Graphic cigarette warnings trigger brain areas key to quitting smoking

February 16, 2016
Credit: Vera Kratochvil/public domain

Viewing graphic anti-smoking images on cigarette packs triggers activity in brain areas involved in emotion, decision-making and memory as observed via brain scans. Researchers from Georgetown University Medical Center and Truth Initiative reported their findings online this week in Addictive Behaviors Reports.

The brain scanning study, the first to be conducted in young adult smokers, suggest these images could effectively warn smokers about cigarettes' health consequences, says the study's co-lead author, Darren Mays, PhD, MPH, an assistant professor of oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC.

"What we found in this study reinforces findings from previous research where scientists have asked participants to report how they think and feel in response to graphic warnings on cigarettes," says Mays, a researcher who studies cancer prevention behaviors including tobacco use interventions. "This study offers us new insights on the biological underpinnings for those responses, bolstering evidence for how these warnings can work to motivate a change in behavior."

When the 19 study participants were shown images such as one of an open mouth, revealing rotted teeth and a tumor on the lower lip, with the text: "WARNING: Cigarettes cause cancer," key showed notable responses, says cognitive neuroscientist Adam Green, PhD, the study's other co-lead investigator.

These areas were the amygdala and the medial prefrontal region, says Green, who administered functional magnetic resonance imaging (fMRI) to the volunteers.

"The amygdala responds to emotionally powerful stimuli, especially fear and disgust. And experiences that have a strong emotional impact tend to impact our decision-making," says Green, an assistant professor in the department of psychology at Georgetown. "The medial prefrontal region that responded to graphic warning labels in this study has been previously associated with self-relevant processing. When we find information to be self-relevant, that may increase how impactful it is for our life decisions."

Other studies have indicated that activation in both the amygdala and might impact future health-related decisions and attitudes, Green says.

"Regulators can and should use this research to craft more effective warning labels and messages to smokers that both deliver facts about the negative effects of smoking, and trigger thoughts and actions that move smokers toward quitting," said Raymond S. Niaura, PhD, senior author of the study and director of Science at the Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative. "Tobacco is still the leading preventable cause of death in the U.S. and the growing body of research showing the effectiveness of warning labels should energize policymaking."

Participants were shown 64 images of a cigarette pack for four seconds each. Among the images used were some displaying the graphic proposed for use by the U.S. Food and Drug Administration that communicate the smoking-associated risks of lung disease, cancer, stroke, heart attack and reduced life longevity.

Some of the test images were not graphic, intended to serve as control stimuli to compare brain response. After each image was shown, the volunteers, smokers who were between 18 and 30 years old, used a push-button control to report how much each image motivated them to quit, from 1 (not at all) to 4 (a lot).

Researchers found that self-reported motivation to quit was significantly greater for graphic warning images than to the control warnings—as was also seen from scanning results. They also found that so called "plain packaging" - packs with no brand names or imagery such as those being used in Australia —did not change participants' responses.

Similar fMRI results have been reported in brain studies of adolescent smokers and older smokers, says Mays.

"As more evidence like this is published, the case grows stronger that graphic warnings are important and can make a difference in terms of motivating to take steps to quit," Mays says.

Explore further: How graphic photos on cigarette packs help smokers consider quitting

More information: Adam E. Green et al, Young adult smokers' neural response to graphic cigarette warning labels, Addictive Behaviors Reports (2016). DOI: 10.1016/j.abrep.2016.02.001

Related Stories

How graphic photos on cigarette packs help smokers consider quitting

December 21, 2015
A new study is the first to provide real-world evidence of the effectiveness of smoking warning labels that include graphic photos of the damage caused by regular tobacco use.

Identifying a better message strategy for dissuading smokers: Add the positive

September 15, 2014
Which is more likely to convince a smoker to quit? The words, "Warning: cigarettes cause cancer" beneath the image of an open mouth with a cancerous lesion and rotten teeth, or the same image with the words, "Warning: Quitting ...

The bigger the better: Cigarette warning labels prompt quit attempts

July 10, 2014
Cigarette warning labels can influence a smoker to try to quit even when the smoker is trying to avoid seeing the labels, according to a survey of thousands of adult smokers in four countries published by the American Psychological ...

Graphic warning labels reduce demand for cigarettes

August 8, 2011
Will graphic cigarette package warning labels significantly reduce demand? A new study suggests it will.

Graphic images on cigarette labels affect smokers' brains, study finds

February 16, 2015
(HealthDay)—Disturbing images on cigarette warning labels have a significant effect on smokers' brains, according to a new study.

Standardized packaging with large graphic health warnings encouraged more thoughts about quitting

March 18, 2015
Introduction of standardised packaging for tobacco products in Australia prompted more smokers to think about quitting and to attempt to quit, show findings of surveys of adults smokers published in Tobacco Control.

Recommended for you

Maternal diet could affect kids' brain reward circuitry

September 25, 2017
Researchers in France found that rats who ate a junk food diet during pregnancy had heavier pups that strongly preferred the taste of fat straight after weaning. While a balanced diet in childhood seemed to reduce the pups' ...

Breathing dirty air may harm kidneys, study finds

September 21, 2017
Outdoor air pollution has long been linked to major health conditions such as heart disease, stroke, cancer, asthma and chronic obstructive pulmonary disease. A new study now adds kidney disease to the list, according to ...

Excess dietary manganese promotes staph heart infection

September 21, 2017
Too much dietary manganese—an essential trace mineral found in leafy green vegetables, fruits and nuts—promotes infection of the heart by the bacterium Staphylococcus aureus ("staph").

Being active saves lives whether a gym workout, walking to work or washing the floor

September 21, 2017
Physical activity of any kind can prevent heart disease and death, says a large international study involving more than 130,000 people from 17 countries published this week in The Lancet.

Frequent blood donations safe for some, but not all

September 21, 2017
(HealthDay)—Some people may safely donate blood as often as every eight weeks—but that may not be a healthy choice for all, a new study suggests.

Higher manganese levels in children correlate with lower IQ scores, study finds

September 21, 2017
A study led by environmental health researchers at the University of Cincinnati (UC) College of Medicine finds that children in East Liverpool, Ohio with higher levels of Manganese (Mn) had lower IQ scores. The research appears ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.