A Psychological War Against Smoking

ABSTRACT: Petri Dish is a blog written and produced by the external relations and communications staff at Fred Hutchinson Cancer Research Center. The blog delivers science and biomedical information to the world by highlighting and illuminating the scientific research at the Hutchinson Center and events and general happenings relevant to the center and our larger community.

Graphic images to deter smoking already work in other countries. Will they do the same in the US?

When I heard about the FDA’s dramatic new step in the anti-smoking fight, I couldn’t help but wonder if it would really make a difference. The new measure requires tobacco companies to add gruesome images to cigarette packages; the images include a corpse, a person’s chest stitched together following heart surgery, and even a man with smoke drifting through a hole in his throat.

A proposed label by the FDA

Sure, the images have shock value. But US smokers have seen warning labels on packages since 1965, and smoking’s health consequences aren’t exactly a secret. Will bigger, gorier labels have enough added impact to prevent people from smoking or spur more of them to quit? And, if the images do work, what psychological mechanism is in play?

In search of answers, I dialed up Dr. Jonathan Bricker, a clinical psychologist who specializes in smoking cessation at the Hutchinson Center.

More than Just Ghastly Pictures

The first thing Bricker did was remind me that the packaging requirements and the images are more than just an advocacy campaign-they’re the result of a long scientific process.

“These ideas didn’t come from a Madison Avenue advertising agency that’s just dreaming up a new slogan,” he said. “They’re based on recommendations from a large group of excellent tobacco research scientists who got together, evaluated whether packaging requirements were effective, tested the images, and confirmed which ones did the best job motivating people to think about quitting.”

This process yielded evidence that the images can be effective. Dozens of other countries have mandated similar packaging requirements. Some of the strongest evidence in their favor comes from one of our closest neighbors, Canada, which enacted the requirements 11 years ago.

Since then, smoking rates have plummeted, indicating that the packages, in conjunction with higher tobacco taxes and other measures, have made an impact.

The Power of Images

What’s more, research by Dr. David Hammond of the University of Waterloo has confirmed that cigarette packaging can make a powerful psychological impression on smokers. “When you introduce large graphic images, you elicit arousal, fear, and disgust,” Bricker said, “and those emotions get people to think about smoking’s impact on their lives, and to think about quitting.”

Still, Bricker cautioned that motivating smokers to quit is only half the battle. They must also have access to strategies that can help them go the distance.

“And unfortunately that’s where we’re weak,” Bricker said. “We have a lot of programs designed to get people to quit smoking, but they have only modest effects, and we haven’t made much progress in improving them in the past quarter-century.”

Fighting Smoking Online

Bricker’s research aims to develop innovative new ways to fix that. His latest initiative is an online smoking cessation study called WebQuit, which is trying to identify the most effective tools for helping people quit smoking and resist cravings once they do.

The study, which is seeking participants nationwide, offers free access to a variety of innovative tools.

Images would be placed on cigarette packages

“No matter which of our study groups people are assigned to, they’re going to be given tools on how to stay motivated to quit,” Bricker said.

Once researchers identify methods that work, Bricker is hopeful the Internet will facilitate a revolution in smoking cessation.

“Online tools can be widely disseminated at low cost,” Bricker said, “and I’m extremely hopeful that, in my lifetime, they can help us get smoking rates down to zero or near zero.”

This article was reprinted from the Petri Dish blog with permission from the Fred Hutchinson Cancer Research Center.