Health promotion and advertising, public policy regulations

Author/Reference Focus of the study (Purpose)/context-advertising, food, product Method (experiment, qualitative) Measure of Effectiveness(attitudes, awareness, recall) Findings
Mays, D., Villanti, A., Niaura, R. S., Lindblom, E. N., & Strasser, A. A. (2019). The effects of varying electronic cigarette warning label design features on attention, recall, and product perceptions among young adults. Health communication34(3), 317-324. To determine the impacts of warning signs in e – cigarette advertising on cigarette smokers. Quantitative research method was used in which participants were interviewed online. Participants were selected randomly and recruited via online. They were then exposed to different electronic advertisements – some coloured, others in black and white. Coloured warning label design attracts attention of cigarette smokers than those in plain text.
Wakefield, M. A., Brennan, E., Dunstone, K., Durkin, S. J., Dixon, H. G., Pettigrew, S., & Slater, M. D. (2018). Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study. Addiction113(6), 1019-1029. To investigate the impacts of warning signs on the alcoholic products to adult population who uses alcohol. Qualitative research method was used in which participants were both adults and youths. Participants were recruited through online. A total of 3718 alcohol users aged between 18 – 64 were given questionnaires to fill online. The study found that the warning labels seemed to be too small and vague to alcohol users. Warning labels does not encourage adult alcohol users to change their behaviours.
Anshari, D., Yong, H. H., Borland, R., Hammond, D., Swayampakala, K., & Thrasher, J. (2018). Which type of tobacco product warning imagery is more effective and sustainable over time? A longitudinal assessment of smokers in Canada, Australia and Mexico. BMJ open8(7), e021983. To assess the the responses of smokers to PHWs using different types of images. The study was done using quantitative method through survey. Adult smokers from online panels of different parts of the world were surveyed. Smokers from online consumer panels in three different countries went through survey. Questionnaires were given to the participants on the 5 main areas for domains of PWH – evaluating, cognitive, behavioural and motivational reactions that were found to be significant mediators for warning label effect. In all the three nations, Pictorial Health Warnings did not greatly change over time. Changes in perception, credibility and discussion differed somewhat across nations depending on the sort of image.
Cho, Y. J., Thrasher, J. F., Yong, H. H., Szklo, A. S., O’Connor, R. J., Bansal-Travers, M., … & Borland, R. (2018). Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US. Social Science & Medicine197, 226-234. To investigate the position of feelings in smokers’ danger concerns and changes in conduct in Australia. Descriptive research design was used. Participants were provided with questionnaires. participants were given questionnaires to fill on whether emotions have influence on behavioural change on smokers. Semantic differential scale ranging between 1 9 was used. There is a link between emotions and behavioural change on smokers. Negative emotions that is elicited by warnings causes cigarate smokers to quit smoking.
Coomber, K., Hayley, A., & Miller, P. G. (2018). Unconvincing and ineffective: Young adult responses to current Australian alcohol product warnings. Australian Journal of Psychology70(2), 131-138. To investigate the impacts of PWS on Australian alcoholics. Qualitative research method was used. Focus groups were of university students were employed in the study. 6 focus groups were used and participants were mainly alcohol users. Participants were video recorded and transcribed then thematically analysed. The study found that the warning labels seemed to be too small and vague to alcohol users. Warning labels does not encourage Australian alcohol users to change their behaviours.
Gallopel‐Morvan, K., Hoek, J., & Rieunier, S. (2018). Do Plain Packaging and Pictorial Warnings Affect Smokers’ and Non‐Smokers’ Behavioral Intentions?. Journal of Consumer Affairs52(1), 5-34. To determine the extent to which tobacco imagery warnings and plain text –only warnings labels influences the attitude of cigarette smokers. Qualitative & quantitative research was used. 53 French daily cigarette smokers were used. 53 smokers were presented with both plain and pictorial label warnings of tobacco. There is significant effect of pictorial warning signs on the emotional behaviour of French smokers. The participants showed fear upon reading the warning labels on effect of cigarette smoking.
Kwan, M. Y., Haynos, A. F., Blomquist, K. K., & Roberto, C. A. (2018). Warning labels on fashion images: Short‐and longer‐term effects on body dissatisfaction, eating disorder symptoms, and eating behavior. International Journal of Eating Disorders51(10), 1153-1161. To investigate the influence of fashion warning signs on health of individuals. Quantitative research method was used in which participants were college students. Participants were randomly selected and exposed to different images of fashion and issue with snacks then given questionnaires to fill. Fashion warning signs have no effects on one’s eating habit.
Maynard, O. M., Gove, H., Skinner, A. L., & Munafò, M. R. (2018). Severity and susceptibility: measuring the perceived effectiveness and believability of tobacco health warnings. BMC public health18(1), 468. To determine the impact and effectiveness of believability of HWLs on Tobacco smokers. Quantitative research method was used. The researchers analysed samples obtained from online sources. Most severe pictorial warning label receives high believability than less severed ones.
Niederdeppe, J., Kemp, D., Jesch, E., Scolere, L., Greiner Safi, A., Porticella, N., … & Byrne, S. (2018). Using graphic warning labels to counter effects of social cues and brand imagery in cigarette advertising. Health Education Research34(1), 38-49. To determine the influence of text only and graphic warning images on cognitive and emotional factors on cigarette smokers. Qualitative research method was used in which participants were cigarette smokers. Participants were organised into control groups and exposed to both graphic and text –only messages. None of the warning labels influences the health risk beliefs of cigarette sokers.
Shang, C., Weaver, S., Zahra, N., Huang, J., Cheng, K. W., & Chaloupka, F. (2018). The association between potential exposure to magazine ads with voluntary health warnings and the perceived harmfulness of electronic nicotine delivery systems (ENDS). International journal of environmental research and public health15(4), 575. To explore the effects of warnings in media advertisements in magazines and electronic ads.. The study was done using quantitative method through experimental design. Two different experiments investigating the effects of warning advertisements using mass media on alcoholic drinks were used. The first one was based on visual and another on print media. Shapes and writings with different conspicuousness were used and participants questioned. The two experiments showed that individuals exposed to high conspicuous warnings in both print and broadcasting advertisements responded faster than those exposed to less conspicuous advertisement warnings.
Sillero-Rejon, C., Attwood, A. S., Blackwell, A. K., Ibáñez-Zapata, J. A., Munafò, M. R., & Maynard, O. M. (2018). Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity. BMC public health18(1), 1403. To determine the effectiveness of pictorial and text –only warning labels on cigarette smokers. Qualitative research method was used. Online articles were analysed. Pictorial warning signs are more effective than text –only warning signs.
Kowitt, S. D., Jarman, K., Ranney, L. M., & Goldstein, A. O. (2017). Believability of cigar warning labels among adolescents. Journal of Adolescent Health60(3), 299-305. To examine believability of cigarette warning labels on adolescents. Quantitative research method was used in which adolescents were the participants. Adolescents were randomly chosen and exposed to different cigarette warning sings. Adolescents does not view messages on cigarette warning labels are believable messages.
Annunziata, A., Vecchio, R., & Mariani, A. (2017). Alcohol warnings and moderate drinking patterns among Italian university students: an exploratory study. Nutrients9(6), 628. To determine the influence of health related warnings label on university students who uses alcohol. Quantitative research method was used. University students were the participants. Participants were exposed to different warning labels and then given questionnaires to fill. Younger generation responds positively to health related warning labels.
Johns, R., Dale, N., Alam, S. L., & Keating, B. (2017). Impact of gambling warning messages on advertising perceptions. To determine the influence of gambling messages on advertising perceptions. Qualitative research method was used in which data from various databases were analysed. Data from different databases were analysed. There exist close link between gambling messages on advertising perceptions.
Dossou, G., Gallopel-Morvan, K., & Diouf, J. F. (2017). The effectiveness of current French health warnings displayed on alcohol advertisements and alcoholic beverages. The European Journal of Public Health27(4), 699-704.   To determine whether French warning labels on alcoholic bottles have influence on alcoholic users. Qualitative research method was used in which alcoholic users were the participants. Participants were presented with two different warning labels. The first one being ‘alcohol abuse is dangerous’ and the second label being a pictorial. Data obtained was then analysed by use of double manual coding. No warning attracted participant’s attention. The French advertisement label warnings on alcoholic bottles were seen to be vague and needed modifications.
Pham, C., Rundle-Thiele, S., Parkinson, J., & Li, S. (2017). Alcohol warning label awareness and attention: a multi-method study. Alcohol and Alcoholism53(1), 39-45. To determine the effectiveness of alcohol warning labels on alcohol users. Qualitative research method was used. Online articles were analysed. Warning labels does not have influence on alcohol users neither does it change their perceptions.
Stafford, L. D., & Salmon, J. (2017). Alcohol health warnings can influence the speed of consumption. Journal of Public Health25(2), 147-154. To determine whether the speed of alcohol consumption is determined by the types of beverage the warning label contain or not. Quantitative research method was used in which participants were mostly females. Participants were exposed to different warning labels and then given questionnaires to fill. Alcohol health warnings does not influence the speed of alcohol consumption.
Stautz, K., Frings, D., Albery, I. P., Moss, A. C., & Marteau, T. M. (2017). Impact of alcohol‐promoting and alcohol‐warning advertisements on alcohol consumption, affect, and implicit cognition in heavy‐drinking young adults: A laboratory‐based randomized controlled trial. British journal of health psychology22(1), 128-150. To determine the effect of alcohol warning labels advertisements on alcohol users. Quantitative research method was used. Two experiments were conducted and then analysed. Advertisement lead to significant perceived benefits and lower perceived risks.
Noar, S. M., Hall, M. G., Francis, D. B., Ribisl, K. M., Pepper, J. K., & Brewer, N. T. (2016). Pictorial cigarette pack warnings: a meta-analysis of experimental studies. Tobacco control25(3), 341-354. To determine the effectiveness of pictorial and text –only warning labels on cigarette smokers. Qualitative research method was used. Online articles were analysed. Pictorial warning signs are more effective than text –only warning signs.
Davis, C., & Burton, S. (2016). Understanding graphic pictorial warnings in advertising: a replication and extension. Journal of Advertising45(1), 33-42. To determine whether graphic pictorial warning labels have impacts on behavioural change on cigarate smokers. Quantitative research was used in which students were participants. Participants were chosen randomly and provided with pictorial label warnings on cigarate smoking. Pictorial graphics have no effect on behavioural change on cigarrate smokers.
Jeong, Y., & Lundy, L. K. (2015). Evaluating food labels and food messages: an experimental study of the impact of message format and product type on evaluations of magazine food advertisements. Journal of Applied Communications99(1), 5. To assess the effect of food labels and messages on consumers. Qualitative research method was used in which control groups consisting of university students were the participants. Experiment was done online by use of surveys administration program. The participants were selected randomly and assigned treatment groups. They were presented with different advertisements and told to examine them. Data obtained was then analysed. Findings shown that no relationship between message food labels on consumers’ attitude.
Coomber, K., Martino, F., Barbour, I. R., Mayshak, R., & Miller, P. G. (2015). Do consumers ‘Get the facts’? A survey of alcohol warning label recognition in Australia. BMC public health15(1), 816. To determine whether the “get the facts” awareness labels directs alcohol users to such sites for reliable information. Quantitative research was used where individuals between age 18 – 45 were the participants. Participants were given online surveys to complete while responding to how effective are warning sign logo on “get the facts right” are. Voluntary warning signs or labels have no influence on alcohol users. Only 16 percent of the participants recognized their effectiveness and visited sites with reliable information on alcohol usage. A significant percentage of participants did not.
Zahra, D., Monk, R. L., & Corder, E. (2015). ‘If you drink alcohol, then you will get cancer’: investigating how reasoning accuracy is affected by pictorially presented graphic alcohol warnings. Alcohol and Alcoholism50(5), 608-616. To investigate the cognitive processing of emotive pictorialwarnings intended to curb alcohol misuse, using novel methodologies adapted fromthe reasoning literature to assess whether emotive pictorial warnings alter reasoning. Quantitative research method was used in which participants were given related and non-related alcohol warning labels to view then provide with questionnaires to fill. Participants were given different images of warning labels on alcohol related to its effect – cancer to view. No difference in negative and positive warning pictorials on reasoning accuracy of alcohol users.
Pettigrew, S., Jongenelis, M., Chikritzhs, T., Slevin, T., Pratt, I. S., Glance, D., & Liang, W. (2014). Developing cancer warning statements for alcoholic beverages. BMC public health14(1), 786. To determine the influence of cancer related warning labels on alcoholic drinks among alcoholics. Qualitative research was used in which focus groups consisting of Australian citizens were used. 6 focus groups of 2168 alcoholic individuals in total were exposed to cancer warning labels Positively framed warning labels showed positive feedback and responses than negatively warning labels.
Glock, S., & Krolak‐Schwerdt, S. (2013). Changing outcome expectancies, drinking intentions, and implicit attitudes toward alcohol: a comparison of positive expectancy‐related and health‐related alcohol warning labels. Applied Psychology: Health and WellBeing5(3), 332-347. To compare the effectiveness of warning labels that contradicts positive outcome expectations with health warning labels on attitudes of alcohol users. Quantitative research method was used in which German college students were the participants. Half the population of participants were presented with health related warning labels while the other half presented with positive related warning labels. Their attitudes were then assessed based on the warning labels exposure. Particpants who were exposed to positive related warning labels portrayed negative attitude towards alcoholic drinks than those presented with health related warning labels. Warning labels have influence on the alcohol users attitude towards alcoholic drinks.
Strasser, A. A., Tang, K. Z., Romer, D., Jepson, C., & Cappella, J. N. (2012). Graphic warning labels in cigarette advertisements: recall and viewing patterns. American journal of preventive medicine43(1), 41-47. To assess variation in viewing and recall patterns of text –only and pictorial label warning signs on cigarate smokers. Quantitative research method was used in which participants were usual smokers. Participants were presented with text only and graphic label warnings. The level of their attention on both was recorded. There is a relationship between graphic label warnings and behavioural change on cigarate smokers. pictorial or graphic warning signs increases smokers warning recalls on the health implications of cigarate smoking.
Scholes‐Balog, K. E., Heerde, J. A., & Hemphill, S. A. (2012). Alcohol warning labels: Unlikely to affect alcohol‐related beliefs and behaviours in adolescents.          Australian and New Zealand journal of public health36(6), 524-529. To examine the influence of alcohol warning labels on adolescents. Quantitative research method was used in which adolescents were the participants. Adolescents were randomly chosen and exposed to different beverage and alcoholic  warning signs. Adolescents does not view messages on alcohol warning messages with keenness. No influence was recorded.
Jones, S. C., & Gregory, P. (2010). Health warning labels on alcohol products—The views of Australian university students. Contemporary Drug Problems37(1), 109-137. To determine the attitudes and opinions of university students on health label warnings on alcoholic products. Quantitative survey was done in which university students were the participants. 18-30-year-old university students were provided with questionnaire with questions online. Responses were made through email. Data obtained was then analysed. Very few individuals pay attention on warning labels on alcohol products.
Stark, E., Kim, A., Miller, C., & Borgida, E. (2008). Effects of Including a Graphic Warning Label in Advertisements for Reduced‐Exposure Products: Implications for Persuasion and Policy 1. Journal of Applied Social Psychology38(2), 281-293. To determine whether warning labels on alcoholic bottles have influence on alcoholic users. Qualitative research method was used in which alcoholic users were the participants. Participants were presented with two different warning labels. The first one being ‘alcohol abuse is dangerous’ and the second label being a pictorial. Data obtained was then analysed by use of double manual coding. No warning label attracted participant’s attention.
Torres, I. M., Sierra, J. J., & Heiser, R. S. (2007). The effects of warning-label placement in print ads: A social contract perspective. Journal of Advertising36(2), 49-62. To determine the impact of print advertisements on alcohol users. Quantitative research method was used. The researchers collected wide range of magazines and analysed the consumers’ response to print media adverts. There is no impact of warning media placement in magazine.
Smith-Jackson, T. L., & Wogalter, M. S. (2000, July). Users’ hazard perceptions of warning components: An examination of colors and symbols. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 44, No. 32, pp. 6-55). Sage CA: Los Angeles, CA: SAGE Publications. To determine the impacts of warning signs in e – cigarette advertising on cigarette smokers. Quantitative research method was used in which participants were interviewed online. Participants were selected randomly and recruited via online. They were then exposed to different electronic advertisements – some coloured, others in black and white. Coloured warning label design attracts attention of cigarette smokers than those in plain text.
MacKinnon, D. P., & Lapin, A. (1998). Effects of alcohol warnings and advertisements: A test of the boomerang hypothesis. Psychology & Marketing15(7), 707-726. To determine the effect of alcohol warning labels on boomerang effect. Quantitative research method was used. Two experiments were conducted and then analysed. Advertisement lead to significant perceived benefits and lower perceived risks.
Barlow, T., & Wogalter, M. S. (1993). Alcoholic beverage warnings in magazine and television advertisements. Journal of Consumer Research20(1), 147-156. To explore the effects of warnings in media advertisements in print media or broadcasting. The study was done using quantitative method through experimental design. Two different experiments investigating the effects of warning advertisements using mass media on alcoholic drinks were used. The first one was based on visual and another on print media. Shapes and writings with different conspicuousness were used and participants questioned. The two experiments showed that individuals exposed to high conspicuous warnings in both print and broadcasting advertisements responded faster than those exposed to less conspicuous advertisement warnings.
Beltramini, R. F. (1988). Perceived believability of warning label information presented in cigarette advertising. Journal of Advertising17(2), 26-32. To investigate the presumed believability of cigarate warning label of data among the youth. Questionnaires were used among individuals 14 health warning labels were shown to participants in the questionnaire. Participants were asked to indicate the level to which health warning labels impacts on cigarate and non cigarate smokers. Semantic differential scale ranging between 1 -5 was used. The perceived health risks do not guarantee  individual’s abstinence from cigarettes.
Smith, S. J. (1990). The impact of product usage warnings in alcoholic beverage advertising. Journal of Public Policy & Marketing9(1), 16-29. To determine the effects of product usage warnings in alcoholic advertisements. Quantitative research method was used in which participants were mostly females. Participants were exposed to different warning labels and then given questionnaires to fill. Product usage warning labels does not influence the consumption of alcohol among alcohol users.