Message Received? The Relationship between Graphic Warning Labels, Message Framing, and Psychological Responses among Smokers

Introduction: This study was designed to evaluate the effects of graphic components and message content on daily smokers’ responses to cigarette pack warning labels. It was hypothesized that graphic warning labels (GWLs) would produce increases in state psychological reactance, that loss-framed messages would generate increases in risk perception and psychological reactance, and that GWLs and gain-framed messages would interact to generate increases in motivation to quit smoking when compared to the GWL/loss-framed condition. It was also hypothesized that trait reactance, smoking behavior, and baseline motivation to quit smoking would moderate effects of the warning label exposures. Method: In a within-subjects design, sixty-two smokers completed four counter-balanced experimental tasks during which pictorial stimuli containing four possible combinations of warning labels and message frames were displayed (GWL/gain-framed, GWL/loss-framed, text-only/gain-framed, text-only/loss-framed). Participants answered self-report measures of reactance, cigarette cravings, motivation to quit smoking, and risk perceptions at baseline and after each experimental task. Results: No primary hypotheses were supported (all p’s \u3e .05). However, hypothesized moderations did emerge, as did other several unexpected main effects. More specifically, exposure to GWLs suppressed cigarette cravings and enhanced motivation to quit smoking. Gain-framed messages suppressed state reactance among heavier, more frequent smokers, while loss-framed messages suppressed state reactance among smokers with higher motivation to quit. Gender, age, and race/ethnicity also moderated main effects of label type and label content. Discussion: These results suggest that cravings and state reactance are important constructs to consider when analyzing the impact of GWLs on smoking cessation. They also support the idea that targeting specific sub-populations of smokers with GWLs may increase the efficacy and impact of this tobacco control measure