Evaluation of Graphic Cigarette Warning Images on Cravings to Smoke

Abstract

While health warnings are present on cigarette packs around the world, the nature of the warnings varies considerably between countries. In the United States, a small text warning citing the dangers of cigarette smoking is found on the side of all packs. This pilot study sought to determine whether graphic cigarette warning images, like those found in the United Kingdom and Canada, were better at decreasing cravings to smoke than existing text warnings found on cigarette packs in the United States. Twenty-five smokers seeking treatment to quit at a specialty tobacco treatment program were administered the Brief Questionnaire of Smoking Urges (QSU — BRIEF), a validated measure of craving, prior to and following exposure to cigarette pack warning images. The graphic cigarette warning images reduced cravings to smoke (6.20 point decrease) more than neutral images (3.36 point decrease) and current text warnings used in the United States (5.75 point decrease), although this difference was not statistically significant. Based on these pilot data, a larger study could further examine the effectiveness of graphic warning images and whether such warnings hold an advantage over the currently used text warnings.