Fear or Knowledge The Impact of Graphic Cigarette Warnings on Tobacco Product Choices

Requiring graphic warning labels (GWLs) on cigarette packaging has become a highly contentious unresolved legal battle. The constitutionality depends, in part, on the likely impact of GWLs on smoking decisions, and whether they generate knowledge as opposed to emotional reactions against smoking. Using an online discrete choice stated preference experiment we compare tobacco choices (cigarettes, e-cigarettes, quitting) for those presented with a GWL versus the currently existing label. We find the fraction of individuals choosing cigarettes to be lower and quitting higher for the GWL group. Our findings reveal that the differences between groups were primarily driven by the evocation of fear and disgust rather than an improvement in health knowledge related to the GWL. The discrete choice experiment also provides new evidence on how cigarette prices, e-cigarette prices, and policy-manipulable e-cigarette attributes such as e-cigarette warning labels, and flavor availability influence tobacco product choices