title: Icons for health effects of cigarette smoke: a test of semiotic type.
abstract: We sought to identify icons to effectively communicate health harms of chemicals in cigarette smoke. Participants were a convenience sample of 701 U.S. adults. A within-subjects online experiment explored the effects of icon semiotic type: symbolic (arbitrary, most abstract), indexical, and iconic (representative, most concrete). Outcomes were perceived representation, affect toward smoking, elaboration, perceived severity, and perceived effectiveness. For not-easy-to-visualize harms of cancer and addiction, symbolic icons received the highest ratings (all p < .001). For easy-to-visualize symptoms of heart attack/stroke, indexical icons received the highest ratings (all p < .001). For easy-to-visualize harm of reproductive organ damage, the iconic image did best (all p < .001). Icon type often had a larger impact among participants with higher health literacy. Symbolic icons may be most effective for health effects not easily visualized. Iconic or indexical icons may be more effective for health effects attributable to specific body parts or symptoms.
authors.affiliation: School of Media and Journalism, University of North Carolina at Chapel Hill, 384 Carroll Hall (CB 3365), Chapel Hill, NC, 27599-3365, USA. lazard@unc.edu.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Lazard
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Annie
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Huyen
authors.initials: H
authors.lastname: Vu
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.|Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: M Justin
authors.initials: MJ
authors.lastname: Byron
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, OH, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Peters
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.|Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Marcella H
authors.initials: MH
authors.lastname: Boynton
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.|Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000328:Adult; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D008297:Male; D010465:Perception; D011634:Public Health; D012907:Smoking / Q000523:psychology*
keywords: Cigarette; Health effects; Icons; Pictograph; Warning