06/21/2011 05:35 pm ET Updated Aug 21, 2011

When Cigarette Warnings Backfire

The U.S. government has just announced a new set of cigarette warning labels that are designed to scare people away from smoking. The labels will cover a substantial portion of the cigarette pack and will feature graphic and disgusting pictures of the dangers of smoking. The idea is that if people really knew what cigarettes can do to them, they would not smoke.

Unfortunately, there is good reason to believe that these warnings will not have the desired effect.

There are two classes of measures that have been taken to fight smoking (and related public health problems like alcohol and unhealthy eating). One is to make smoking less attractive in the short-term to counteract the positives of smoking. The other is to provide warnings about the dangers of smoking.

A key reason why smoking is so difficult to quit is that it provides some pleasure in the short term (and, for the addicted smoker, also the absence of painful cravings). The health risks are in the long term, so they have a weaker pull over current behavior. Thus, measures like making it illegal to smoke indoors in public places and raising the price of cigarettes through taxes are aimed at decreasing the pleasure of smoking in the short term.

The other major public health initiative is to influence the information that is available about smoking. For example, in the U.S., there are very few venues in which cigarette manufacturers are allowed to advertise, and so there are few positive messages about smoking in mainstream media. In addition, by law, cigarette packs have to come with a warning about the dangers of smoking.

A paper by Jochim Hansen, Susanne Winzeler and Sascha Topolinski in the January 2010 issue of the Journal of Experimental Social Psychology examined the effectiveness of these warnings on the attitudes of smokers toward smoking.

The authors reasoned that there are two kinds of smokers. Some smokers find that smoking is an important part of their self-concept. They are truly smokers. Other people smoke cigarettes, but that is not an important part of their self-concept. They do not identify strongly as smokers.

There are also two kinds of warnings that are often given about smoking. Some of those messages are about the negative social consequences of smoking. For example, a warning might point out, "Smoking makes you unattractive." Most of the warnings that actually appear on cigarette packs tend to focus on the danger of death associated with cigarettes, issuing warnings like, "Cigarettes are dangerous for your health," or, "Cigarettes cause lung cancer."

There is a psychological theory called Terror Management Theory that is relevant here. The idea is that we are able to imagine our own deaths, but we have a variety of psychological mechanisms that help us manage the terror that comes along with being able to contemplate that someday we will die.

Based on Terror Management Theory, Hansen and colleagues reasoned that a cigarette warning that highlights that cigarettes may cause death could actually backfire. When someone identifies strongly as a smoker, then a warning that focuses on mortality can threaten that person's self-esteem. Because they identify strongly as a smoker, the easiest way to boost their self-esteem is to increase their favorable attitude toward cigarettes.

To test this hypothesis, a number of cigarette smokers were tested. Some of these people were ones for whom smoking was an important part of their self-concept, while others were ones for whom smoking was not that important to their self-concept. The smokers read either a warning that talked about how smoking decreases a person's attractiveness or a warning that talked about how smoking causes death. Later, these people rated their attitude toward smoking.
As these researchers predicted, if people thought smoking was an important part of their self-concept, they rated smoking as much more attractive if they read a warning that focused on death than if they read a warning focused on attractiveness. That is, for the group of smokers whose identity is bound up with smoking, the kinds of warnings that are typically shown on cigarette packs actually backfire.

This research suggests the importance of gathering evidence about programs that relate to the behavioral aspects of public health problems. On the surface, nobody could oppose big warnings on cigarettes that trumpet their health risks. However, we must be careful, because these warnings could actually do more harm than good.