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Gruesome Cigarette Pack Images Sway Smokers, Study Finds
Date:11/13/2012

the University of South Carolina in Columbia. "Our research supports this finding while also showing what tobacco researchers have assumed for a while -- that warnings with pictures work particularly well among smokers with low levels of literacy."

The scientists recruited nearly 1,000 adult smokers for the study from public places such as grocery stores, sporting events and flea markets across South Carolina. They asked them questions about their education, salary levels, race and smoking habits. All of the participants had to have smoked at least 100 cigarettes during their lifetime and had to currently be daily smokers.

To assess their health literacy, the researchers asked each smoker to interpret a nutrition label. The participants were randomly assigned to one of two groups.

The control group of 207 male and female smokers, aged 18 and up, were shown four text-only warnings currently used on cigarette packs, which warn of lung cancer, pregnancy complications and other medical problems.

The other 774 individuals, also a mix of men and women over 18 who smoked regularly, were shown nine different cigarette packs that carried warning text and pictures showing the consequences of smoking. While some visuals were very graphic -- including a close-up of a gray and scarred cadaver chest -- other pictures featured a distraught person or included more abstract visual images warning of cancer, heart disease and stroke.

Both groups rated the messages according to credibility, personal relevance and effectiveness. Smokers' ratings of personal relevance and effectiveness were higher for the warnings with pictures compared to the warnings with just words. Smokers with low health literacy rated the warning labels with pictures as more credible than text-only messages, the authors reported.

The warnings with very graphic imagery were rated as the most effective by smokers with both high and low health literacy, and by those from both whit
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