Smokers' Neurological Responses to Novel and Repeated Health Warning Labels (HWLs) From Cigarette Packages.

Johann F Fridriksson,Roger D Newman-Norlund,James F Thrasher,Brett Froeliger,Chris Rorden

doi:10.3389/fpsyt.2018.00319

Johann F Fridriksson, Roger D Newman-Norlund + Show 3 more

Open Access

https://doi.org/10.3389/fpsyt.2018.00319

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Abstract

Graphic health warning labels (HWLs) depicting bodily injury due to smoking are effective for producing changes in affect, cognition and smoking behavior in adult smokers. However, little is known about the effects of repeated presentation of graphic HWL's on the aforementioned processes. The goal of this study was to examine neural and behavioral responses to graphic HWL's and evaluate whether the repeated presentation of graphic HWL's leads to repetition suppression (RS). Smokers (N = 16) performed an event-related HWL cue task while blood oxygen level dependent (BOLD) signal was collected during a functional magnetic resonance imaging (fMRI) experimental session. Consistent with prior literature, graphic HWL's, as compared to scrambled images, elicited increased BOLD response in brain regions involved in self-referential and emotion processing. Importantly, BOLD response at sites in this network diminished during repeated presentation of the same HWL. These findings suggest that while novel graphic HWL's may have a significant effect on smokers' brain activity, repeated presentation may lead to muted responses and thus limit their potential to induce behavioral change.

Highlights

Despite the known adverse effects of smoking on health [1], smoking remains the leading cause of preventable death in the world [2], with tobacco-related deaths projected to reach 8 million annually by the year 2030 [2]
In order to establish the putative brain regions responding to all health warning labels (HWLs), we first computed a onesample T-test using the contrast comparing pictorial HWLs to scrambled images ([HWLForCon + HWLDomCon +HWLForIncon + HWLDomIncon]–[SCRCon + SCRIncon])
There was no significant difference in this contrast (i.e., [HWLForIncon + HWLDomIncon]–[HWLForCon + HWLDomCon]) when comparing functional magnetic resonance imaging (fMRI) run 1 and fMRI run 2 in the regions identified during the initial comparison

Summary

Introduction

Despite the known adverse effects of smoking on health [1], smoking remains the leading cause of preventable death in the world [2], with tobacco-related deaths projected to reach 8 million annually by the year 2030 [2]. The goal is to effectively communicate the adverse effects of tobacco use to current and potential consumers of tobacco products, as well as to promote smoking cessation and prevent smoking uptake [2]. In 2001, Canada became the first country in the world to implement pictorial HWLs. Since pictorial HWLs have been adopted and implemented in over 100 countries around the world. A key concern regarding HWLs concerns their “wear out” over time, i.e., the extent to which people adapt to the initially salient nature of the graphic component of the HWLs

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