The Paradox of Smoking & Perceived Stress: Do Graphic Health Warnings Influence Smokers under High Stress in Adverse Ways?

Abstract

The positive effects of graphic health warnings (GHWs) on quitting smoking have been widely demonstrated in the literature on cigarette warning. However, recent findings of smoker reactance to GHWs demand investigations of factors that may constrain the effects of GHWs. The current study sought to identify conditions in which GHWs do not have a positive impact on smokers' desire to quit with a focus on smokers' perceived stress. Two hundred and forty-four smokers in South Korea were exposed to either a text-only or a GHW cigarette pack in a between-subjects experiment. Results from this study suggest that the GHW condition is effective in increasing attention to the GHW, enhancing perceived usefulness of information, and desire to quit only among those with low (vs. high) perceived stress. In addition, an interaction effect between warning type and perceived stress on the desire to quit was sequentially mediated by attention and perceived information effectiveness. Based on the results, we suggest that GHWs were less effective for smokers with high levels of perceived stress because their stress appeared to exhaust the cognitive resources necessary to process the information.