More than 40 countries around the world force cigarette companies to print graphic images of things like decaying teeth, open-heart surgeries and cancer patients on their packs, in an effort to discourage smoking by directly linking cigarettes with their most gruesome effects. The United States, however, is not one of these countries: The U.S. Food and Drug Administration unveiled graphic designs in November 2010, but repeated lawsuits by the tobacco industry have delayed implementation of the new warnings. If and when the labels do hit, the images could go a long way towards continuing the decline in smoking rates across the country. That’s because, as new research demonstrates, seeing these images every time a person reaches for a pack is a more effective deterrent than a text-only warning. The research also indicates that the graphic warnings are especially powerful in discouraging low-health literacy populations from smoking—the one group in which smoking rates have remained stubbornly high over the past few decades.
The study, published yesterday in the American Journal of Preventive Medicine [PDF], was conducted by James Thrasher of the University of South Carolina and colleagues. A control group of 207 smokers saw text-only warning labels, while 774 smokers evaluated nine different graphic labels, both images proposed by the FDA and a selection of others currently used in foreign countries. The smokers were asked to judge each label on a scale of one to ten for credibility, relevance and effectiveness. The results were unequivocal: The text-only warnings’ average ratings were mostly in the fives and sixes, while simpler text messages combined with striking graphics scored in the sevens and eights across the board.