Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T07:10:05.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Emotional Impact and Perceived Effectiveness of Text-Only versus Graphic Health Warning Tobacco Labels on Adolescents

Published online by Cambridge University Press:  17 April 2019

Pedro Margalhos ,
Francisco Esteves ,
Jaime Vila Open the ORCID record for Jaime Vila [Opens in a new window]  and
Patrícia Arriaga Open the ORCID record for Patrícia Arriaga [Opens in a new window]
Pedro Margalhos
Affiliation:
Instituto Superior Manuel Teixeira Gomes - ISMAT (Portugal)
Francisco Esteves
Affiliation:
Mid Sweden University (Sweden)
Jaime Vila
Affiliation:
Universidad de Granada (Spain)
Patrícia Arriaga*
Affiliation:
ISCTE-Instituto Universitário de Lisboa (Portugal)
*
*Correspondence concerning this article should be addressed to Patrícia Arriaga. ISCTE-Instituto Universitário de Lisboa, CIS-IUL. Departamento de Psicologia Social e das Organizações. Ava das Forças Armadas, Edifício ISCTE. 1649–026 Lisboa (Portugal). E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The study of smoking in adolescence is of major importance as nicotine dependence often begins in younger groups. Tobacco health warnings have been introduced to inform people of the negative consequences of smoking. This study assessed the emotions and perceived effectiveness of two formats of tobacco warnings on adolescents: Text-only versus graphic warning labels. In addition, we analyzed how emotions predicted their perceived effectiveness. In a cross-sectional study, 413 adolescents (131 smokers, 282 non-smokers) between 13–20 years of age rated their emotions (valence and arousal) and perceived effectiveness towards a set of tobacco warnings. Results showed that graphic warnings evoked higher arousal than text-only warning labels (p = .038). Most of the warning labels also evoked unpleasantness with smokers reporting higher unpleasantness regarding text-only warnings compared to non-smokers (p = .002). In contrast, perceived effectiveness of the warnings was lower in smokers than in non-smokers (p = .029). Finally, high arousal and being a non-smoker explained 14% of the variance of perceiving the warnings more effective. Given the role that warnings may play in increasing health awareness, these findings highlight how smoking status and emotions are important predictors of the way adolescents consider tobacco health labels to be effective.

Keywords

adolescentsemotionsperceived effectivenesstobacco health labels
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 22 , 2019 , E17
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

How to cite this article:

Margalhos, P., Esteves, F., Vila, J., & Arriaga, P. (2019). Emotional impact and perceived effectiveness of text-only versus graphic health warning tobacco labels on adolescents. The Spanish Journal of Psychology, 22. e17. doi:10.1017/sjp.2019.20

References

Andrews, J. C, Netemeyer, R. G., Burton, S., & Kees, J. (2016). Effects of plain package branding and graphic health warnings on adolescent smokers in the USA, Spain and France. Tobacco Control, 25, e120–e126. https://doi.org/10.1136/tobaccocontrol-2015-052583CrossRefGoogle ScholarPubMed
ASPECT Consortium (2004). Tobacco or health in the European Union: Past, present and future. Luxembourg, Luxembourg: Office for Official Publications of the European Communities.Google Scholar
Bekalu, M. A., Ramanadhan, S., Bigman, C. A., Nagler, R. H., & Viswanath, K. (2018). Graphic and arousing? Emotional and cognitive reactions to tobacco graphic health warnings and associated quit-related outcomes among low SEP population groups. Health Communication. Advance online publication. https://doi.org/10.1080/10410236.2018.1434733Google Scholar
Bradley, M. M., Codispoti, M., Cuthbert, B. N., & Lang, P. J. (2001). Emotion and motivation I: Defensive and appetitive reactions in picture processing. Emotion, 1(3), 276–298. https://doi.org/10.1037//1528-3542.1.3.276CrossRefGoogle ScholarPubMed
Bradley, M. M., & Lang, P. J. (1994). Measuring emotion: The Self-Assessment Mannequin and the semantic differential. Journal of Behavior Therapy and Experimental Psychiatry, 25(1), 49–59. https://doi.org/10.1016/0005-7916(94)90063-9CrossRefGoogle Scholar
Crawford, M. A., Balch, G. I., Mermelstein, R., & Group, T. C. N. W. (2002). Responses to tobacco control policies among youth. Tobacco Control, 11(1), 14–19. https://doi.org/10.1136/Tc.11.1.14CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY: Routledge Academic.Google Scholar
Evans, A. T., Peters, E. Shoben, A. B., Meilleur, L. R., Klein, E. G., Tompkins, M. K., Tusler, M. (2017). Cigarette graphic warning labels are not created equal: They can increase or decrease smokers’ quit intentions relative to text-only warnings. Nicotine & Tobacco Research, 19(10), 1155–1162. https://doi.org/10.1093/ntr/ntw389Google ScholarPubMed
Frijda, N. H. (2010). Impulsive action and motivation. Biological Psychology, 84(3), 570–579. https://doi.org/10.1016/j.biopsycho.2010.01.005CrossRefGoogle ScholarPubMed
Gendall, P., Hoek, J., & Gendall, K. (2018). Evaluating the emotional impact of warning images on young adult smokers and susceptible non-smokers. Journal of Health Communication, 23(3), 291–298. https://doi.org/10.1080/10810730.2018.1440332CrossRefGoogle Scholar
Hovland, C., Janis, I., & Kelly, H. (1953). Communication and persuasion. New Haven, CT: Yale University Press.Google Scholar
Hammond, D., Fong, G. T., McDonald, P. W., Brown, K. S., & Cameron, R. (2004). Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers. American Journal of Public Health, 94, 1442–1445. https://doi.org/10.2105/AJPH.94.8.1442CrossRefGoogle ScholarPubMed
Haugtvedt, C. P., Schumann, D. W., Schneier, W. L., & Warren, W. L. (1994). Advertising repetition and variation strategies: Implications for understanding attitude strength. Journal of Consumer Research, 21(1), 176–189. https://doi.org/10.1086/209391CrossRefGoogle Scholar
Hitchman, S. C., Mons, U., Nagelhout, G. E., Guignard, R., Mcneill, A., Fong, G. T. (2012). Effectiveness of the European Union text-only cigarette health warnings: Findings from four countries. European Journal of Public Health, 22(5), 693–699. https://doi.org/10.1093/eurpub/ckr099CrossRefGoogle ScholarPubMed
Janis, I. L. (1967). Effects of fear arousal on attitude change: Recent developments in theory and experimental research. In Berkowitz, L. (Ed.), Advances in experimental social psychology (Vol. 3, pp. 166–225). New York, NY: Academic Press.Google Scholar
Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the future. National survey results on drug use 1975–2017: Overview, key findings on adolescent drug use. Ann Arbor, MI: The University of Michigan, Institute for Social Research.CrossRefGoogle Scholar
Lang, P. J. (1995). The emotion probe: Studies of motivation and attention. American Psychologist, 50(5), 372–385. https://doi.org/10.1037/0003-066X.50.5.372CrossRefGoogle ScholarPubMed
Lang, P. J. (2000). Emotion and motivation: Attention, perception, and action. Journal of Sport & Exercise Psychology, 22, S122–S140. https://doi.org/10.1123/jsep.22.s1.s122CrossRefGoogle Scholar
LaVoie, N. R., Quick, B. L., Riles, J. M., & Lambert, N. J. (2017). Are graphic cigarette warning labels an effective message strategy? A test of psychological reactance theory and source appraisal. Communication Research, 44(3), 416–436. https://doi.org/10.1177/0093650215609669CrossRefGoogle Scholar
Liu, J., Zhao, S., Chen, X., Falk, E., & Albarracín, D. (2017). The influence of peer behavior as a function of social and cultural closeness: A meta-analysis of normative influence on adolescent smoking initiation and continuation. Psychological Bulletin, 143(10), 1082–1115. https://doi.org/10.1037/bul0000113CrossRefGoogle ScholarPubMed
McNeill, A., Gravely, S., Hitchman, S., Bauld, L., Hammond, D., & Hartmann-Boyce, J. (2018). Tobacco packaging design for reducing tobacco use: Cochrane systematic review. Tobacco Induced Diseases, 16(1), A183. https://doi.org/10.18332/tid/84186CrossRefGoogle Scholar
Monárrez-Espino, J., Liu, B., Greiner, F., Bremberg, S., & Galanti, R. (2014). Systematic review of the effect of pictorial warnings on cigarette packages in smoking behavior. American Journal of Public Health, 104(10), e11–e30. https://doi.org/10.2105/AJPH.2014.302129CrossRefGoogle ScholarPubMed
Muñoz, M. A., Viedma-del-Jesus, M. I., Rossello, F., Sanchez-Nacher, N., Montoya, P., & Vila, J. (2013). The emotional impact of European tobacco-warning images. Tobacco Control, 22(2), 123–129. https://doi.org/10.1136/tobaccocontrol-2011-050070CrossRefGoogle ScholarPubMed
Noar, S. M., Hall, M. G., Francis, D. B., Ribisl, K. M., Pepper, J. K., & Brewer, N. T. (2016). Pictorial cigarette pack warnings: A meta-analysis of experimental studies. Tobacco Control, 25, 341–354. https://doi.org/10.1136/tobaccocontrol-2014-051978CrossRefGoogle ScholarPubMed
Pepper, J. K., Cameron, L. D., Reiter, P. L., McRee, A.-L., & Brewer, N. T. (2013). Non-smoking male adolescents’ reactions to cigarette warnings. PLoS ONE 8(8), e65533. https://doi.org/10.1371/journal.pone.0065533CrossRefGoogle ScholarPubMed
Peters, G.-J. Y., Ruiter, R. A. C., & Kok, G. (2013). Threatening communication: A critical reanalysis and a revised meta-analytic test of fear appeal theory. Health Psychology Review, 7, S8–S31. https://doi.org/10.1080/17437199.2012.703527CrossRefGoogle Scholar
Samet, J. M, Yoon, S. Y., & World Health Organization Tobacco Free Initiative (2001). Women and the tobacco epidemic: Challenges for the 21st century. Geneva, Switzerland: World Health Organization.Google Scholar
Tannenbaum, M. B., Hepler, J., Zimmerman, R. S., Saul, L., Jacobs, S., Wilson, K., & Albarracín, D. (2015). Appealing to fear: A meta-analysis of fear appeal effectiveness and theories. Psychological Bulletin, 141(6), 1178–1204. https://doi.org/10.1037/a0039729CrossRefGoogle ScholarPubMed
Vardavas, C. I., Connolly, G., Karamanolis, K., & Kafatos, A. (2009). Adolescents perceived effectiveness of the proposed European graphic tobacco warning labels. European Journal of Public Health, 19(2), 212–217. https://doi.org/10.1093/eurpub/ckp015CrossRefGoogle ScholarPubMed
Wehbe, M. S., Basil, M., & Basil, D. (2017). Reactance and coping responses to tobacco counter-advertisements. Journal of Health Communication, 22(7), 576–583. https://doi.org/10.1080/10810730.2017.1329853CrossRefGoogle ScholarPubMed
Witte, K., & Allen, M. (2000). A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Education & Behavior, 27, 591–615. https://doi.org/10.1177/109019810002700506CrossRefGoogle ScholarPubMed
World Health Organization (2017). WHO report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies. Geneva, Switzerland: Author.Google Scholar