Cognitive and emotional responses to pictorial warning labels and their association with quitting measures after continued exposure

• Published in: Addictive behaviors Vol. 124; p. 107121
• Main Authors: Sidhu, Anupreet K., Johnson, Andrea C., Souprountchouk, Valentina, Wackowski, Olivia, Strasser, Andrew A., Mercincavage, Melissa
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2022
• Subjects: Cigarette smoking; Cognition; Cognitive responses; Emotions; Experimental; Humans; Product Labeling; Smoking Cessation; Smoking Prevention; Tobacco Products; Tobacco regulatory science; Warning labels; Cigarette smoking; Cognitive responses; Tobacco regulatory science; Experimental; Warning labels
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2021.107121

•Adult smokers used cigarettes with pictorial warning labels (PWLs) for 10 days.•End-of-study cognitive-emotional evaluations of the PWLs were generally favorable.•Quitting attitudes, positive beliefs, and intentions also increased following PWL use.•These increases were positively associated with cognitive-emotional evaluations.•Cognitive and emotional appraisals may assist understanding PWL effectiveness. Previous research has highlighted the role of cognitive and affective mediators in facilitating the effectiveness of pictorial warning labels (PWLs). This study examines smokers’ responses towards PWLs after 10 days of use and their associations with changes in quitting attitudes, beliefs, and intentions during this period. Non-treatment-seeking, daily smokers completed a randomized, parallel design trial. Participants were randomized to either a PWL or control (i.e., text only or no warning label) group and received their preferred brand cigarettes affixed with their assigned label for 10 days. We assessed quitting attitudes, intentions, and beliefs at the onset and end of the study. At study end, smokers rated their PWL on a 5-point scale for 8 cognitive and emotional attributes: memorable, understandable, shocking, informative, offensive, boring, relevant, and interesting. Mean ratings of the PWLs were high for memorable, understandable, informative, relevant, and interesting (range = 3.4 to 4.0), moderate for shocking (2.9), and low for offensive (1.7), and boring (1.5). Among the PWLs, quitting-related attitudes, positive beliefs, and intentions increased over the study period (p < .001) and these changes were positively associated with most attributes except offensive and boring (p < .05). For the text-only label group, attitudes and intentions increased significantly but these changes were not associated with any attributes. Smokers generally have favorable evaluations of PWLs following repeated exposures. Further, these evaluations are associated with increased quitting attitudes and intentions, which may facilitate cessation attempts over longer periods of exposure.