Study: Graphic cigarette warning labels are more effective with young adult smokers

A small study of young adults, using functional magnetic resonance imaging (fMRI), found that graphic warning labels affected their motivation to quit smoking more than text-only warning message labels. 

Virtually no difference in response occurred whether the graphic warnings appeared on branded or generic cigarette packaging.

Nineteen young adults, ages 18 to 30, participating in the study smoked an average of five cigarettes per day, and had a low level of nicotine dependence.

The research appeared in the February 2016 issue of Addictive Behaviors Reports.

Previous studies, which found similar results for both adult and adolescent populations, did not look at the young adult population. 

"However, young adults are a priority for tobacco control due to high rates of smoking experimentation, frequent transitions to regular smoking, and the high prevalence of smoking in this group." the authors state.

The researchers note that previous studies rely on self-reporting, whereas this study used fMRI to examine areas of the brain involved while participants were viewing images, not simply brain structure.

Study participants looked at each image for four seconds and pushed a button indicating how the image affected them, ranging from "not at all" to "a lot." The graphic warnings included four images designed by the U.S. Food and Drug Administration (FDA).

The fMRI imaging analysis found that "significantly greater activation" occurred in response to the graphic warning labels compared with the text warning in "left medial frontal gyrus, right middle occipital gyrus, right orbital gyrus, left parietal precuneus, areas of left medial temporal cortex, specifically, left parahippocampal gyrus (extending to hippocampus), and left amygdala."

The researchers note that two of these regions – the medial prefrontal cortex and amygdala – play a role in emotional and cognitive decision-making.

Despite the study's small size, the researchers state: "These data begin to delineate a neural underlay for recent self-report investigations indicating that GWLs [graphic warning labels] are an important intervention for motivating young adult smokers to quit."

Future studies, the researchers conclude, could examine whether the neural activation measured is correlated with "future quitting behavior," and provide guidance for policy makers.