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Study: Graphic tobacco warning labels more effective at delivering anti-smoking message

In this combo made from file images provided by the U.S. Food and Drug Administration shows two of nine new warning labels cigarette makers were to use by the fall of 2012. AP Photo/U.S. Food and Drug Administration, File

(CBS News) Graphic warning labels on cigarette packs are used throughout the world to deter people from smoking by using stark images of blackened lungs or diseased individuals along with warnings of tobacco's health effects.

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A new study finds that the labels actually work, and are more effective at teaching smokers the health risks from cigarette smoking than traditional warnings.

Previous studies on the effectiveness of graphic tobacco warning labels in Europe and Canada have found people may be more likely to feel a negative response or more likely to report an intention to quit smoking, but according to the authors behind the new research, the smokers in those large population-based studies could have been influenced by other anti-smoking campaigns or tax increases.

The authors of this new study wanted to remove those other variables and determine if a graphic warning label alone could get people to learn an anti-smoking message. They tested this by enlisting 200 smokers who were assigned to view either a text-only warning label containing an unedited Surgeon General's warning and Federal Trade Commission testing information - both of which have appeared on cigarette ads since 1985 - or a graphic warning label that contained a hospitalized patient on a ventilator with a large textual warning - similar to the labels proposed by the U.S. Food and Drug Administration that were set to hit U.S. cigarette packs in 2012.

Using eye-tracking technology, the researchers measured how long participants viewed various parts of the ad, how many times they viewed each area of the ad, and other eye measures that might determine if someone is paying attention. After reading the ads, each participant was also asked to rewrite the warning label text to demonstrate how well they remembered it.

The researchers found that 50 percent of subjects remembered the text-only warning label, while 83 percent correctly recalled the label that contained a graphic image. The quicker a smoker looked at the large text in the graphic warning, as well as the longer they viewed the graphic image, were tied to the best recall ability.

The researchers say their study shows that drawing attention to the warning label can improve how a smoker recalls the warning label information, improving the chances they'll take the information about smoking risks to heart.

"In addition to showing the value of adding a graphic warning label, this research also provides valuable insight into how the warning labels may be effective, which may serve to create more effective warning labels in the future," study author Dr. Andrew A. Strasser, an associate professor of psychiatry at the University of Pennsylvania, said in a written statement. "We're hopeful that once the graphic warning labels are implemented, we will be able to make great strides in helping people to be better informed about their risks, and to convince them to quit smoking."

In 2009, the Family Smoking Prevention and Tobacco Control Act mandated the FDA to require graphic labels on cigarette packages. In June, 2011, the FDA approved nine images it would require cigarette manufacturers to place prominently on cigarette packs, examples of which included color images of a man exhaling cigarette smoke or a cadaver on a table with post-autopsy chest staples. Tobacco companies sued to block the requirement, and the cases are still pending.

The Centers for Disease Control and Prevention answered with a $54 million graphic campaign of its own called "Tips from Former Smokers," which used images and videos of former smokers suffering from health ailments such as amputations or a lung removal from smoking.

According to the CDC those ads may be working as well: Call volume to the 1-800-QUIT-NOW hotline featured in the ad more than doubled from 14,437 calls to 34, 413 calls two weeks after the ad aired.

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