Freakonomics Poll: Will New Cigarette Warning Labels Reduce Smoking?

Photo: kadavy

Soon, new warning labels on cigarette packs will have even scarier messages, and photos too. Canada has been doing this for years. Will it reduce smoking?

Here are three quick thoughts.

1)    I strongly doubt it will increase the quantity of information about smoking. Folks know it is bad for you already.

2)    This does not mean it won’t work. Maybe people try to forget the health risks in that moment of passion (folks know birth control helps prevent pregnancy, but similarly, when faced with impending temptations, magically forget such trivial details). Will these photos remind them at that moment of temptation? Maybe. Or maybe it will increase how often their kids or friends give them grief for it, thus creating some social pressure to stop. Naturally there is a counter-argument, that this may enhance teenage smoking, if “being bad” makes it cooler.

3)    We do have some related evidence on this. It doesn’t bode well for the messages and photos. A few years ago Levitt blogged here about a commitment contract randomized trial I did in the Philippines. The commitment contracts worked great to reduce smoking for those who would sign a contract (disclosure: these contracts are designed similarly to stickK.com, a corporate wellness program and personal behavior modification website I co-founded with Ian Ayres, except minus the internet). And 11% signed a contract, which is really high for any consumer products or services firm, but low if your goal is to eliminate smoking entirely.

The commitment contracts treatment arm was the main point, but there was a placebo group which didn’t get much attention. Messages and photos!

A group also received a card to keep in their wallet or home. The card had nasty photos of black lungs and throat cancer. Spot checks conducted during the study found that folks knew where their card was, they didn’t just throw it away.

 

After one year, we found that the cue card barely made a dent in smoking, a reduction of 0.9 percentage points (at 95% confidence, +/- 3.1 percentage points). At six months the point estimate was slightly higher (1.5 – 2.2 percentage points), but still not statistically significant. Hardly a resounding success, and a decently small confidence interval, so the null effect we believe was truly a sign of an ineffective treatment.

In fairness to the CDC’s new messages and photos, this was not the same as putting the messages and photos on the cigarette packages themselves. There is a constancy in putting it on the packages themselves that maybe is essential to make this work? (Although I also suspect this policy will now create a new line of products for cigarette package covers, to cover up the nasty photos. This could be like a new fashion statement, changing every week with your ringtone.)

There is hope though: another study, here, found that sending frequent text messages to encourage individuals to stop smoking had a big effect. The timing here is different, and in a potentially important way. These messages came throughout the day, not at the moment of passion. Imagine sending someone frequent messages throughout the week to practice safe sex, compared to just tapping someone on the shoulder immediately before the act to remind them. I strongly suspect the former would be more effective than the latter.

So what will the net effect be, fewer smokers or more smokers?

Will more graphic warning labels and pictures on cigarette packs

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  1. jim says:

    people know by now what they’re doing to their bodies. they either don’t care or are addicted. this is pointless stuff to change(the new warning lables), but it can’t hurt either.

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    • Nikki says:

      Or addiction is not really an addiction but part of identity and attention now is more important than health damage in the future (which may not happen at all if you die from other causes before that future arrives). People love being addicted. They don’t just like coffee: it’s their brain in the cup! They don’t just like Apple products: they’ll not use a Blackberry even if it’s all they’ve got on a desert island and their life depends on it! Both are actual statements, I’m not making this up. I knew a grown-up person who assured everyone she was literally unable to drink tea from a cup, so she drank it from a saucer. Nobody gave a darn. She magically learned to use cups. So I suspect shrug-and-move-on may be a better policy for curing some other addictions as well.

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      • ThatMattGuy says:

        “People love being addicted.” That may be the stupidest thing ever said or written. Refusing to use anything but an iPhone and being addicted to a drug aren’t even in the same sport, let alone ballpark. (Hint: the iPhone thing isn’t an addiction. It’s a preference. A preference over everything else but a preference nonetheless.)

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    • Nazumi says:

      Okay first off you can’t make anyone quit or try to cinconve anyone to quit. The only way to quit is because that person WANTS to quit. I was a smoker for years and it took alot of self disaplin to actually quit. I have quit for a long time and I still think about smoking and every few months I will have a drag or two. Once your addicted to cigarettes you are addicted for life. Especially when your stressed out they calm you down and help you relax. But you can go from smoking to the E cigarette. It’s electrical and not as bad. It’s still nicotine but it doesn’t have the nasty smoke or nasty smell and doesn’t have carbon monoxide and all that other gross stuff. It would be at least a start

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  2. Mike B says:

    Why are we trying to reduce smoking again? Declines in smoking have been associated with obesity, increased Medicare costs and pension fund insolvency. The only reason government and industry were able to promise such lavish retirement benefits in the first place was because smoking tended to kill people at or before the retirement age.

    Hot debate. What do you think? Thumb up 12 Thumb down 13
    • Nanno says:

      Here in Europe the U S of MackeyD, BK and KFC is associated with obesity and smoking with increased healthcare costs.

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      • Nanno says:

        I might actually be wrong…

        herewith healthcare costs (in the Netherlands) attributed to risk factors by gender in millions of Euros (in 1999).

        Man Woman Total
        Smoking 334,1 174,6 508,7
        Obesity 257,9 247,4 505,4

        http://www.kostenvanziekten.nl/object_binary/o3366_kvz_folder.pdf (table 3 and 4)

        Damn obese women screwing up my (point of) view. (not going to bother finding out whether there were more smoking or obese people in 1999)

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  3. BL1Y says:

    Why are we putting forward explanations for why it would or would not reduce smoking, when we can just look at 43 countries that already do this and ask has it actually reduced smoking?

    It looks like there’s pretty wide spread evidence that these campaigns cause smokers to either reduce how much they smoke, or increase the chance they will try to quit. http://www.tobaccofreekids.org/research/factsheets/pdf/0325.pdf

    The argument against the labels isn’t that they might be ineffective, but that they go too far in interfering with free enterprise. It’s pretty hard to brand and market your product, when that much of the packaging is taken up by a warning (and I suspect that’s a large part of the motivation to have this type of warning, since branding it very important to cigarette companies).

    Well-loved. Like or Dislike: Thumb up 9 Thumb down 1
  4. Tedy Acosta says:

    what about the non-smokers youth? dont you think this photos and messages frightened enough to even try??

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    • Mark_H says:

      My thought exactly. The end of the linked CNN article says:

      “Every day of the year approximately 2,200 adults — who presumably have heard about the health hazards their entire lives — begin, for the first time, to smoke cigarettes on a daily basis.”

      It’d be hard to believe that these types of ads wouldn’t have any effect on them.

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  5. Daniel says:

    Here in Chile we’ve had this campaign since a couple of years, 50% of the package must come with the nasty warnings. Now the cigarettes come with a sheet (with 50% nasty photos) that you fold in half, insert outside the box but inside the plastic to cover the warnings.

    Well-loved. Like or Dislike: Thumb up 5 Thumb down 0
  6. Nabeel says:

    I think the main affect will be in cigarette boxes sales.

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  7. Nanno says:

    The Dutch government subsidizes tools to help you quit smoking since January 1, 2011 and research has show that we had a 25% drop in smokers to reach an all time low. However, since it is too costly they will reduce it in 2012 and fully stop subsidizing in 2013.
    stats are found here: http://www.depers.nl/binnenland/588469/Aantal-rokers-lager-dan-ooit.html
    more on topic: Studies in France, Scotland and Belgium have shown that generic packs will make smoking less attractive for non-regular smokers and especially for adolescents. Secondly they have shown that the health-warnings become more noticeable. And third they supposedly look more ‘unreliable, cheap and of lesser quality’. Therefore the Association of European Cancer Leagues wants the European Committee to make generic packaging (no logo’s, brand colors, brand name in a ‘neutral font’) mandatory.
    http://www.ad.nl/ad/nl/1015/Gezondheid-wetenschap/article/detail/1886377/2011/01/12/Oersaaie-pakjes-maken-roken-onaantrekkelijk.dhtml?redirected

    I personally think this will work much better, especially for adolescents (which should be the primary target), in discouraging people to start smoking and “making it less cool”

    Well-loved. Like or Dislike: Thumb up 6 Thumb down 0
  8. Brad says:

    Dennis Leary was right – you could name your cigarettes “Tumors” and put a skull and crossbones on the pack and people would still smoke. There are too many “other” reasons for people to smoke to have this change human behavior. Noble effort, however.

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