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David Hammond, MSc, Geoffrey T. Fong, PhD, Paul W. McDonald, PhD, K. Stephen Brown, PhD and Roy Cameron, PhD

David Hammond and Geoffrey T. Fong are with the Department of Psychology at the University of Waterloo, Waterloo, Ontario. Paul W. McDonald and Roy Cameron are with the Department of Health Studies, and K. Stephen Brown is with the Department of Statistics and Actuarial Science at the University of Waterloo. Paul W. McDonald and K. Stephen Brown are also with the Ontario Tobacco Research Unit. Geoffrey T. Fong, Paul W. McDonald, Roy Cameron, and K. Stephen Brown are also with the Centre for Behavioural Research and Program Evaluation, University of Waterloo.

Correspondence: Requests for reprints should be sent to David Hammond, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada (e-mail: dhammond{at}uwaterloo.ca).

Objectives. We assessed the impact of graphic Canadian cigarette warning labels.

Methods. We used a longitudinal telephone survey of 616 adult smokers.

Results. Approximately one fifth of participants reported smoking less as a result of the labels; only 1% reported smoking more. Although participants reported negative emotional responses to the warnings including fear (44%) and disgust (58%), smokers who reported greater negative emotion were more likely to have quit, attempted to quit, or reduced their smoking 3 months later. Participants who attempted to avoid the warnings (30%) were no less likely to think about the warnings or engage in cessation behavior at follow-up.

Conclusions. Policymakers should not be reluctant to introduce vivid or graphic warnings for fear of adverse outcomes.

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