Impact of gender, age and smoking habits on the effectiveness of health warning messages on cigarette packets: research on a highly educated Turkish sample

This study investigated the perceived effectiveness of health warning labels (HWs) on smokers and non-smokers. Data were collected online and 342 valid responses were obtained. The impact of HWs in smoking abstinence was analyzed with canonical correlation technique and the results illustrated that the perceived effectiveness of HWs changed with gender, age and smoking levels. HWs depicting unhealthy infants due to second-hand smoking were found to be more effective for female participants. In contrast, depicting male figures who had had heart surgery, a sexual impotence problem and difficulty in breathing during a treadmill stress test were found more effective for males. Although the impact was not very strong, HW that read "smoking causes lethal lung cancer' was considered effective mostly by the older participants. Finally, smoking frequency was not a significant predictor of the perceived effectiveness of all HWs, except for the two warnings which illustrated the adverse effect of second-hand smoking on infants. These two warnings were considered ineffective against the increase in smoking frequency. From a health promotion viewpoint, these findings highlight the importance of including social determinants in the process of HWs design since the effectiveness of HWs changed based on age, gender and the smoking status of participants. Thus, this study recommends that health policymakers tailor HWs based on gender, age, and smoking status rather than mass communicating the same message across different social groups.