Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA;
Nicotine Tob Res. 2014 Mar;16(3):263-9. doi: 10.1093/ntr/ntt124. Epub 2013 Aug 14.
Research conducted by the U.S. Food and Drug Administration to select graphic warning labels for cigarette packs has been challenged as inadequate for demonstrating effects on smokers' beliefs about smoking. The present study tested the prediction that warnings alter risk perceptions and thoughts of quitting indirectly through a cognitive pathway (warning believability) and an affective pathway (worry about health), both of which are important for encouraging smokers to consider quitting.
Using a national Internet panel, individuals who smoke were randomly assigned to view 1 of 3 types of warning labels: basic text only, graphic image with basic text, and graphic image with both basic and additional text elaborating on the reason for the health risk. Analyses were conducted to determine whether cognitive and affective reactions mediated effects on smoking-related outcomes.
Images influenced perceived risk, immediate desire to smoke, and feelings toward quitting indirectly through affective reactions; elaborated text influenced these outcomes through cognitive believability, with little evidence of direct effects. Believability also enhanced positive feelings toward quitting among smokers who were less worried about health risks due to smoking.
The findings indicate that (a) many effects of warnings on smokers' beliefs are mediated rather than direct, (b) both cognitive and affective responses are important mediators, and (c) elaborated text can help to increase effects of images through a cognitive pathway. Warning labels should be designed to maximize effects on these mediators in order to influence smoking outcomes.
美国食品和药物管理局进行的研究旨在为香烟包装选择图形警示标签，但该研究因未能充分证明对吸烟者吸烟观念的影响而受到质疑。本研究通过认知途径（警示可信度）和情感途径（对健康的担忧）测试了这样一种预测，即警告通过改变风险认知和戒烟想法间接影响吸烟者，这两种途径对鼓励吸烟者考虑戒烟都很重要。
利用全国互联网小组，随机分配吸烟的个体观看 3 种类型的警告标签之一：仅基本文字、带有基本文字的图形图像、以及带有基本文字和额外文字详细说明健康风险原因的图形图像。进行分析以确定认知和情感反应是否对与吸烟相关的结果产生影响。
图像通过情感反应间接影响感知风险、立即吸烟的欲望和戒烟的感觉；详细的文字通过认知可信度影响这些结果，几乎没有直接影响的证据。对于因吸烟而对健康风险不太担心的吸烟者，可信度也增强了他们对戒烟的积极感受。
研究结果表明：（a）警告对吸烟者观念的许多影响是通过中介而不是直接产生的；（b）认知和情感反应都是重要的中介因素；（c）详细的文字可以通过认知途径帮助增加图像的效果。为了影响吸烟结果，警告标签的设计应旨在最大限度地提高这些中介因素的效果。
