Effects of Large Cigarette Warning Labels on Smokers' Expected Longevity.

OBJECTIVES

Smokers underestimate the health risks of smoking and overestimate their expected longevity. Warning labels on cigarette packs might help correct these misperceptions.

METHODS

We carried out an online study with 1200 smokers (18-62 years old), randomized to 3 conditions: text warning labels, pictorial warning labels, and a control group (water bottle labels). Warning labels were based on those proposed by the US Food and Drug Administration in 2010. Participants in each condition saw 4 randomly selected labels and rated their expected longevity and chances of surviving to age 75 after exposure. Analyses of covariance controlled for cigarettes per day and self-rated health.

RESULTS

Compared to control, both text and pictorial warnings reduced participants' expected longevity (text: mean = 76.8 years, pictorial: 77.3, control 79.4) and their estimated chances of living to 75 (text: 62.0%, pictorial: 63.0%, control 66.5%). The contrast between text and pictorial labels combined and control showed significantly reduced expected longevity (p = .011) and chances of living to 75 (p = .004). Differences between text and pictorial conditions were not statistically significant.

CONCLUSIONS

Large text or pictorial warnings on cigarette packs might help smokers develop a more accurate understanding of the effects of smoking on their longevity.