FDA Publishes Results of Experimental Study of Graphic Cigarette Labels

By Susan J. Matthees –

Last Tuesday, FDA announced the availability of final results from its experimental study of graphic cigarette warning labels.  As we previously reported, FDA proposed 36 graphic warning images to accompany the health warning statement required under section 201 of the Family Smoking Prevention and Tobacco Control Act.  As part of that process, FDA conducted a study of smokers ages 18 and older and youth ages 13 to 17 who were identified as being at risk for smoking.  Participants were divided into a control and a test group, with the control group seeing only the worded warning and the test group seeing the worded warning and the images.  After seeing the warnings or the warnings plus images, participants were asked about their reactions, related attitudes and beliefs about the risks of smoking, and intentions to quit or start smoking. 

The results of the study were mixed.  Although nearly every graphic image was associated with a higher emotional response than words alone and many of the images were associated with an increased recall of the message, only a few images actually had an influence on the participants’ beliefs about the health risks of cigarettes or the participants’ likelihood of quitting or not starting smoking.  In fact, some of the images were negatively associated with beliefs about health and behavior (i.e., participants were less likely to believe that smoking was dangerous or were less likely to consider quitting after viewing the image).  In its analysis, FDA opined that participants may need to see a certain “dose” of images before the images would have an actual impact on beliefs and behaviors.

The report made no conclusions on which images, if any, would ultimately be selected for use on cigarette labels.