Cigarette Package Graphic Warning Labels: The Role of Affect and Mechanisms of Change
Open AccessWarning labels on cigarette packaging are a recommended part of comprehensive tobacco control interventions. Although graphic warnings motivate cessation and increase quit attempts, legal challenges to the Food and Drug Administration’s regulations questioned the evidence on how graphic warnings produce behavior change. Research is needed to understand how graphic warnings work in vulnerable groups such as young adults to inform strategies for improving their efficacy. This dissertation studies if and how graphic labels motivate cessation in young adult smokers with a focus on affective processes. This research is important because it advances understanding of the mechanisms by which graphic warning labels work in young smokers, enabling researchers and policy makers to develop effective warning labels in the future. The goals of this dissertation are to: 1) examine affect-based mechanisms through which graphic warnings motivate young smokers to quit and 2) examine if individual dispositional factors moderate these effects. Study data were drawn from a prospective randomized trial of graphic cigarette warning labels in a sample of young adult smokers ages 18-30 from the Washington, DC area. Participants completed a baseline assessment and were assigned to experimental conditions with exposure to either cigarette packs with graphic warnings or current U.S. text-only warnings. Exposure occurred for 4 weeks with outcomes measured post-intervention, 1 month, and 3 months later. This study uniquely addresses gaps in the literature by prospectively measuring emotional responses to graphic warnings (e.g. fear, anger), deliberative and affective risk perceptions, and risk-orientated dispositional moderators. Paper 1 examines the prospective effects of graphic warnings on emotional responses to the warnings, risk perceptions, and motivation to quit smoking. Paper 2 investigates mediators of the prospective effect of graphic warning labels on motivation to quit smoking. Paper 3 examines risk oriented moderating factors including the behavioral inhibition and behavioral activation systems (BIS/BAS) on the prospective outcomes after exposure to a graphic warning label in a sample of young adults.The results of the study demonstrate that graphic warnings can indeed offset the appeal of marketing by way of the cigarette package among young adults both immediately after 4 weeks of exposure and longitudinally over 3 months. The results also illuminate nuances with regard to mediating factors for prospective change in motivation to quit smoking among young adults after exposure to a graphic warning label. Findings demonstrate that leveraging emotion (e.g., fear) and other affective processes (e.g., affective risk perceptions) may be justifiable and appropriate for a population that is vulnerable to tobacco marketing. Notably, graphic warnings functioned more universally than expected as it relates to emotion. Although those with higher levels of BAS Drive were more likely to increase their risk perceptions, specifically affective risk perceptions, after exposure to a graphic warning label.Overall, this work complements and reinforces calls for further understanding of risk perceptions and affective processes in relation to exposure to a graphic warning label among young adults. This work specifically addresses aspects of the legal challenges focused on affective processes in the initial rule and could potentially inform impending regulations proposed by FDA.
- All rights reserved
Notice to Authors
If you are the author of this work and you have any questions about the information on this page, please use the Contact form to get in touch with us.