Effects of Repeated Exposure to a Graphic Smoking Warning Image

Several countries have introduced graphic warning images aimed at discouraging smoking. However, the images may be subject to an habituation effect. This study examined the effects of repeated exposure to an image of smoking-related mouth cancer in 24 smokers, 20 ex-smokers, and 39 individuals who had never smoked regularly. Participants viewed the warning image seven times over 7 to 14 days. Trend analysis showed that the smokers had high distress initially when viewing the image, followed by a significant lessening of image-related distress that leveled out over time. Nonetheless, viewing the image had a significant linearly increasing positive effect on their intention to quit smoking, with no sign that the effect of the image on intention was wearing out. The two groups of nonsmokers showed response patterns different from those of the smokers, including signs of habituation to the image. Other results showed a significant relationship between experiencing a high level of distress when viewing the image and having a negative attitude toward smoking. The implications of these findings are discussed in light of anti-smoking campaigns.