Does Visual Attention To Graphic Warning Labels On Cigarette Packs Predict Key Outcomes Among Youth And Low-Income Smokers?

Objectives: In this study, we examined whether patterns of visual attention to graphic warning labels on images of cigarette packs predict key outcomes associated with warning label effectiveness. Methods: A mobile lab with 5 eye tracking stations traveled to socioeconomically disadvantaged communities to recruit biologically confirmed adult smokers (Study 1: N = 725) and middle school youth (Study 2: N = 767). We examined patterns of association between eye tracking measures and negative emotional responses, health risk beliefs, intentions to quit smoking (Study 1), and susceptibility to smoke in the future (Study 2). Results: In both studies, participants attended to warnings over branded content. Within the warning area, images attracted attention for longer than text. Findings differed between studies in how attention to content features predicted discrete emotions. Youth who gazed longer at the images in warnings reported lower susceptibility to future smoking. Conclusions: Images function as an important addition to text warnings, partly because they divert attention from branded content. Fixation on images associate with key outcomes, including negative affect and, for youth only, susceptibility to smoking.