Graphic Image Tobacco Warnings

Tobacco labels with graphic images of negative health outcomes detered diverse groups

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) There’s nothing like a nasty picture of a diseased lung to make smoking seem gross. Regardless of race, ethnicity, wealth, poverty or education level, pictures get the message across.

A recent study compared graphic image warning labels on cigarette packaging to the current text-only version. The diverse groups which participated in the study all found the graphic images to be more of a deterrent to smoking than text-only warnings.

“Given the disproportionate burden of tobacco-related disease faced by the poor and minorities, mandating strong pictorial warnings is an effective and efficient way to communicate the risk of tobacco use,” said co-author, Donna Vallone, PhD.

"For help, call 1-800-QUIT-NOW."

Jennifer Cantrell, DrPH, MPA, Assistant Director, and Donna Vallone, PhD, Senior Vice President for Research and Evaluation at the Legacy Foundation in Washington, DC, worked with scientists from the Harvard School of Public Health for the investigation.

Dr. Vallone said, “There is a nagging question whether benefits from social policies accrue (build up) equally across ethnic and racial minority and social class groups. The evidence from this paper shows that this new policy of mandated Graphic Health Warnings would benefit all groups.”

In 2009, the US Family Smoking Prevention and Tobacco Control Act passed, which requires cigarette packages to replace the text-only health warning with nine different warnings that incorporate a graphic image. The nine graphic images with new accompanying text were designed by the US Food and Drug Administration (FDA).

Graphic image warnings have been successful in deterring people from smoking in several countries around the world.

For this study, 3,371 adults aged 18 and over were recruited to participate in a web-based experiment where they either looked at text-only warnings or one of the new graphic image warning labels.

Researchers surveyed each participant’s smoking habits, attitudes, desire to quit and any previous quit attempts.

Demographics of those who expressed an intention to quit after seeing the warning labels were 29 percent white, 48 percent black and 44 percent Hispanic; 39 percent lower-income, 38 percent middle-income and 42 percent upper-income; 36 percent high school educated or less, 38 percent with come college and 47 percent with a college degree or higher.

Dr. Vallone said, “Tobacco is a social justice issue. Given that low income and minority communities have higher smoking rates and suffer disproportionately from tobacco’s health consequences, studies like this show us that graphic warning labels can help us reach these subgroups in a more effective way, ultimately saving more lives.”

Graphic image health warning labels on cigarette packaging are a deterrent to smoking across racial, ethnic, wealth and poverty and education lines.

This study was published in January in PLOS ONE.

Legacy provided funding for this study. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
January 16, 2013
Last Updated:
January 20, 2013