The control group of 207 smokers rated each of the four HWLs that are currently on cigarette packs, which warn about lung cancer, heart disease, emphysema, pregnancy complications, and carbon monoxide inhalation. The experimental condition group evaluated nine different pictorial labels, representing a variety of health topics, including cancer, heart disease, and lung disease caused by second-hand smoke. Each message combined text with an image depicting either a graphic image of diseased organs, imagery of human suffering, or an abstract symbol, including both imagery that the FDA has recommended for warning labels in the US and alternative imagery used in other countries.
Respondents in both groups assessed their reactions to the messages according to a 10-point scale for credibility, personal relevance, and perceived effectiveness.
"The present study provided the first direct test of the hypothesis that pictorial health warning labels work better than text-only labels among people with low health literacy," explains Dr. Thrasher. "Ratings of the personal relevance and effectiveness of pictorial labels compared to textual labels were no different for smokers in high- compared to low-health literacy groups. However, smokers with low-health literacy rated pictorial labels as more credible than text-only warnings, whereas no difference was found among smokers with high health literacy."
The reaction to the specific type of imagery used in the pictorial HWL also varied by study participants' health literacy and race. H
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Elsevier Health Sciences