Graphic warning labels in cigarette advertisements: recall and viewing patterns.
BACKGROUND
The Family Smoking Prevention and Control Act gave the U.S. Food and Drug Administration (FDA) legal authority to mandate graphic warning labels on cigarette advertising and packaging. The FDA requires that these graphic warning labels be embedded into cigarette advertising and packaging by September 2012.


OBJECTIVE
The aim of this study was to examine differences in recall and viewing patterns of text-only versus graphic cigarette warning labels and the association between viewing patterns and recall.


METHODS
Participants (current daily smokers; N=200) were randomized to view a cigarette advertisement with either text-only or graphic warning labels. Viewing patterns were measured using eye-tracking, and recall was later assessed. Sessions were conducted between November 2008 and November 2009. Data analysis was conducted between March 2011 and July 2011.


RESULTS
There was a significant difference in percentage correct recall of the warning label between those in the text-only versus graphic warning label condition, 50% vs 83% (χ(2)=23.74, p=0.0001). Time to first viewing of the graphic warning label text and dwell time duration (i.e., time spent looking) on the graphic image were significantly associated with correct recall. Warning labels that drew attention more quickly and resulted in longer dwell times were associated with better recall.


CONCLUSIONS
Graphic warning labels improve smokers' recall of warning and health risks; these labels do so by drawing and holding attention.
Center for Interdisciplinary Research on Nicotine Addiction, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-3309, USA. strasse3@mail.med.upenn.edu
Andrew A
AA
Strasser
Kathy Z
KZ
Tang
Daniel
D
Romer
Christopher
C
Jepson
Joseph N
JN
Cappella
D000328:Adult; D000329:Advertising; D000368:Aged; D001288:Attention; D053483:Eye Movement Measurements; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010781:Photography; D011356:Product Labeling / Q000331:legislation & jurisprudence; D019064:Product Packaging; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology; D055815:Young Adult