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The purpose of this paper is to test the effects of cigarette warning labels that used text-only or text-plus relevant graphics. The labels were framed in terms of either the negative consequences of smoking (loss frame) or the benefits of not smoking (gain frame). The role of smoking identity – the centrality of being a smoker to one's self-concept – in the effects of the warning labels was also examined.

An experiment was conducted online with 132 college smokers. Participants were randomly assigned to viewing either graphic or text-only labels that were either gain or loss framed. Smoking identity was measure prior to viewing. Message evaluations and smoking intentions were assessed after exposure as dependent measures.

A consistent interaction between graphics and framing emerged across a number of dependent measures. For graphic warning labels, the loss frame was more advantageous than the gain frame. For text-only warning labels, framing did not make any difference. This two-way interaction was further qualified by smoking identity for some, but not all, dependent measures.

Findings from this study support the use of graphic warning labels that focus on the negative health consequences of smoking.

Experimental research on graphic cigarette warning labels is limited and rarely considers the roles of framing and smoking identity. This study offered an initial test of the complex interaction among these message and audience variables as they jointly influence message reception and smoking intentions.

The cone of uncertainty (COU) warning graphic has created confusion for people trying to make evacuation and safety decisions. The purpose of this research was to create several alternative tropical cyclone graphics and present them to the public and college students via face‐to‐face surveys and polling.

Surveys depicting hypothetical landfall scenarios were administered in Pensacola and Jacksonville, FL. Respondents ranked five graphics in order of preference, and were encouraged to discuss their rankings. Following this initial field research, the most popular graphic of these five was compared to a graphic resembling the one used by The Australian Bureau of Meteorology. Comments were recorded for respondents favoring or disliking the Australian graphic in two separate analyses. A final graphic emphasizing post‐landfall hazards was also created as a suggestion for future research and evaluated directly against the most popular graphics from field research.

A graphic called the color‐probability‐cone was the most popular graphic in field research. There were subtle differences in graphic preference resulting from age and gender influences, with only one significant result. Comments from subsequent analyses reveal that the Australian graphic causes mixed reactions. A final analysis with a larger sample of college students revealed that the color‐probability‐cone was the most popular choice; however, comments reveal that many respondents who had used hurricane graphics before liked the specificity presented by the Australian graphic and the hazards graphic.

This research represents a possible initial step in the process of establishing a tropical cyclone warning graphic that is informative, visually appealing, and effective.

Graphic health warnings (GHWs) on tobacco product packaging constitute one component within a multifaceted set of tobacco control measures. This study aims to understand whether consumers’ attention to GHWs will be associated with recall and quit intentions, using Australia as the case for this study.

Using the 14 GHWs currently in market as visual stimuli, non-probability intercept sampling was conducted, eye tracking and post-survey datasets were collected from a total of 419 respondents across three Australian cities.

Results show the front graphic image areas draw initial attention and the Quitline message area holds the longest attention duration. Attention is highly correlated with better quality of recall of health warning information, emotive responses, believability ratings among smokers and smokers’ perception of health risks and quit intentions. Associations are also noted with perceived health risk and quitting intentions.

To the best of the authors’ knowledge, this is the first study that has objectively tested the effectiveness of in-market tobacco GHWs in Australia and highlights eye tracking as a valid measurement approach that can enhance and drive new insights to evaluate consumer behaviour towards visual stimuli. This study extends new knowledge around the physiological relationships between viewing behaviours, health vulnerability perceptions and intentions to quit smoking, which has theoretical implications for the extended parallel process model which underpins this research.

Purpose: The public health burden caused by tobacco is heavy among first-generation Chinese immigrant men whose home country has significantly higher smoking rates than the United States. The current study is part of a larger effort to pilot an mHealth tobacco cessation intervention using MMS (graphic) mobile phone technologies to target East Asian immigrant populations. Grounded in the Extended Parallel Process Model (EPPM), our specific aims were to determine what message themes, level of graphic intensity, and types of efficacy information are most appropriate and useful for mHealth interventions targeting this population.

Methodology/Approach: A qualitative study utilizing a series of focus groups (k = 5) was conducted with male adult smokers who were born in China and currently reside in the United States. The primary aim of the focus groups was to solicit reactions to a series of preliminary messages developed by the research team. A secondary aim was to gauge receptivity to the use of MMS as a vehicle for smoking cessation intervention. Participants (n = 32) were recruited from local Chinese communities in a large Mid-Atlantic metropolitan area.

Findings: Opinions about different message strategies were mixed. However, participants tended to rate messages more positively when they focused on the impact of smoking on family and loved ones, particularly children. Messages with fear-arousing images were also perceived to be effective at low frequency of exposure, but there were concerns that they may backfire at high exposure. Awareness of and interest in Quitline were low, and concrete quitting tips were perceived as more effective. Participants reported a preference for receiving messages a few times a week, and an MMS message platform was generally preferred to WeChat (a Chinese social media platform).

Implications: Our results suggest that graphic MMS messaging holds promise as an effective intervention method for this population and that EPPM is an appropriate framework to develop, test, and analyze mHealth intervention messages. While messages that focused primarily on impact on children, health, and specific quitting tips were generally found to be more effective, a mix of different types of messages that address a wide range of issues may be most appropriate for this population.

Originality/Value: This study is the first to explore the utility of graphic text messaging as an intervention method to promote smoking cessation among male Chinese immigrants. Findings from the study provide important insights for future intervention work targeting this underserved population.

The purpose of this study is to examine the effects of self-affirmation on African American smokers' intentions to quit smoking sooner and desire to stop smoking altogether in response to viewing graphic cigarette warning labels. It also tested the mediating role of perceived susceptibility and self-efficacy in explaining the impact of self-affirmation.

African American smokers (N = 158) were recruited to participate in a controlled experiment. Participants first completed a short questionnaire about their demographic background and smoking-related attitudes and behavior. They were then randomly assigned to engage in either a self-affirmation task or a control task and viewed two graphic cigarette warning labels subsequently. Participants then responded to a questionnaire about their perceived susceptibility to smoking-related diseases, perceived self-efficacy to quit smoking, intentions to quit smoking and desire to stop smoking altogether.

Results showed that engaging in self-affirmation prior to exposure to graphic cigarette warning labels increased African American smokers' perceived susceptibility to smoking-related diseases, but decreased their perceived self-efficacy to quit smoking. Furthermore, self-affirmation indirectly enhanced smokers' intentions to quit smoking sooner and desire to stop smoking altogether through increased perceived susceptibility. It also had an unexpected negative indirect effect on intentions to quit smoking sooner through decreased self-efficacy.

This study is one of the few studies that investigates the effect of self-affirmation on African American smokers' responses toward graphic cigarette warning labels.

The placement of warning labels on alcoholic beverages is a policy area with renewed interest, yet a strong evidence base regarding the efficacy of text-based or pictorial warning labels has still to emerge. Increased interest by policymakers has spurred research into potential alcohol warning label designs and messages. The purpose of this article is to draw together recearch in the alcohol warnings literature.

The current study seeks to review research that has sought to examine the effectiveness of alcohol warning labels. Searches for English-language articles (since 2000) using the terms “alcohol” and “warning label*” were conducted in 2015 across four databases (Web of Science, PubMed, PsycInfo and Cochrane). Articles were included if they empirically assessed the effectiveness and/or design of alcohol warning labels. Only studies that addressed the targeted individual consumer (consistent with downstream social marketing) were included. A narrative analysis approach was used for the 15 articles identified.

Findings are reported on five themes covering the design of the warning, starting with the use of imagery or recommendations, followed by a focus on the warning messages and whether they are specific, use signal words and are based on qualitative or quantitative information.

Overall, there was little consistency in approach and measures, with very limited research having explored the potential of pictorial warning labels. Numerous research gaps are identified; thus, much more research is needed in this area. The evidence base is weak and caution is needed by policymakers regarding the introduction and implementation of alcohol warning labels. Limitations are discussed.

The review provides a timely up-to-date evaluation of the alcohol warning labels literature that has seen a recent resurgence but has not been critically reviewed.

The tobacco industry consistently opposes measures that would limit their marketing, but provides little empirical evidence to support its position. This paper aims to test claims that pictorial health warnings on tobacco products would be no more effective than text‐only warnings.

Three studies used face‐to‐face interviews with smokers and non‐smokers to compare pictorial and text‐only warnings. Two studies used semantic differential scales to estimate cognitive and affective responses to pictorial and text‐only warnings, and the Juster Scale to provide behavioural estimates. The final study used best worst scaling to compare paired pictorial and text‐only warnings.

Images featuring medical and social images elicited stronger affective, cognitive and behavioural responses than a control, text‐only message. Comparisons of refreshed text and pictorial warnings found the latter elicited stronger reactions while the former produced similar results to the control. Updating text warnings did not render these more effective; however, adding an image to an existing text warning made this more effective than the control.

Arguments advanced by the tobacco industry need empirical analysis to assess their validity.

This study provides evidence that pictorial health warnings are more effective than text warnings and suggests that refreshing the text used in warning labels, the alternative promoted by the tobacco industry, would be less effective than introducing pictorial warnings.

This is the first comparison of pictorial and refreshed text warnings; the findings challenge the tobacco industry's position on tobacco warning labels and contradict arguments used to oppose the introduction of pictorial warning labels.

The purpose of this paper is to find out whether the plain packaging format in cigarette labeling is worth adopting or not.

A lab experiment with a 2 (existing vs plain packaging format) × 2 (familiar vs unfamiliar brand) factorial design was conducted with Chinese subjects in Macau.

The plain packaging format in cigarette labeling reduces both smoking intent and brand likability in familiar brand condition but not unfamiliar brand condition.

When many governments are currently deliberating about whether to follow the plain packaging initiative, this study constitutes a timely investigation of the effects of it on smoking intent and brand likability among Chinese young non-smokers. The positive effect of the plain packaging in familiar brand condition provides the justification of adopting it by the governments.

Studies of plain packaging have not been taking brand familiarity into consideration (the only exceptional study used the top three familiar brands and thus failed to examine the familiarity effect) but the study focussed on it. In the data analysis, if brand familiarity is not considered, wrong conclusion will be drawn. Therefore, by having brand familiarity as moderator, the authors are able to correctly conclude that plain packaging format is worth adopting.

This study aimed to provide user-centered evidence for health professionals to make optimal use of images for the effective dissemination of health information on Facebook (FB).

Using an eye-tracking experiment and a survey method, this study examined 42 participants' reading patterns as well as recall and recognition outcomes with 36 FB health information posts having various FB post features.

The findings demonstrated that FB posts with text-embedded images received more attention and resulted in the highest recall and recognition. Meanwhile, compared to text-embedded images, visual only images yielded less effective recall of information, but they caught the viewers' attention; graphics tended to attract more attention than photos. For effective communication, the text features in FB posts should align with the formats of the images.

The findings of this study provide practical implications for health information disseminators by suggesting that text-embedded images should be used for effective health communication.

This study provided evidence of users' different viewing patterns for FB health information posts and the relationship between FB post types and recall and recognition outcomes.

The U.S. 2009 Tobacco Control Act opened the door for new antismoking policies by giving the Food and Drug Administration broad regulatory authority over the tobacco industry. We develop a behavioral welfare economics approach to conduct cost-benefit analysis of FDA tobacco regulations. We use a simple two-period model to develop expressions for the impact of tobacco control policies on social welfare. Our model includes: nudge and paternalistic regulations; an excise tax on cigarettes; internalities created by period 1 versus period 2 consumption; and externalities from cigarette consumption. Our analytical expressions show that in the presence of uncorrected internalities and externalities, a nudge or a tax to reduce cigarette consumption improves social welfare. In sharp contrast, a paternalistic regulation might either improve or worsen social welfare. Another important result is that the social welfare gains from new policies do not only depend on the size of the internalities and externalities, but also depend on the extent to which current policies already correct the problems. We link our analytical expressions to the graphical approach used in most previous studies and discuss the information needed to complete cost-benefit analysis of tobacco regulations. We use our model as a framework to reexamine the evidence base for strong conclusions about the size of the internalities, which is the key information needed.