TCORS study shows effectiveness of testimonial warning labels on tobacco products

December 12, 2016

Cigarette smoking is the leading cause of preventable disease and death in the United States. Cigarette packaging has required textual warning labels about the health risks of smoking since 1966. Yet, 15 percent of U.S. adults -- 36.5 million Americans -- currently smoke cigarettes. How can warning labels be improved to encourage smokers to quit?

A new study by researchers at the Penn Tobacco Center of Regulatory Science (TCORS) at the Annenberg School for Communication found that warning labels featuring photos of real smokers who were harmed by their habit are more effective in getting smokers to quit than the text-only labels currently in use.

At least 77 nations around the world use images as a part of their cigarette warning labels. The United States does not. In 2011, the U.S. Food and Drug Administration (FDA) was poised to roll out a series of pictorial warning labels for use on tobacco products as mandated by the Family Smoking Prevention and Tobacco Control Act (FSPTCA).

However, a legal challenge by the tobacco industry led to these labels being rejected in large part because they were emotional rather than factual. These images showed things like fictional photographs of smokers and simulations of diseased body parts. In response, the FDA withdrew their original labels and began a research campaign to rethink and redesign the labels.

In an effort to support this research, this study, "Potential Effectiveness of Pictorial Warning Labels That Feature the Images and Personal Details of Real People," which will be published in Nicotine & Tobacco Research, tested images that graphically showed real people who had been harmed by smoking -- an appeal that is both factual and emotional.

"Our aim in this study was to find out how smokers respond to cigarette pack warning labels that use photographs of real people whose health has been affected by their own, or by someone else's, smoking," says the lead author Emily Brennan, Ph.D., David Hill Research Fellow at the Cancer Council Victoria in Australia.

In the study, adult smokers viewed several labels from one of three categories: labels that showed a photograph of a real person who had been harmed by smoking, some of which were accompanied by a short text description of the person; the FDA's previous image-based warning labels; or the text-only warning labels currently in use in the United States.

Participants were then asked to report their initial response to the labels and their intentions to quit smoking. Five weeks later, the researchers followed up to see if the smokers had made any attempts to quit, and if so, how successful they had been.

The researchers found that warning labels containing images consistently outperformed text-only labels.

Among the smokers who viewed the text-only labels, 7.4% of smokers attempted to quit in the subsequent five weeks. Those who viewed the testimonial photos from real smokers, however, had a quit attempt rate of 15.4% -- roughly double -- and were four times as likely to have been successful.

There was no additional advantage of supplementing the testimonial photos with a caption - for example, "Terrie: Died from cancer at age 53."

"There's a stickiness to the testimonial photos - the suffering of real people in real contexts - and they increased the likelihood that people would attempt to quit and stay quit," says senior author Joseph N. Cappella, Ph.D., Gerard R. Miller Professor of Communication at the Annenberg School, suggesting that people are more engaged with facts when those facts are imbued with the emotions of real life.

In addition, the study also showed that these new testimonial images were equally as effective as the FDA's previous photo-based labels.

The research team hopes that the data from this study, along with findings from similar studies (for example, the evaluation of the Centers for Disease Control and Prevention's Tips From Former Smokers campaign), will lead to the adoption of more effective warning labels.

"The use of testimonial images," they write in the study, "may help to minimize how vulnerable the next iteration of warning labels in the United States are to legal challenges based on the factual nature of the messages."
-end-
In addition to Brennan and Cappella, the research team included Erin Maloney, Ph.D., TCORS Research Director at the Annenberg School, and Yotam Ophir, a doctoral candidate at the Annenberg School. The study was supported by the National Cancer Institute of the National Institutes of Health and the FDA's Center for Tobacco Products (P50CA179546). The views presented are those of the authors alone.

University of Pennsylvania

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.