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Using Eye Tracking to Understand and Improve Graphic Warning Label Effectiveness

Principal Investigator: Andrew Strasser

Funding Mechanism: National Institutes of Health- Grant

ID number: 1R01CA180929-01

Award Date: 9/5/2013

Institution: University of Pennsylvania

Population-level research indicates that graphic warning labels (GWLs) are effective in eliciting negative responses to smoking, increasing reported intention to quit, and modifying beliefs about the dangers of smoking; however, this research does not evaluate which aspects of GWLs make them effective. A critical indicator of GWL effectiveness is whether smokers can correctly recall their content; recent eye tracking research has revealed that how quickly individuals attend to the text in the label and how long they dwell on the image are positively associated with correct recall, and other research indicates that congruent label features (i.e., the text and image have similar or complementary messages) also leads to better recall. The goal of this study is to provide empirical data regarding the aspects of GWLs that make them effective, how viewing patterns impact effectiveness, and the effect of recall on smoking attitudes and beliefs, intention to quit, and smoking behavior. Investigators will randomize 360 adult daily smokers (aged 21-60) to exposure to one of the nine FDA-approved GWLs, paired with a text warning that is congruent or incongruent. Participants will have their eye tracking assessed during the initial exposure to the GWL and then receive their own brand cigarettes with the same GWL affixed to their packs. Over ten days, participants will attend three additional laboratory visits, where they will: complete measures of recall, cigarette risk beliefs, attitudes, and intentions to quit smoking; report daily cigarette consumption and smoking topography (i.e., puffs, puff volume, puff duration, maximum flow, interpuff interval); and participate in eye tracking assessments that reveal label feature viewing order and dwell duration. Specific aims are: (1) to examine the effect of GWL format and eye tracking patterns on initial recall; (2) to examine the effect of viewing patterns, GWL type and initial recall on long term recall, beliefs, attitudes, intentions, and smoking behaviors; and (3) to examine the effects of individual differences (i.e., education, nicotine dependence, numeracy-literacy) on the above stated outcomes to identify prone sub-groups.

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