title: Implicit motivational impact of pictorial health warning on cigarette packs.
abstract: OBJECTIVE
  The use of pictorial warning labels on cigarette packages is one of the provisions included in the first ever global health treaty by the World Health Organization against the tobacco epidemic. There is substantial evidence demonstrating the effectiveness of graphic health warning labels on intention to quit, thoughts about health risks and engaging in cessation behaviors. However, studies that address the implicit emotional drives evoked by such warnings are still underexplored. Here, we provide experimental data for the use of pictorial health warnings as a reliable strategy for tobacco control.
  
  
  METHODS
  Experiment 1 pre-tested nineteen prototypes of pictorial warnings to screen for their emotional impact. Participants (n = 338) were young adults balanced in gender, smoking status and education. Experiment 2 (n = 63) tested pictorial warnings (ten) that were stamped on packs. We employed an innovative set-up to investigate the impact of the warnings on the ordinary attitude of packs' manipulation, and quantified judgments of warnings' emotional strength and efficacy against smoking.
  
  
  RESULTS
  Experiment 1 revealed that women judged the warning prototypes as more aversive than men, and smokers judged them more aversive than non-smokers. Participants with lower education judged the prototypes more aversive than participants with higher education. Experiment 2 showed that stamped warnings antagonized the appeal of the brands by imposing a cost to manipulate the cigarette packs, especially for smokers. Additionally, participants' judgments revealed that the more aversive a warning, the more it is perceived as effective against smoking.
  
  
  CONCLUSIONS
  Health warning labels are one of the key components of the integrated approach to control the global tobacco epidemic. The evidence presented in this study adds to the understanding of how implicit responses to pictorial warnings may contribute to behavioral change.
authors: Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Eliane
authors: E
authors: Volchan
authors: Isabel A
authors: IA
authors: David
authors: Gisella
authors: G
authors: Tavares
authors: Billy M
authors: BM
authors: Nascimento
authors: Jose M
authors: JM
authors: Oliveira
authors: Sonia
authors: S
authors: Gleiser
authors: Andre
authors: A
authors: Szklo
authors: Cristina
authors: C
authors: Perez
authors: Tania
authors: T
authors: Cavalcante
authors: Mirtes G
authors: MG
authors: Pereira
authors: Leticia
authors: L
authors: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal; D001348:Aversive Therapy; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010775:Photic Stimulation; D011356:Product Labeling; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D062789:Tobacco Products; D055815:Young Adult
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