The study is one of the first to examine the effectiveness of pictorial warning labels versus text-only labels across diverse racial and socioeconomic groups. Although a growing body of research has shown that disadvantaged groups may differ in their ability to access, process and act on health information, little is known about communication inequalities when it comes to cigarette warning labels.

The study authors note that text-only cigarette warnings have been repeatedly characterised as unlikely to be noticed or have an impact, and cite prior research indicating pictorial warning labels are more effective.

“Interventions that have a positive impact on reducing smoking among the general population have often proven ineffective in reaching disadvantaged groups, worsening tobacco-related health disparities,” said Jennifer Cantrell from Legacy, a public health foundation devoted to reducing tobacco use in the United States. “It’s critical to examine the impact of tobacco policies such as warning labels across demographic groups.”

Senior author Vish Viswanath, associate professor of society, human development, and health at Harvard, said: “There is a nagging question whether benefits from social policies accrue equally across ethnic and racial minority and social class groups. The evidence from this paper shows that a policy of mandating graphic health warnings would benefit all groups. Given the disproportionate burden of tobacco-related disease faced by the poor and minorities, mandating strong pictorial warnings is an effective and efficient way to communicate the risk of tobacco use.”

The study, published in the journal PLOS ONE, examined reactions to cigarette warning labels from more than 3 300 smokers. Results show that hard-hitting, pictorial graphic warnings are more effective than text-only versions, with smokers indicating the labels are more impactful, credible, and have a greater effect on their intentions to quit. Moreover, the study found that the stronger impact of pictorial warnings was similar across vulnerable subpopulations, with consistent reactions across race/ethnicity, education, and income.

“The implementation of graphic warning labels appears to be one of the few tobacco control policies that have the potential to reduce communication inequalities across groups,” Cantrell said.

Source: EurekAlert!