Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
PLoS One. 2013 Aug 15;8(8):e72117. doi: 10.1371/journal.pone.0072117. eCollection 2013.
The use of pictorial warning labels on cigarette packages is one of the provisions included in the first ever global health treaty by the World Health Organization against the tobacco epidemic. There is substantial evidence demonstrating the effectiveness of graphic health warning labels on intention to quit, thoughts about health risks and engaging in cessation behaviors. However, studies that address the implicit emotional drives evoked by such warnings are still underexplored. Here, we provide experimental data for the use of pictorial health warnings as a reliable strategy for tobacco control.
Experiment 1 pre-tested nineteen prototypes of pictorial warnings to screen for their emotional impact. Participants (n = 338) were young adults balanced in gender, smoking status and education. Experiment 2 (n = 63) tested pictorial warnings (ten) that were stamped on packs. We employed an innovative set-up to investigate the impact of the warnings on the ordinary attitude of packs' manipulation, and quantified judgments of warnings' emotional strength and efficacy against smoking.
Experiment 1 revealed that women judged the warning prototypes as more aversive than men, and smokers judged them more aversive than non-smokers. Participants with lower education judged the prototypes more aversive than participants with higher education. Experiment 2 showed that stamped warnings antagonized the appeal of the brands by imposing a cost to manipulate the cigarette packs, especially for smokers. Additionally, participants' judgments revealed that the more aversive a warning, the more it is perceived as effective against smoking.
Health warning labels are one of the key components of the integrated approach to control the global tobacco epidemic. The evidence presented in this study adds to the understanding of how implicit responses to pictorial warnings may contribute to behavioral change.
在世界卫生组织（世卫组织）有史以来第一份针对烟草流行的全球卫生条约中，使用香烟包装上的图形警示标签是其中一项规定。有大量证据表明，图形健康警示标签对戒烟意愿、对健康风险的思考和戒烟行为有影响。然而，对于这些警示所引发的隐性情绪驱动因素的研究仍不够充分。在这里，我们提供了使用图形健康警示作为烟草控制可靠策略的实验数据。
实验 1 预先测试了 19 个图形警示原型，以筛选其情绪影响。参与者（n=338）在性别、吸烟状况和教育程度方面均衡分布。实验 2（n=63）测试了印在烟盒上的 10 个图形警示。我们采用了一种创新的设置来研究警示对普通包装操作的态度的影响，并量化了对警示的情绪强度和戒烟效果的判断。
实验 1 表明，女性比男性更认为警示原型令人厌恶，吸烟者比非吸烟者更认为它们令人厌恶。受教育程度较低的参与者比受教育程度较高的参与者更认为原型令人厌恶。实验 2 表明，盖章警示会通过对香烟包装操作施加成本来干扰品牌的吸引力，尤其是对吸烟者而言。此外，参与者的判断表明，警示越令人厌恶，就越被认为对戒烟有效。
健康警示标签是控制全球烟草流行的综合方法的关键组成部分之一。本研究提供的证据增加了对隐性对图形警示的反应如何有助于行为改变的理解。
