Lipkus Submits NIH R21 Proposal to Study Impact of Graphic Warning Labels on Smoking

Isaac Lipkus and team submitted an NIH R21 application entitled "Effects of 3D vs 2D Graphic Warning Labels on Smoking Beliefs and Behaviors" requesting funding for a two-year period with a start date of July 1, 2013.

Cigarette packages that contain graphic warnings of the harms of smoking compared to text-only warnings result in heightened perceptions of smoking-related risks and intentions to quit. However, data showing that graphic warnings directly increase quitting are weak; alternative strategies to display warnings are needed. To this end, graphic warnings that capture powerfully smokers’ attention and in doing so increase the potency of mediators of change can achieve cessation. The ability of 3D images to grab attention and effect behavior change may be striking when images of harm display change in health status--that is, going from a healthy to a diseased state.

Despite these and other many positive reasons to use 3D graphic health warnings, they have not been applied to cigarette packages. This may be due, in part, to potential unintended consequences of using 3D images, such as increasing smokers’ defensive reactions to the feelings of threat these images can evoke. Thus, in this study we will explore whether 3D vs. 2D health warnings on cigarette packages that either do or do not show changes in health states are more likely to: 1) grab attention and influence processing and recall of smoking-related health risk information; and 2) increase knowledge, perceived risk, worry, fear of smoking-related harms, the desire to quit, and smoking behaviors.

If 3D warnings do enhance quit rates, this would provide much needed data to counter the tobacco company’s claims that graphic warnings should not be mandated on cigarette packages in the United States and abroad because of the failure of these warnings to directly increase cessation.