Market Testing of New Health Warnings and Information Messages for Tobacco Product Packaging: Premium Cigars, Cigarillos / Little cigars and Roll your own

Reactions to the 'Lung cancer' health warning

The Government commissioned GfK Bluemoon to undertake consumer and market research and prepare reports on Market Testing of New Health Warnings and Information Messages for Tobacco Product Packaging and Market Research to Determine Effective Plain Packaging of Tobacco Products. The research reports informed the Government's approach to the new graphic health warnings and the design of plain packaging for cigarettes.

Page last updated: 13 June 2012

Figure 6.8.1: 'Lung cancer' health warning

D/H. Cigar smoking causes lung cancer
Image: Cigar smoking causes lung cancer: Image of man in hospital with tubes for breathing, beside image of healthy and damaged lungs, above text warning (see below).

Text from Figure 6.8.1:
Cigar smoking causes lung cancer, even if you do not inhale. The risk is higher if you do inhale. Most people who get lung cancer die from it.
Want to talk about quitting? Call Quitline 137848, talk to your doctor or pharmacist, or visit Quit Now

Premium cigar smokers did not find this message relevant or credible. This was simply due to the fact that they perceive smoking a cigar properly results in not inhaling the smoke. As they believe the smoke is not entering the lungs they do not identify this as potentially causing lung cancer. Using this message on products containing premium cigars could impact on credibility of other messages as it may be seen to demonstrate a lack of understanding of premium cigar smoking behaviour.

Cigarillo / little cigar smokers that also smoked cigarettes felt that the headline to the message was credible, particularly if they inhaled cigarillo / little cigar smoke. At the same time, these cigarillo / little cigar smokers were also of the belief that they consumed less harmful smoke by smoking cigarillos / little cigar than cigarettes, so on balance the cigarillo / little cigar was the better alternative of the two. This can minimise the impact of the message, however, it is still seen as relevant.

Neither of the images tested are effective in increasing credibility or relevance. Respondents have a highly rational reaction to the image of the healthy and unhealthy lungs. Firstly, it is difficult to decipher the image as representing human lungs as they bear little resemblance as to what respondents are familiar with in regards to human organs. The healthy lung was widely criticised for being white in appearance, with most understanding lungs to be at least pink. Secondly, the image is viewed with dispassionate disinterest, much like smokers may views an image in a scientific or medical textbook. It does not prompt any shock that can be the result from images of actual human organs.

The image of the man in hospital, while sad, was perceived as lacking direct relevance to the message. His illness or injury could have any number of causes, for example, a car accident. The lack of an oxygen mask, which is strongly associated with smoking illnesses, increases the sense of irrelevance.

The image of the unhealthy lung that was used in the testing would be a far more effective image for use if the lung cancer message was to proceed. It is clearly of a human organ and there is an immediate discomfort prompted by the image. Although not clearly comprehensible as being of a lung when viewed in isolation, when combined with the warning message referencing lung cancer, respondents readily accept they are being shown the disease.

The phrases of ‘the risk is higher if you do inhale’ minimise relevance rather than increases it. Those that do not inhale simply accept the lower risk, with this being far more preferable than inhaling cigarette smoke among those cigarillo / little cigar smokers who also smoke cigarettes. Similarly the phrase ‘even if you do not inhale’ acts as a caveat for those who do not rather than includes them. The phrase would be more inclusive if it states ‘whether you inhale or not’.

A strength of this message was the last line of the copy, ‘Most people who get lung cancer die from it’. It is definitive and factual. The statement does not attempt to persuade by use of emotion, thereby making it irrefutable.

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