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Objectives

Smokers might think that the negative effects of smoking can be compensated for by other behaviours, such as doing exercise or eating healthily. This phenomenon is known as compensatory health beliefs (CHBs). Graphic warning labels on cigarette packets emphasize the negative effects of smoking, which may impact CHBs. Research so far has assessed CHBs explicitly only via questionnaires, although implicit cognition might be an important factor in continuing to smoke. This study investigated the impact of graphic warning labels on CHBs, by testing CHBs both implicitly and explicitly.

Design

The study had a three-group experimental design. ANOVAs and multiple regression analyses were run on the results.

Methods

We assessed explicit CHBs among non-smokers, smokers, and smokers confronted with graphic warning labels (N = 107; 47 females, 23.89 years old, 78 daily smokers). Implicit associations between smoking and CHB-specific behaviours (e.g., eating healthy food) were measured using a Single-Target Implicit Association Test. After the experiment, participants were able to choose between a healthy and unhealthy food reward.

Results

Non-smokers and smokers differed in explicit CHBs but not in implicit cognitions. Warning labels influenced implicit associations among smokers but did not affect explicit CHBs. Most interestingly, implicit associations and explicit CHBs predicted food choice and smoking among smokers not confronted with warning labels.

Conclusions

Graphic warning labels could be used in interventions to inhibit automatic associations between smoking and healthy behaviours. Unlearning implicit cognitions might in turn affect explicit CHBs, thus decreasing their role in reducing the negative feelings caused by smoking.

Statement of contribution

What is already known on this subject? Smokers develop compensatory health beliefs as means to reduce cognitive dissonance. CHBs predict behavioural intentions but not actual behaviours. CHBs so far are assessed via questionnaires. The influence of warning labels has not been investigated so far.

What does this study add? Warning labels only affected implicit cognitions. Implicit as well as explicit CHBs predicted smoking behaviour as well as actual healthy nutrition behaviour among the smokers control group.