In a first of its kind study in the U.S., researchers at the Perelman School of Medicine at the University of Pennsylvania have shown that the addition of graphic warning labels on cigarette packaging can improve smokers' recall of the warning and health risks associated with smoking. The new findings will be published online-first in the American Journal of Preventive Medicine.

In past studies in Europe and Canada, graphic warning labels have proven to be effective in eliciting negative responses to smoking, increasing reported intention to quit smoking in smokers, and modifying beliefs about smoking dangers. However, these previous research results have generally been conducted using large, population-based studies that could be confounded by concurrent tax increases or anti-smoking media campaigns that coincide with the introduction of new warning labels.

"An important first step in evaluating the true efficacy of the warning labels is to demonstrate if smokers can correctly recall its content or message," said Andrew A. Strasser, PhD, associate professor, Department of Psychiatry at Penn, and lead author of the new study. "Based on this new research, we now have a better understanding of two important questions about how U.S. smokers view graphic warning labels: do smokers get the message and how do they get the message."

In the study, 200 current smokers were randomized to view either a text-only warning label advertisement, which was unaltered and utilized the Surgeon General's warning and Federal Trade Commission (FTC) testing information that has appeared on cigarette advertisements since 1985; or a graphic warning label version that contained a graphic image (depicting a hospitalized patient on a ventilator) and a health warning with larger text, similar to what has been proposed by the FDA to be adopted in the U.S.

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