Impact of FDA-approved graphic front-of-package health warnings on attention, package choice, and quit intentions.

Introduction: The FDA has the authority to regulate tobacco products, including the implementation of graphic health warnings on cigarette packaging. This study examines the short-term effects of these front-of-package health warnings on smokers' attention, package preferences, and intentions to quit. Methods: A total of 951 smokers were recruited via Amazon Mechanical Turk. Participants completed an online survey that included demographic questions, measures of attention to warnings, package choice, and quit intention. Participants were randomly assigned to view cigarette packs with or without warnings. Results: First, exposure to warnings increased attention to the warning area (OR = 1.747, p = 0.0109), and increased the likelihood of choosing packages without warnings as prices increased (OR = 18.244, p<0.001). Additionally, focusing on the warning content also made smokers more likely to choose packages without warnings as price increased (OR = 5.025, p<0.001). However, warnings had no significant effect on quit intentions. Conclusions: Warnings effectively capture attention and influence cigarette package preferences, but their impact on quit intentions was not detectable after single exposure. These findings suggest that while warnings may affect short-term purchasing behavior, they are insufficient for driving cessation. Future research should investigate the long-term impact of warnings and consider other factors influencing quitting behavior.