Abstract
The Message Impact Framework suggests that social interactions may offer smokers the opportunity to process pictorial warnings on cigarette packs more deeply. We aimed to describe adult smokers’ social interactions about pictorial cigarette pack warnings in two longitudinal pilot studies. In Pilot Study 1, 30 smokers used cigarette packs with one of nine pictorial warnings for two weeks. In Pilot Study 2, 46 smokers used cigarette packs with one of five pictorial warnings for four weeks. Nearly all smokers (97%/96% in Pilot Study 1/2) talked about the warnings with other people, with the most common people being friends (67%/87%) and spouses/significant others (34%/42%). Pilot Study 2 found that 26% of smokers talked about the warnings with strangers. Discussions about the health effects of smoking and quitting smoking were more frequent during the first week of exposure to pictorial warnings than in the week prior to beginning the study (both p < 0.05). Pictorial warnings sparked social interactions about the warnings, the health effects of smoking, and quitting smoking, indicating that pictorial warnings may act as a social intervention reaching beyond the individual. Future research should examine social interactions as a potential mediator of the impact of pictorial warnings on smoking behavior.
Highlights
Tobacco use is the leading cause of preventable morbidity and mortality worldwide, causing nearly six million deaths each year [1]
Social interactions are a key mechanism through which health communication campaigns, including pictorial cigarette pack warnings, may exert their effects [7,8,9,10,11]
Our study found that the pictorial warnings sparked conversations about the warnings themselves, and about the health effects of smoking and about quitting smoking
Summary
Tobacco use is the leading cause of preventable morbidity and mortality worldwide, causing nearly six million deaths each year [1]. A large body of observational and experimental research suggests that pictorial cigarette pack warnings are a promising policy solution for communicating information about the health risks of smoking and increasing quit intentions [2,3,4]. Social interactions are a key mechanism through which health communication campaigns, including pictorial cigarette pack warnings, may exert their effects [7,8,9,10,11]. While definitions of interpersonal communication and social interactions vary [8,14], we define social interactions as an exchange between two or more people, in this case sparked by a health message. Our Message Impact Framework [3] suggests that social interactions triggered by messages can facilitate change in smoking attitudes and beliefs
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