Can repulsive photos make smokers quit?
Scary pictures of cancerous lungs and blackened teeth on cigarette packs have the desired effect, says researcher. They make people stop smoking.
A tongue covered by cancerous boils and a slimy baby lying on a heap of cigarette butts. These are a couple of examples of the photos printed on cigarette packs around the world.
But how do these repulsive photos actually affect smokers – and can a picture of a dead baby stop the desire to smoke?
Hans Dam Christensen, the dean of research at the Royal School of Library and Information Science in Copenhagen, has studied these questions for several years as part of his research into the relationship between pictures and information.
His smoking research has just been published in the Norwegian journal Ekfrase: Nordic Journal of Visual Culture.
“The pictures work,” he says. “They get more people to stop smoking and at the same time people feel they are better informed about the risks of smoking.”
The worse the photos, the better the effect
In his study of repulsive photos on cigarette packs, Christensen has analysed a number of international studies of how photographs have impacted on smoking in various countries.
He says there appears to be a clear correlation between how repulsive the photos are and smokers’ desire to stop smoking.
“One can say that the worse the photos are, the better they work,” he says. “These graphic warnings are so striking that they get people to reflect that smoking is dangerous. In other words, the photos have the effect of changing people’s attitudes.”
The pictures work. They get more people to stop smoking and at the same time people feel they are better informed about the risks of smoking.
Hans Dam Christensen
The international studies that Christensen has analysed include interviews and questionnaires, in which people are asked about their reactions to certain photos – and, for example, whether the photos motivate smokers to stop smoking.
“Some of the studies also show increases in calls to ‘stop smoking’ telephone numbers in connection with the launch of photos on cigarette packs,” says the researcher.
Well-documented effects of photos
Christensen emphasises that there is a difference between the way repulsive pictures are used on cigarette packs and in other campaigns, such as cinema advertising spots or newspaper adverts.
“If you see an anti-smoking campaign in the cinema, it will often use the same type of photograph of diseased lungs and so on – but how good or bad these spots actually are is more uncertain,” says Christensen.
One can say that the worse the photos are, the better they work. These graphic warnings are so striking that they get people to reflect that smoking is dangerous. In other words, the photos have the effect of changing people’s attitudes.
Hans Dam Christensen
“What is interesting is that the photos on cigarette packs are some of the best-documented pictures found. I haven’t heard about other types of photograph where the effect on the subject is so well documented.”
Danish photos less repulsive
He explains that, among other factors, the size of the repulsive picture on the cigarette pack is important.
“Studies have shown that the larger the picture, the better it works,” he says.
“The photos we see on Danish cigarette packs are actually quite small compared with those elsewhere. Nor are the Danish photos anywhere near as repulsive as the pictures in say Brazil or Canada.”
We underestimate pictorial information
Warnings on cigarette packs
In the USA, Congress required warnings against smoking on cigarette packs as early as in 1965.
In 1986, the Danish authorities and the tobacco industry signed a voluntary agreement requiring cigarette packs to carry the warning text: “The Danish Health and Medicines Authority says that smoking tobacco damages your health”.
In 1991, cigarette-makers were forced by law to intensify the text, so cigarette packs should carry texts such as “Smoking can seriously damage your health”, “Smoking is a cause of cancer” and “Your smoking may bother other people”.
In 2001, Canada became the first country in the world to introduce warning pictures on cigarette packs. A large number of countries on all continents have since started using pictures on cigarette packs.
In 2004, the EU prepared a catalogue of warning photographs which EU member states could choose voluntarily to use on cigarette packs.
Belgium was the first country to use these EU photographs, in 2006. Denmark used them for the first time in February 2012.
According to Christensen, the special aspect of the photos on cigarette packs is that they are not intended to be pleasing, unlike most other types of picture. Their purpose is precisely to inform the people who see them about the effects of smoking.
“Our pictorial references normally make us associate a picture with something appealing in terms of our senses or experience,” he says. “But we connect everything related to knowledge or information to written sources. The ability of pictures to inform us is often underestimated.”
However, we do use pictures a lot when giving information – on cigarette packs, as traffic signs or in instructions: how would we assemble IKEA furniture without pictures?
“I’m not saying that pictorial information is always better than written information, but my point is that pictures and text often work best when they are combined,” says the researcher. “You feel better informed about the risk of lung cancer if you see a photo of a cancerous lung with a text that states that smoking can give you cancer.
“Here in August we will start a new study aimed specifically at pictures on cigarette packs and their impact,” says Jørgen Falk, an expert in preventing smoking at the Danish Health and Medicines Authority.
Danes most sceptical in EU about cigarette pack photos
Falk adds that a recent EU study shows that the Danes are the most sceptical EU population in terms of repulsive photos on cigarette packs.
According to the European study, 61 percent of Danes are positive to having warning photos on cigarette packs, while in the two most positive countries – Cyprus and Malta – the figure is 91 percent.
“Although Denmark ranks at the bottom of the study’s statistics, we are 6 percentage points higher today than when that study was carried out in 2009,” says Falk. “So these photos have growing support.”
Translated by: Michael de Laine
- Hans Dam Christensen's profile
- Danish cigarette warnings (pictures)
- Picture-based cigarette warnings from across the world