Institute For The Future

What You Know Can Kill You

"Smoking can kill you"--it's an old message, but appears as one of several new blunt warning labels on packs of cigarettes along with other much more explicit messages such as "Cigarettes cause cancer." Though the new warning labels are aimed at more directly communicating the health risks of smoking to encourage people to quit, a small study suggests the new labels may have the opposite effect, at least for some smokers who view smoking as a positive aspect of their self-identities.

In the study, researchers gave a group of 39 smokers a questionnaire about their feelings of self-identity and smoking; half of the participants also read smoking warnings that linked smoking to mortality risk, while the other half read warnings that did not directly tie smoking to dying. For individuals who saw smoking as related to positive aspects of their self-identities, smoking labels related to dying actually increased their desire to smoke, while warnings that did not mention death discouraged their desires.

According to Miller-McCune, the surprising result stems from the effect that a sudden fear of death can have on a person's psyche.

 

[O]ur awareness of our own deaths creates the potential for extreme anxiety, which we keep at bay by reaffirming faith in our belief systems (which give our lives a sense of meaning) and maintaining a high level of self-esteem.

Reasonably enough, the researchers assert that for some people, smoking is a facet of their positive self-image. They consider the habit sexy or attractive, or perhaps a proud example of their rebellious spirit.

For those individuals, terror management theory suggests mortality-laced warning labels could be counterproductive. The threat to one's life would presumably result in an urge to pump up one's self-esteem — which, for those individuals, could easily mean a renewed commitment to smoking.

 

Of course, with just 39 participants, the study is small and requires some additional research to confirm. And as the study's authors note, since only individuals who tie smoking to self esteem get scared into smoking more by warning labels, it's impossible to determine population-wide effects of the labeling.

That said, the study's authors suggest that in light of their findings, public health officials develop "risk communication that matches the self-esteem contingencies of the recipient." Which is to say that for a certain segment of the population, it might make sense to deliver messages like "smoking stains your teeth" that focus on the social costs of smoking.