Abstract

Objective: To determine the effects of health warning characteristics in smokeless tobacco magazine print ads on warning recall, and the implications for current US Federal regulations.

Design: Subjects examined two distracter ads and one of nine randomly assigned smokeless tobacco ads varying in health warning presence, size (8 to 18 point font), and contrast (low versus high)—including no health warning. They were then interviewed about ad content using recall and recognition questions.

Subjects: A convenience sample of 895 English speaking males aged 16–24 years old who were intercepted at seven shopping malls throughout Massachusetts during May 2000.

Main outcome measures: Proven aided recall, or recall of a health warning and correct recognition of the warning message among distracters, and false recall.

Results: Controlling for covariates such as education, employment/student status, and Hispanic background, proven aided recall increased significantly with font size; doubling size from 10 to 20 point font would increase recall from 63% to 76%. Although not statistically significant, recall was somewhat better for high contrast warnings. Ten per cent of the sample mistakenly recalled the warning where none existed.

Conclusions: As demonstrated by substantially greater recall among ads that included health warnings over ads that had none, health warnings retained their value to consumers despite years of exposure (that can produce false recall). Larger health warnings would enhance recall, and the proposed model can be used to estimate potential recall that affects communication, perceived health risk, and behaviour modification.