. Cigarette Package Health Warnings: International Status Report. 3rd ed. Toronto: Framework Convention Alliance; 2012.
5.
Zurück zum Zitat Borland R, Yong HH, Wilson N, et al. How reactions to cigarette packet health warnings influence quitting: Findings from the ITC four-country survey. Addiction. 2009; 104: 669-675.PubMedCentralCrossRefPubMed Borland R, Yong HH, Wilson N, et al. How reactions to cigarette packet health warnings influence quitting: Findings from the ITC four-country survey. Addiction. 2009; 104: 669-675.PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Hammond D, Fong GT, McDonald PW, Cameron R, Brown KS. Impact of the graphic Canadian warning labels on adult smoking behavior. Tob Control. 2003; 12: 391-395.PubMedCentralCrossRefPubMed Hammond D, Fong GT, McDonald PW, Cameron R, Brown KS. Impact of the graphic Canadian warning labels on adult smoking behavior. Tob Control. 2003; 12: 391-395.PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Hammond D, Fong G, McDonald PW, Brown S, Cameron R. Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers. Am J Public Health. 2004; 94: 1442-1445.PubMedCentralCrossRefPubMed Hammond D, Fong G, McDonald PW, Brown S, Cameron R. Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers. Am J Public Health. 2004; 94: 1442-1445.PubMedCentralCrossRefPubMed
9.
Zurück zum Zitat Hammond D, Reid JL, Driezen P, Boudreau C. Pictorial health warnings on cigarette packs in the United States: An experimental evaluation of the proposed FDA warnings. Nicotine Tob Res. 2013; 15: 93-102.PubMedCentralCrossRefPubMed Hammond D, Reid JL, Driezen P, Boudreau C. Pictorial health warnings on cigarette packs in the United States: An experimental evaluation of the proposed FDA warnings. Nicotine Tob Res. 2013; 15: 93-102.PubMedCentralCrossRefPubMed
11.
Zurück zum Zitat Peters GY, Ruiter RAC, Kok G. Threatening communication: A critical re-analysis and a revised meta-analytic test of fear appeal theory. Health Psychol Rev. 2013; 7(sup 1): S8-S31.PubMedCentralCrossRefPubMed Peters GY, Ruiter RAC, Kok G. Threatening communication: A critical re-analysis and a revised meta-analytic test of fear appeal theory. Health Psychol Rev. 2013; 7(sup 1): S8-S31.PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat British American Tobacco (NZ). BAT's Submission to the Ministry of Health Consultation Paper on the Review of the Smoke-free Environments Regulations. Auckland: British American Tobacco (NZ); 2004. British American Tobacco (NZ). BAT's Submission to the Ministry of Health Consultation Paper on the Review of the Smoke-free Environments Regulations. Auckland: British American Tobacco (NZ); 2004.
13.
Zurück zum Zitat Chapman S, Carter SM. “Avoid health warnings on all tobacco products for just as long as we can”: A history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes. Tob Control. 2003; 12: iii13-iii22.PubMedCentralCrossRefPubMed Chapman S, Carter SM. “Avoid health warnings on all tobacco products for just as long as we can”: A history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes. Tob Control. 2003; 12: iii13-iii22.PubMedCentralCrossRefPubMed
14.
Zurück zum Zitat Ruiter RA, Kok G. Saying is not (always) doing: Cigarette warning labels are useless. Eur J Public Health. 2005; 15: 329-330.CrossRef Ruiter RA, Kok G. Saying is not (always) doing: Cigarette warning labels are useless. Eur J Public Health. 2005; 15: 329-330.CrossRef
15.
Zurück zum Zitat Brown SL, Smith Z. The inhibitory effect of a distressing anti-smoking message on risk perceptions in smokers. Psychol Health. 2007; 22: 255-268.CrossRef Brown SL, Smith Z. The inhibitory effect of a distressing anti-smoking message on risk perceptions in smokers. Psychol Health. 2007; 22: 255-268.CrossRef
16.
Zurück zum Zitat Harris PR, Mayle K, Mabbott L, Napper L. Self-affirmation reduces smokers’ defensiveness to graphic on-rack cigarette warning labels. Health Psychol. 2007; 4: 437-446.CrossRef Harris PR, Mayle K, Mabbott L, Napper L. Self-affirmation reduces smokers’ defensiveness to graphic on-rack cigarette warning labels. Health Psychol. 2007; 4: 437-446.CrossRef
18.
Zurück zum Zitat Styles M, Williams B, Humphris G. Is the effectiveness of tobacco image-based labels likely to vary by socio-demographic variables? Findings from an online survey of 19,000 members of the UK Public. Health Educ J. 2012; 72: 351-362. Styles M, Williams B, Humphris G. Is the effectiveness of tobacco image-based labels likely to vary by socio-demographic variables? Findings from an online survey of 19,000 members of the UK Public. Health Educ J. 2012; 72: 351-362.
19.
Zurück zum Zitat Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, eds. The Self-Regulation of Health and Illness Behaviour. London: Routledge; 2003: 42-65. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, eds. The Self-Regulation of Health and Illness Behaviour. London: Routledge; 2003: 42-65.
20.
Zurück zum Zitat Cameron LD. Illness risk representations and motivations to engage in protective behavior: The case of skin cancer risk. Psychol Health. 2008; 23: 91-112.CrossRefPubMed Cameron LD. Illness risk representations and motivations to engage in protective behavior: The case of skin cancer risk. Psychol Health. 2008; 23: 91-112.CrossRefPubMed
21.
Zurück zum Zitat Petrie KJ, Cameron LD, Ellis C, Buick D, Weinman J. Changing illness perceptions following myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002; 64: 580-586.CrossRefPubMed Petrie KJ, Cameron LD, Ellis C, Buick D, Weinman J. Changing illness perceptions following myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002; 64: 580-586.CrossRefPubMed
22.
Zurück zum Zitat Cameron LD, Petrie KJ, Ellis C, Buick D, Weinman J. Trait anxiety and responses to a psychoeducational intervention for promoting adaptive illness perceptions in myocardial infarction patients. Psychol Health. 2005; 1: 1-12.CrossRef Cameron LD, Petrie KJ, Ellis C, Buick D, Weinman J. Trait anxiety and responses to a psychoeducational intervention for promoting adaptive illness perceptions in myocardial infarction patients. Psychol Health. 2005; 1: 1-12.CrossRef
23.
Zurück zum Zitat Phillips LA, Leventhal H, Leventhal E. Physicians’ communication of the common-sense self-regulation model results in greater reported adherence than physicians’ use of interpersonal skills. British J Health Psychol. 2012; 17: 224-257.CrossRef Phillips LA, Leventhal H, Leventhal E. Physicians’ communication of the common-sense self-regulation model results in greater reported adherence than physicians’ use of interpersonal skills. British J Health Psychol. 2012; 17: 224-257.CrossRef
24.
Zurück zum Zitat Lee TJ, Cameron LD, Wünsche B, Stevens C. A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviours. British J Health Psychol. 2011; 16: 72-91.CrossRef Lee TJ, Cameron LD, Wünsche B, Stevens C. A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviours. British J Health Psychol. 2011; 16: 72-91.CrossRef
25.
Zurück zum Zitat Cameron LD, Chan CKY. Designing health communications: Harnessing the power of affect, imagery, and self-regulation. Soc Personal Psychol Compass. 2008; 2: 262-282.CrossRef Cameron LD, Chan CKY. Designing health communications: Harnessing the power of affect, imagery, and self-regulation. Soc Personal Psychol Compass. 2008; 2: 262-282.CrossRef
26.
Zurück zum Zitat Witte K, Allen M. A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Educ Behav. 2000; 27: 608-632.CrossRef Witte K, Allen M. A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Educ Behav. 2000; 27: 608-632.CrossRef
27.
Zurück zum Zitat Emery L, Romer D, Sheerin KM, Jamieson KH, Peters E. Affective and cognitive mediators of the impact of cigarette warning labels. Nicotine Tob Res. 2014; 16: 263-269.PubMedCentralCrossRefPubMed Emery L, Romer D, Sheerin KM, Jamieson KH, Peters E. Affective and cognitive mediators of the impact of cigarette warning labels. Nicotine Tob Res. 2014; 16: 263-269.PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat McCaul KD, Mullens AB, Romanek KM, Erickson SC, Gatheridge BJ. The motivational effects of thinking and worrying about the effects of smoking cigarettes. Cogn Emot. 2007; 21: 1580-1798.CrossRef McCaul KD, Mullens AB, Romanek KM, Erickson SC, Gatheridge BJ. The motivational effects of thinking and worrying about the effects of smoking cigarettes. Cogn Emot. 2007; 21: 1580-1798.CrossRef
30.
Zurück zum Zitat European Union. Directive 2001/37/EC of the European parliament and of the council on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco products. Article 5 Labelling. 2001; 1:1–9. European Union. Directive 2001/37/EC of the European parliament and of the council on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco products. Article 5 Labelling. 2001; 1:1–9.
31.
Zurück zum Zitat Department of Health. Consultation on the Introduction of Picture Warnings on Tobacco Packs: Report on Consultation. London: Department of Health; 2007. Department of Health. Consultation on the Introduction of Picture Warnings on Tobacco Packs: Report on Consultation. London: Department of Health; 2007.
34.
Zurück zum Zitat Cameron LD, Moss-Morris R. Illness-related cognitions and behaviour. In: French D, Vedhara K, Kaptein AA, Weinman JA, eds. Health Psychology. 2nd ed. Oxford: Blackwell; 2010: 84-110. Cameron LD, Moss-Morris R. Illness-related cognitions and behaviour. In: French D, Vedhara K, Kaptein AA, Weinman JA, eds. Health Psychology. 2nd ed. Oxford: Blackwell; 2010: 84-110.
35.
Zurück zum Zitat Chandler D. Semiotics: The Basics. London: Routledge; 2007. Chandler D. Semiotics: The Basics. London: Routledge; 2007.
37.
Zurück zum Zitat SAS Institute Inc. SAS Software Version 9.2. Cary, NC: SAS Institute Inc.; 2012. SAS Institute Inc. SAS Software Version 9.2. Cary, NC: SAS Institute Inc.; 2012.
38.
Zurück zum Zitat Nonnemaker J, Farrelly M, Kamyab K, Busey A, Mann N. Experimental study of graphic cigarette warning labels. Rockville, MD: Center for Tobacco Products, Food and Drug Administration; 2010. Contract No. HHSF-223-2009-10135G. Nonnemaker J, Farrelly M, Kamyab K, Busey A, Mann N. Experimental study of graphic cigarette warning labels. Rockville, MD: Center for Tobacco Products, Food and Drug Administration; 2010. Contract No. HHSF-223-2009-10135G.
39.
Zurück zum Zitat Williams B, Cameron L. Images in health care: Potential and problems. J Health Serv Res Policy. 2009; 14: 251-254.CrossRefPubMed Williams B, Cameron L. Images in health care: Potential and problems. J Health Serv Res Policy. 2009; 14: 251-254.CrossRefPubMed
40.
Zurück zum Zitat Hammond D, Thrasher J, Reid JL. Perceived effectiveness of pictorial health warnings among Mexican youth and adults: A population-level intervention with potential to reduce tobacco-related inequities. Cancer Causes Control. 2012; 23: 57-67.CrossRefPubMed Hammond D, Thrasher J, Reid JL. Perceived effectiveness of pictorial health warnings among Mexican youth and adults: A population-level intervention with potential to reduce tobacco-related inequities. Cancer Causes Control. 2012; 23: 57-67.CrossRefPubMed
41.
Zurück zum Zitat Cameron L, Leventhal H, Leventhal E. Symptom representations and affect as determinants of care seeking in a community-dwelling, adult sample population. Health Psychol. 1993; 12: 171-179.CrossRefPubMed Cameron L, Leventhal H, Leventhal E. Symptom representations and affect as determinants of care seeking in a community-dwelling, adult sample population. Health Psychol. 1993; 12: 171-179.CrossRefPubMed
42.
43.
Zurück zum Zitat Clarke JN, Everest MM. Cancer in the mass print media: Fear, uncertainty and the medical model. Soc Sci Med. 2006; 62: 2591-2600.CrossRefPubMed Clarke JN, Everest MM. Cancer in the mass print media: Fear, uncertainty and the medical model. Soc Sci Med. 2006; 62: 2591-2600.CrossRefPubMed
44.
Zurück zum Zitat Durkin SJ, Biener L, Wakefield MA. Effects of different types of antismoking ads on reducing disparities in smoking cessation among socioeconomic subgroups. Am J Public Health. 2009; 99: 2217-2223.PubMedCentralCrossRefPubMed Durkin SJ, Biener L, Wakefield MA. Effects of different types of antismoking ads on reducing disparities in smoking cessation among socioeconomic subgroups. Am J Public Health. 2009; 99: 2217-2223.PubMedCentralCrossRefPubMed
45.
Zurück zum Zitat Dunlop S, Wakefield M, Kashima Y. ‘Can you feel it?’ Negative emotion, risk, and narrative in health communication. Media Psychol. 2008; 11: 52-75. Dunlop S, Wakefield M, Kashima Y. ‘Can you feel it?’ Negative emotion, risk, and narrative in health communication. Media Psychol. 2008; 11: 52-75.
46.
Zurück zum Zitat Kreuter MW, Green MC, Cappella JN, et al. Narrative communication in cancer prevention and control: A framework to guide research and application. Ann Behav Med. 2007; 33: 221-235.CrossRefPubMed Kreuter MW, Green MC, Cappella JN, et al. Narrative communication in cancer prevention and control: A framework to guide research and application. Ann Behav Med. 2007; 33: 221-235.CrossRefPubMed
47.
Zurück zum Zitat Thrasher JF, Arillo-Santillan E, Villalobos V, et al. Can pictorial warning labels on cigarette papckages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content. Cancer Causes Control. 2012; 23: 69-80.PubMedCentralCrossRefPubMed Thrasher JF, Arillo-Santillan E, Villalobos V, et al. Can pictorial warning labels on cigarette papckages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content. Cancer Causes Control. 2012; 23: 69-80.PubMedCentralCrossRefPubMed
48.
Zurück zum Zitat Wilson N, Peace J, Li J, Edwards R, et al. Distribution of new graphic warning labels: Are tobacco companies following regulations? Tob Induc Dis. 2009; 5: 14.PubMedCentralCrossRefPubMed Wilson N, Peace J, Li J, Edwards R, et al. Distribution of new graphic warning labels: Are tobacco companies following regulations? Tob Induc Dis. 2009; 5: 14.PubMedCentralCrossRefPubMed
49.
Zurück zum Zitat White V, Webster B, Wakefield M. Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviors? Addiction. 2008; 103: 1562-1571.CrossRefPubMed White V, Webster B, Wakefield M. Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviors? Addiction. 2008; 103: 1562-1571.CrossRefPubMed
50.
Zurück zum Zitat Yong H, Borland R, Thrasher JF, et al. Mediational pathways of the impact of cigarette warning labels on quit attempts. Health Psychol. 2014; 11: 1410-1420.CrossRef Yong H, Borland R, Thrasher JF, et al. Mediational pathways of the impact of cigarette warning labels on quit attempts. Health Psychol. 2014; 11: 1410-1420.CrossRef
51.
Zurück zum Zitat Weinstein ND, Slovic P, Gibson G. Accuracy and optimism in smokers’ beliefs about quitting. Nicotine Tob Res. 2004; 6: S375-S380.CrossRefPubMed Weinstein ND, Slovic P, Gibson G. Accuracy and optimism in smokers’ beliefs about quitting. Nicotine Tob Res. 2004; 6: S375-S380.CrossRefPubMed
52.
Zurück zum Zitat Pbert L, Flint AJ, Young MH, Druker S, DiFranza JR. Effects of a pediatric practice-based smoking prevention and cessation intervention for adolescents: A randomized, controlled trial. Pediatrics. 2008; 121: 738-747.CrossRef Pbert L, Flint AJ, Young MH, Druker S, DiFranza JR. Effects of a pediatric practice-based smoking prevention and cessation intervention for adolescents: A randomized, controlled trial. Pediatrics. 2008; 121: 738-747.CrossRef
53.
Zurück zum Zitat Michie S, Richardson M, Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013; 46(1): 81-95.CrossRefPubMed Michie S, Richardson M, Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013; 46(1): 81-95.CrossRefPubMed
55.
Zurück zum Zitat Luciani A, Urma D, Marliere S, Chevrier J. PRESENCE: The sense of believability of inaccessible words. Comput Graph. 2004; 1: 509-517.CrossRef Luciani A, Urma D, Marliere S, Chevrier J. PRESENCE: The sense of believability of inaccessible words. Comput Graph. 2004; 1: 509-517.CrossRef
56.
Zurück zum Zitat Rooke S, Malouff J, Copeland J. Effects of repeated exposure to a graphic smoking warning image. Curr Psychol. 2012; 31: 282-290.CrossRef Rooke S, Malouff J, Copeland J. Effects of repeated exposure to a graphic smoking warning image. Curr Psychol. 2012; 31: 282-290.CrossRef
57.
Zurück zum Zitat Magnan R, Cameron LD. Do young adults perceive that cigarette graphic warnings provide new knowledge about the harms of smoking? Ann Behav Med. 2014. (in press). Magnan R, Cameron LD. Do young adults perceive that cigarette graphic warnings provide new knowledge about the harms of smoking? Ann Behav Med. 2014. (in press).
58.
Zurück zum Zitat Nonnemaker JM, Choiniere CJ, Farrelly MC, Kamyab K, Davis KC. Reactions to graphic health warnings in the United States. Health Educ Res. 2014;Advance Online Publication. Nonnemaker JM, Choiniere CJ, Farrelly MC, Kamyab K, Davis KC. Reactions to graphic health warnings in the United States. Health Educ Res. 2014;Advance Online Publication.
59.
Zurück zum Zitat Borland R. Tobacco health warnings and smoking-related cognitions and behaviours. Addiction. 1997; 92: 1427-1435.CrossRefPubMed Borland R. Tobacco health warnings and smoking-related cognitions and behaviours. Addiction. 1997; 92: 1427-1435.CrossRefPubMed
Metadaten
Titel
Which Images and Features in Graphic Cigarette Warnings Predict Their Perceived Effectiveness? Findings from an Online Survey of Residents in the UK
verfasst von
Linda D. Cameron, Ph.D
Brian Williams, Ph.D
Publikationsdatum
01.10.2015
Verlag
Springer US
Erschienen in
Annals of Behavioral Medicine / Ausgabe 5/2015
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-015-9693-4

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