Picture Warnings More Effective for Quitting Smoking

Study Examines Picture Warnings on Cigarette Packs

Background: Scary pictures on cigarettes packs draw attention and increase quit intentions, but their effect on smoking behavior is uncertain. Study: Investigators at the University of North Caroline at Chapel Hill studied adult cigarette smokers from the general population in California and North Carolina from September 2014 through August 2015. 88% of the 2,149 participants completed the study. There were two groups: Group A received their cigarette packs for 4 weeks with word-only warnings on the side of the packs; Group B received their cigarette packs for 4 weeks with picture warnings on the top half of the front and back of the packs. The article was published on line June 06, 2016, in JAMA Intern Med. doi:10.1001/jamainternmed.2016.2621
Warnings used in the study

Warnings used in the study

Results: Participants included 1,060 women, 1,039 men, and 34 transgender people. Average age was 40 years. A total of 1,091 completed the study. Smokers were 29% more likely to at least try quitting if they received cigarette packs with images of rotting teeth and people dying of cancer. Picture warnings also increased skipping a cigarette, intentions to quit, negative emotional reactions to the pictures, and conversations about quitting.
Noel T. Brewer, Ph.D., Associate Professor at the University of North Carolina Gillings School of Global Public Health

Noel T. Brewer, Ph.D., Associate Professor at the University of North Carolina Gillings School of Global Public Health

Conclusion: Noel Brewer, Ph.D. and colleagues concluded that picture warnings were more effective than word warnings to increase intentions to quit smoking over 4 weeks. The researchers suggested that implementing picture warnings on cigarette packs in the United States would discourage smoking.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.