An evaluation of health warnings in cigarette advertisements using standard market research methods: what does it mean to warn?

Abstract

Objective - To evaluate the effectiveness of the mandated Surgeon General's warning on cigarette advertisements in comparison to new warnings developed using standard advertising techniques.Design - Adolescent subjects were exposed in a controlled setting to slide images of advertisements including a Marlboro cigarette advertisement containing either mandated or newly developed warnings.Setting - Subjects were recruited from, and testing was completed in, high schools from the area of Augusta, Georgia (USA).Participants - A convenience sample of 220 subjects ranging in age from 13 to 19 years.Intervention - Controlled exposure to either a currently mandated warning or one of three newly developed warnings placed within a cigarette advertisement.Main outcome measure - Post-exposure recall, masked recall, and aided recognition tests were used to evaluate the effectiveness of the warnings' communication. These are standard market research methods that are frequently employed to evaluate print advertisements.Results - The mandated warning performed poorly as a communication device. It was identified as a health advisory, but failed to communicate more specific risk information. Only 15% of subjects recalled the warning's health concept in the masked recall test. In contrast, newly developed warnings were more effective in communicating specific health information: 66% recalled the health message. The major elements of the cigarette advertisement were quickly noted and frequently recalled. The median cumulative exposure time required to identify the advertisement as a Marlboro cigarette advertisement was only 0.03 seconds. Conclusions - The currently mandated warnings on cigarette advertisments fail to communicate specific health risk information effectively. Warnings which are novel, targeted, and developed through a creative process function more effectively as communicating devices.