Graphic Pictorial Warning Labels on Cigarettes Most Effective

Pictorial images more effective than text-only for adult smokers with low health literacy

WEDNESDAY, Nov. 14 (HealthDay News) -- Pictorial health warning labels on cigarette packages are effective in reaching adult smokers with low health literacy, with graphic images having the most pronounced effect on all adult smokers, according to a study published online Nov. 13 in the American Journal of Preventive Medicine.

James F. Thrasher, Ph.D., of the Arnold School of Public Health at the University of South Carolina in Columbia, and colleagues evaluated pictorial health warning labels in a study involving 207 adult smokers who were exposed to text-only labels and 774 smokers who were exposed to pictorial labels. Health warning labels were varied by health topic and image type.

The researchers found that, among participants with low health literacy, pictorial warnings on cigarette labels were significantly more personally relevant and effective, and more credible compared with text-only warning labels. Significantly higher ratings of credibility, personal relevance, and effectiveness were noted for pictorial health warnings with graphic imagery, compared with imagery of human suffering and symbolic imagery. Across racial groups and levels of health literacy, labels with graphic images produced minimal differences, while other imagery produced greater differences between groups.

"This study provides further evidence of the greater effectiveness of pictorial health warning labels compared to text-only labels, while suggesting that graphic imagery is likely to have the greatest population impact," the authors write. "Future research should focus on finding the best content, design, and rotation strategies to maximize and sustain the influence of this cost-effective intervention."

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