Gory Tobacco Warnings Doomed to Fail

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Cigarette Warning Labels

The FDA has released the images that will be added to cigarette packages. Instead of the old text boxes, the new labels are graphic reminders of the health consequences of smoking. The FDA calls the new labels, which will debut next year, “the first change in cigarette warnings in more than 25 years” and says they are a “significant advancement in communicating the dangers of smoking.” Those statements may be true, but the neuromarketing evidence says that smokers will adapt to the new labels and that even these gory images will end up triggering craving for tobacco.

In Are Tobacco Warnings Really Ads? I discussed research that used brain scans to show that viewing a tobacco warning label lit up an area of smokers’ brains associated with craving. The research was described in Buyology by Martin Lindstrom, who noted in a TV interview, “We couldn’t help but conclude that those same cigarette warning labels intended to reduce smoking, curb cancer, and save lives had instead become a killer marketing tool for the tobacco industry.”

While calling gruesome labels a “marketing tool” is perhaps a bit over the top, the conclusion is that smokers quickly become accustomed to even graphic warnings. Eventually, these warnings become as much of the cigarette package “trade dress” as the distinctive Marlboro Red.

I don’t think these images will actually increase the desirability of smoking, and perhaps a few non-addicts will be dissuaded from starting. As repulsive as we find the images, though, we shouldn’t expect them to have much impact on long-time smokers.

35 Comments
  1. Chester Butler says

    Many years ago as a teen we were shown graphic auto mobile accidents with dismembered bodies, injured parties screeming for help, etc.. I still remember the images. Did that stop me from speeding or driving recklessly as a teen. Nope. If wrecked cars are an indication it had no effect on me. What saved me were were seat belts installed before they were required and maturity.
    During WWII GI were shown the result of VD in graphic detail. Did that stop them from having unprotected sex? And then there is the NFL! So I can understand that this tactic will have little long term effect. Why not approach it this way:
    Eighty percent of Americans do not smoke or Join 95% of teens who do not smoke. Eight five percent of smokers have quit. You can too. (The percentages are just made up and the real percentages should be inserted.)

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  2. pedro camargo says

    Roger, there are results of research in neuromarketing to car accidents?

  3. Roger Dooley says

    How do you mean that, Pedro? Are you thinking accidents with a specific reason?

    Roger

  4. Jacob Lepiarz says

    Roger, I remember reading the same findings in Lindstrom’s book and not being at all surprised. As an ex-smoker I remember watching the “Truth” commercials, and having an immediate craving for a cigarette.

    What I do find interesting though is that Australia has had great success with their anti-smoking campaign, with much of that success attributed to the gruesome nature of the ad campaigns. They’ve had such great success that they’ve begun to use the same tactics in a road safety campaign.

    Any thoughts on this?

    1. Roger Dooley says

      I’m not familiar with the Australian data, Jacob, but I can imagine gruesome warnings being more effective in dissuading non-smokers from starting. And even smokers who resolve to quit might find the images helpful if they really focus on what is depicted. We can sometimes overcome our brain’s automated processing by focused effort.

      Roger

  5. JBird says

    Those photos are clearly not real, they look phony, as though they made them gruesome via photoshop (I’m not refuting smoking’s bad side effects, but those pictures are horrific renderings). It seems like an angry attempt by avid non-smokers to piss on their ever-loathed smoking counterparts, and has nothing to do with a well-intentioned concern to help people quit smoking (which, by the way, is a DEEPLY personal and internally-motivated endeavor). There is nothing about these photos that speaks of true concern, but more of a mockery of a deeply misunderstood addiction.

    I’ve never been an advocate of fear-based behavior modification, either. I hope to see some statistics on the smoking decrease one year after these go on the market.

    1. Roger Dooley says

      I agree that the images are oddly artificial, JBird – neither straight photography nor pure illustration. Maybe the intent was for them to be a little creepy looking.

      Roger

  6. Neil Hopkins says

    I’m not sure that these will work brilliantly well. If you look at road safety advertising (my current wage payer), we have had much better interaction and retention from non-preaching, cognitively consonant works such as http://www.embracethis.co.uk (Embrace Life seatbelt ad).

    Our research suggests that people turn away from the blood and gore, either because they ‘can’t handle it’ or because such work depicts a situation that ‘will never happen to me’ and so never forms a cognitive bond.

    There must be other ways of interacting with the smoking population to deter people from starting and provide the kick needed for the people nearing the ‘stop’ decision to get a move on.

    1. Roger Dooley says

      One positive thing is that the new labels will prominently show a toll-free number for help with quitting smoking, Neil. There’s probably a limited amount that you can do on the package itself.

      Roger

  7. pedro camargo says

    Roger I wonder if the campaign for accident prevention and defensive driving work with threats, showing accidents.

    1. Roger Dooley says

      I think accident photos, unlike tobacco effect photos, won’t trigger any cravings. As a negative, the accident photos won’t be there when the individual is getting behind the wheel.

      Roger

  8. Kerry Butt says

    Echoing Jacob’s comment – a number of other countries (including Canada) have used these types of warnings for awhile. Did you check the experiences of those countries as to whether these labels have an impact?

    1. Roger Dooley says

      As with most broad advertising campaigns, trying to assign specific results to one element can be difficult. Haven’t seen the data on this, anyone know?

      Roger

  9. Chester Butler says

    Australians have been successful with their campaign regarding skin cancer prevention. They start training children at a very young age. I am wondering if the age is not a bigger factor than the graphic impact.of images? You would not show children extreme images but training and repetition at a young age does carry forward into later years

    1. Roger Dooley says

      I’m sure age is critical, Chester. In the case of smoking, if you can make the habit undesirable/disgusting before addiction occurs, you will likely succeed. The one danger is the “forbidden fruit” effect – if parents say “don’t smoke” kids may do the opposite.

      Roger

  10. Hans Delbaek says

    This has been tried in some European countries with mixed results. The WHO released a study where they claimed that the campaigns in Brazil, Canada, Indonesia and Singapore had so far been successful.
    At least it has been able to create debate.
    I think the only thing that has worked so far to make smokers quit has been to raise the price A LOT! (See Norway where prices have increased a lot and the amount of smokers have decreased steadily).

  11. Doug Lance says

    Numerous double-blind, peer reviewed studies have shown that a mustachioed man with the clean shaven head and a corny t-shirt eliminates the desire for cigarettes. It’s true.

  12. Teresa says

    In order to prevent tobacco use and the associated chronic diseases it is important to take an ecological approach. There is no (and never will be) one silver bullet. Educational campaigns such as this one are just one technique that needs to be coupled with changing policies and societal norms around tobacco use. For example, people used to smoke on planes – they didn’t stop because everyone realized how gross it was, they stopped because laws changed and as a result it now seems disgusting to most people. If graphic warnings can stop a few new smokers from starting, while costing tax payers nothing – I don’t see any problem with the approach.

    @Chester Butler – smoking is still the leading case of preventable death in the US by far. In Oregon for example, tobacco was responsible for 7,000 preventable deaths, while diet and activity patterns caused “only” 1,400 (DHS Center for Health Statistics) As of 2005 25% of US 11th graders still reported smoking (OHT, 1994 – 2006) and in 2005 19% of Oregon adults reported being current smokers and another 27% were former smokers who may also suffer some health consequences. (BRFSS, 2005)

    So yes, of you are looking at these anti-tobacco ads as the cornerstone of a tobacco prevention program-they are doomed to fail. If you are looking at them as a piece of a comprehensive tobacco prevention strategy geared towards policy and environmental change – than the answer is not as clear.

  13. Huw says

    A big issue with Lindstrom’s statements about anti-cigarette warnings is that they may promote a craving in ex-smokers, but that can’t be the only effect or else all the anti-smoking ads would actually be driving cigarette sales up.

    Australia has seen adult smoking rates fall dramatically over the past few decades and it has been due to a mix of factors. The horror factor of what is shown on packets – and the US versions are mild compared to the Australian ones – helps dissuade new people from taking up the habit while also reminding smokers who are trying to quit some of the reasons why. It won’t stop long-term, ingrained smokers, but stopping new people from starting is a positive impact too (for everyone but Big Tobacco, of course).

    Australia is currently going through the process of stripping off all visual branding elements on cigarette packaging, so the packs will literally be blank canvases plus a horrible picture and warning.

    1. Roger Dooley says

      I’ve heard about the de-branding process, Huw. Maybe I’m just too interested in branding, but it seems rather unfair to restrict a legal product with a distinct brand identity to generic packaging. Why not just make the product illegal, or put even higher taxes on tobacco if it will continue to be legal? Either step would no doubt cut consumption more quickly.

      Roger

  14. Leo says

    i think everyone is missing a big factor here: health literacy. plain text doesnt explain as much as an image would. a significant portion of the population has low functional literacy, and using images would overcome this hurdle. (in my county on California’s Central coast 25% of the population has low literacy).

    the CDC says 4,000 teens begin smoking each day. a few words wont stop them, but a picture is a worth a thousand words, especially in younger generations who are raised on facebook and youtube. as a previous commenter said, it could leave an imprint on their memory for years to come. and it wont be a sexy model image in their head; rather, a grotesque image would come to mind. every little bit helps.

    1. Roger Dooley says

      Leo, I think you have hit the group where the images may be most effective: young, non-smokers. They aren’t habituated to the warnings, and aren’t addicted.

      Roger

  15. Franck Sarrazit says

    these images are currently shown on packs in Europe. Shame they didn’t anticipate the launch of cheap and stylish protective casings to hide those images…facebox and slyp are the leaders in this market. thefacebox.com

    1. Roger Dooley says

      Ha, great idea, Franck. Would a “Marlboro” sleeve for a pack of cigarettes be legal? So, even if the box itself was generic (as proposed in Australia) or had pictures of diseased lungs, a smoker could restore the familiar brand image with a cover of his own?

      Roger

  16. Chester Butler says

    I just checked out the cig pack covers popular in Europe. As a marketer I am reminded that the classical interpretation makes all of us who create desire for a product are pornographers. So I guess there are pornographers on both sides of this issue, too. As an ex smoker of many years I can tell you with certainty that the addiction allows you to rationalize any argument against smoking. And I agree that the price of the product will have a greater impact that any image. I suspect expense and the fear of future expense will have impact in the short term. You may ask, what motivated me to quit? Well it was not graphics of someone else, but personalized terror after I Iooked at my own xrays before a doctor reviewed them. Turns out it was not cancer. But my doctor very quickly made a deal with me which I bought into…I’d record every future cigarette and visit him weekly. Each cigarette carried a $5 fine payable to him weekly. It was an instant cure that has lasted 20 years. I was lucky to have a wise doctor. But you folks that want to show me unrelated pictures on cigarette packs are making me nervy and have started a new craving!

    1. Roger Dooley says

      Thanks for sharing your story, Chester. I’m sure that a powerful personal experience like your scare is one of the few things that is potent enough to overcome the addiction.

      Roger

  17. Thomas Zoëga Ramsøy says

    Dear Roger,

    I just posted on this when seeing your post. I hope you can see what I’m getting at. This is indeed a good way to use neuromarketing: improve warning signs to increase health (or at the least help us avoid spending bucks on choosing the wrong strategies…)

    Here’s the link:
    http://brainethics.org/?p=929

    Best wishes,
    Thomas

  18. Cognitive David says

    I remember being pretty disgusted when seeing pretty horrible pictures on cig packs a few years ago. Not sure if this is a major reason why I’ve never started smoking, but it could be a contributing factor.

  19. Christophe Morin says

    hi Roger,
    I respectfully disagree with you on the predictive effectiveness of picture warnings. There is plenty of evidence in the neuroscientific litterature showing that we are more affected by visual stimuli than just words. Also, the first visual station in the brain is actually in the brain stem, a subcortical area that can trigger rapid and dramatic emotional responses in the limbic system, especially in the insula, a brain area known to fire when we experience disgust. I realize that Martin Lindstrom has claimed otherwise but if you have access to his studies, I would really like to read them.

  20. Roger Dooley says

    Sad to say, Christophe, I don’t have access to Lindstrom’s data either. I’m basing my comments on his conclusions as described in Buyology. It’s certainly possible that a disgusting but familiar cigarette pack photo could simultaneously trigger a craving but also other emotions that might dissuade a smoker from lighting up.

    Roger

  21. Robin Jennings says

    As Huw mentioned the Australian Gov are trying to introduce a debranding of all cigarette packaging to plain packaging.

    The tobacco companies have established a significant fighting fund to stop the plain packaging legislation. They have set up a website: http://www.plainpack.com/noflash.aspx and in each corner store they have petitions asking people to sign a ‘Say no to the legislation’.

    If images and branding didn’t work the companies wouldn’t be spending such huge amounts fighting this.

    1. Roger Dooley says

      There’s no doubt at all that branding works. I doubt if most smokers could pick their brand in a blind test, but they certainly show plenty of loyalty. I have mixed feelings about debranding. If the product is legal, then eliminating branding seems like a blatant attempt to kill the product without taking the more honest step of making it illegal or greatly increasing the tax rate.

  22. Jim Stevanovski says

    I tend to agree with Doug Lance, as simple as it may seem

  23. […] a blog post, Roger Dooley gives his take on the reason he thinks that these warnings will not […]

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