Abstract

BackgroundWhile the majority of the health messages on cigarette packages contain threatening health information, previous studies indicate that risk information can trigger defensive reactions, especially when the information is self-relevant (i.e., smokers). Providing coping information, information that provides help for quitting smoking, might increase attention to health messages instead of triggering defensive reactions.MethodsEye-movement registration can detect attention preferences for different health education messages over a longer period of time during message exposure. In a randomized, experimental study with 23 smoking and 41 non-smoking student volunteers, eye-movements were recorded for sixteen self-created cigarette packages containing health texts that presented either high risk or coping information combined with a high threat or a low threat smoking-related photo.ResultsResults of the eye movement data showed that smokers tend to spend more time looking (i.e., more unique fixations and longer dwell time) at the coping information than at the high risk information irrespective of the content of the smoking-related photo. Non-smokers tend to spend more time looking at the high risk information than at the coping information when the information was presented in combination with a high threat smoking photo. When a low threat photo was presented, non-smokers paid more attention to the coping information than to the high risk information. Results for the smoking photos showed more attention allocation for low threat photos that were presented in combination with high risk information than for low threat photos in combination with coping information. No attention differences were found for the high threat photos.ConclusionsNon-smokers demonstrated an attention preference for high risk information as opposed to coping information, but only when text information was presented in combination with a high threat photo. For smokers, however, our findings suggest more attention allocation for coping information than for health risk information. This preference for coping information is not reflected in current health messages to motivate smokers to quit smoking. Coping information should be more frequently implemented in health message design to increase attention for these messages and thus contribute to effective persuasion.

Highlights

  • While the majority of the health messages on cigarette packages contain threatening health information, previous studies indicate that risk information can trigger defensive reactions, especially when the information is self-relevant

  • A large body of self-report studies suggest that health warning labels are effective in informing people about the negative health consequences of smoking [6,7,8,9,10,11,12,13,14]

  • For non-smokers, an attention preference was found for high risk information above coping information, but only when the health information was combined with a high-threat photo

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Summary

Introduction

While the majority of the health messages on cigarette packages contain threatening health information, previous studies indicate that risk information can trigger defensive reactions, especially when the information is self-relevant (i.e., smokers). For starters and smokers intending to quit smoking, graphic warnings that are highly visible and show the negative health consequences of smoking were identified as successful vehicles for reducing smoking prevalence [8]. None of these studies used an experimental setup with manipulation of both textual and imagery content. Most studies into the effectiveness of graphic health warnings and health communication rely on selfreport measures This runs the risk of false introspection from the participants as people may not be aware of (implicit) motives that drive their behaviour [17,18,19,20,21,22]

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