Assessing the influence of warnings with testimonies from former smokers on smoking and quitting behaviour

Objectives Cigarette pack warnings are widely used internationally for reducing smoking behaviour. Current warnings typically consist of a textual or graphic warning that smoking can lead to negative (health) outcomes. Though these warnings have proven benefits, they also have important limitations. Most notably, they do not produce beneficial changes in important cognitive determinants of smoking cessation such as self-efficacy to refrain from smoking and they do not reduce smoking for specific subsets of the target population. Recent studies provide evidence for the effectiveness of health warnings that include health-related testimonies from former smokers. Methods We designed cigarette pack warnings that consist of more general testimonial statements from former smokers, selected in a pilot study for their potential impact on two important cognitive determinants of smoking (i.e., self-efficacy beliefs and outcome expectancies). In the main study, online participants were either exposed to the new testimonial warnings, to graphic health warnings, or to text-only health warnings on four separate occasions during a 24-h window. Results In a sample of 416 daily smokers, we observed beneficial changes in self-reported cigarette smoking, craving, quit intentions, evaluations of smoking, self-efficacy, and outcome expectancies, immediately after viewing the warnings a first time and after multiple exposures. These effects were comparable for participants in the three warning type groups, with some (small) differences for changes in outcome expectancies and craving. Conclusions Warnings with general testimonies from former smokers might provide a useful evidence-based addition to currently used cigarette pack health warnings.

Automated summary

This study found that cigarette pack warnings with general testimonies from former smokers have a positive impact on smokers' smoking behavior, quit intentions, self-efficacy, and other cognitive determinants. The effects of these warnings were comparable across different warning types, with some small differences in outcome expectancies and craving changes. This suggests that warnings with general testimonies could be a valuable addition to current cigarette pack health warnings.