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The emotional impact of European tobacco-warning images
  1. M A Muñoz1,
  2. M I Viedma-del-Jesús2,
  3. F Rosselló1,
  4. N Sánchez-Nácher1,
  5. P Montoya1,
  6. J Vila3
  1. 1Research Institute on Health Sciences (IUNICS), Department of Psychology, University of the Balearic Islands, Palma, Spain
  2. 2Department of Marketing and Market Research, University of Granada, Granada, Spain
  3. 3Department of Personality, University of Granada, Granada, Spain
  1. Correspondence to Dr M A Muñoz, Departamento de Psicología, Research Institute on Health Sciences (IUNICS) Building, Cra.deValldemossa, km 7.5, Palma (IllesBalears), Palma de Mallorca E-07122, Spain; miguelamuoz{at}


Objective The emotional impact of the tobacco-warning images proposed by the European Commission to reduce tobacco consumption is evaluated in the context of the International Affective Picture System, a well-established procedure for investigating appetitive (approach) and defensive (avoidance) motivational tendencies evoked by images.

Methods In a cross-sectional study, 597 healthy male and female volunteers (from the University of Granada, the University of Balearic Islands and four different schools of Valencia and Balearic Islands) distributed in six age groups (13–14, 15–16, 17–18, 19–20, 21–22 and over 23 years old) and four smoking status groups (non-smokers, one-time smokers, occasional smokers and heavy smokers) rated their emotional responses to 35 European tobacco-warning images together with 42 pleasant and 42 unpleasant International Affective Picture System pictures using the valence and arousal scales of the Self-Assessment Manikin.

Findings The results of the study indicate that the majority of the tobacco-warning images (83%) were distributed within the unpleasant space and ranged from moderately unpleasant to very unpleasant. However, a small but significant number of images (17%) were also distributed within the pleasant space, ranging from moderately pleasant to very pleasant. Only four unpleasant pictures were rated as highly arousing (11.4%). Women, the older age groups (over 17 years old), and occasional smokers evaluated these images as significantly more arousing than the other groups.

Conclusion Findings suggest that the capability of the European tobacco-warning images to prompt negative attitudes to reduce tobacco consumption might not extend to the general population but would be limited to specific target groups.

  • Packaging and labelling
  • tobacco
  • warning images
  • avoidance behaviour
  • defensive motivation
  • emotion
  • prevention
  • nicotine
  • addiction
  • cessation
  • global health
  • smoking-caused disease

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  • Funding This work was supported by Spanish Ministry of Science and Innovation, grant number JCI-2008-3074.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethical committee of University of Granada and ethical committee of University of Balearic Islands.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data might be available only on request to MAM.