Conversations About Pictorial Cigarette Pack Warnings: Theoretical Mechanisms of Influence

• In Event: HIGH-DENSITY: Tobacco Warning Label Mechanisms and Effects

Abstract

Background: Little research has examined how and when conversations about pictorial warnings motivate behavior. We sought to establish whether and how smokers’ conversations explain the effect of pictorial warnings on quit attempts.
Methods: US adult smokers (n=2,149) participated in a controlled trial that randomly assigned them to have cigarette packs labeled with pictorial or text-only warnings. Surveys assessed the number of conversations sparked by pictorial warnings, theoretical mechanisms, and conversational content. Analyses used structural equation modeling.
Results: The number of conversations about the warnings mediated the relationship between exposure to pictorial warnings and quit attempts (p<.001). The number of conversations was associated with greater cognitive elaboration, which in turn was associated with more quit attempts (p<.05). Conversations about negative emotional reactions to the warnings mediated the path from warnings to quit attempts (p<.05).
Conclusions: Our findings suggest designing warnings that increase conversations in order to better inform and motivate smokers.

Authors

• Jennifer Morgan, Annenberg School for Communication at the U of Pennsylvania

• Shelley Golden, Gillings School of Global Public Health, U of North Carolina at Chapel Hill

• Seth M. Noar, U of North Carolina at Chapel Hill

• Kurt Ribisl, U of North Carolina at Chapel Hill

• Brian G. Southwell, RTI International

• Michelle Jeong, U of North Carolina at Chapel Hill

• Marissa G Hall, U of North Carolina at Chapel Hill

• Noel T. Brewer, U of North Carolina