ArticleHuman communication research2020
Pictorial Cigarette Pack Warnings Increase Some Risk Appraisals But Not Risk Beliefs: A Meta-Analysis.
Article in Human communication research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies.Health communication · 2023Pooled it
- Can Extant Vaping Prevention Message Experiments Tell Us Something About What Works? A Response to O'Keefe.Health communication · 2023Pooled it
- Harnessing Hope and Bolstering Knowledge of How to Quit: A Qualitative Investigation of Including Efficacy Content in Tobacco Risk Communication via Daily SMS.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Developing and testing health warnings about alcohol and risk for breast cancer: Results from a national experiment with young adult women in the United States.Alcohol, clinical & experimental research · 2025Trial
- Effects of narrative versus non-narrative pictorial warning labels on visual attention and alcohol-related cancer risk perceptions: An eye-tracking study.Addictive behaviors · 2025Trial
- Understanding Potential Mechanisms of Vaping Prevention Messages: A Mediation Analysis of the Real Cost Campaign Advertisements.Health education & behavior : the official publication of the Society for Public Health Education · 2025Trial
- Exploring the effects of cannabis health warnings on protective health intentions among US adults in legal recreational states.The International journal on drug policy · 2024Trial
- Effects of Pictorial Health Warning Labels on Intention to Quit Waterpipe in Lebanon: A Mediation Analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- Responses to pictorial versus text-only cigarillo warnings among a nationally representative sample of US young adults.Tobacco control · 2023Trial
- Reactions to Pictorial and Text Cigarette Pack Warning Labels among Chinese Smokers.International journal of environmental research and public health · 2022Trial
- Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2022Trial
- The impact of pictorial health warnings on purchases of sugary drinks for children: A randomized controlled trial.PLoS medicine · 2022Trial
- Testing the Effects of Hookah Tobacco Social Media Risk Communication Messages Among Young Adults.Health education & behavior : the official publication of the Society for Public Health Education · 2021Trial
- A Walk in the Park? Examining the Impact of App-Based Weather Warnings on Affective Reactions and the Search for Information in a Virtual City.International journal of environmental research and public health · 2021Trial
- Designing warnings for sugary drinks: A randomized experiment with Latino parents and non-Latino parents.Preventive medicine · 2021Trial
- Reactions to graphic and text health warnings for cigarettes, sugar-sweetened beverages, and alcohol: An online randomized experiment of US adults.Preventive medicine · 2020Trial
- Perceptions of cannabis warnings and recommendations for improvement: a qualitative study with people who use cannabis from the United States.BMC public health · 2025Article
- Strategies for Effective Public Health Communication in a Complex Information Environment.Annual review of public health · 2025Review
- Consumer reactions to multiple and single health warnings on static alcohol ads: A factorial survey experiment with a convenience sample of adults in Ireland.Drug and alcohol review · 2025Article
- Conversations about cigarette health warning labels and smoking cessation attempts in Mexico.Salud publica de Mexico · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Pictorial warnings on cigarette packs motivate smokers to quit, and yet the warnings' theoretical mechanisms are not clearly understood. To clarify the role that risk appraisals play in pictorial warnings' impacts, we conducted a meta-analysis of the experimental literature. We meta-analyzed 57 studies, conducted in 13 countries, with a cumulative N of 42,854. Pictorial warnings elicited greater cognitive elaboration (e.g., thinking about the risks of smoking; d = 1.27; p < .001) than text-only warnings. Pictorial warnings also elicited more fear and other negative affect (d = .60; p < .001). In contrast, pictorial warnings had no impact on perceived likelihood of harm (d = .03; p = .064), perceived severity (d = .16; p = .244), or experiential risk (d = .06; p = .449). Thus, while pictorial warnings increase affective and some cognitive risk appraisals, they do not increase beliefs about disease risk. We discuss the role of negative affect in warning effectiveness and the implications for image selection and warning implementation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.