Each time smokers take a cigarette out of their cigarette pack they are confronted with a warning displayed on the front of the pack that may read ‘Smoking causes lung cancer’, ‘Smoking can make you infertile’ or ‘Smoking causes a slow and painful dead’. The warnings on packs of cigarettes are supposed to make smokers concerned about the hazardous consequences of smoking in such a way that they will stop smoking, yet most smokers continue to smoke.

Does that mean that the warnings are ineffective? If these warnings are indeed ineffective, what should be put on a cigarette pack to convince smokers to quit smoking? For example, would it help if the message made smokers feel like they themselves were personally at risk to die from smoking? Alternatively, would it help if smokers were informed how to stop smoking?

Warnings that are printed on cigarette packs are just one example of fear-arousing communications. Fear-arousing communications have been used in health education campaigns since the 1950’s, and have been applied to numerous different topics. Fear-arousing communications usually consist of two parts, namely (1) a fear appeal that stresses the severity of and personal vulnerability to a health risk, and (2) an action recommendation that emphasizes how to reduce or eliminate the health risk.

The basic assumption underlying fear-arousing communications is that the more one succeeds in making individuals concerned about the negative consequences of a certain behavior, the higher will be the probability that they change their health impairing behavior.

Over fifty years of empirical research on fear-arousing communications has resulted in a large body of evidence that shows that high fear messages are generally more effective than low fear messages in changing people’s attitudes, intentions and behavior. However, these empirical studies have not succeeded in fully explaining the processes underlying the effects of fear-arousing communications on persuasion.

Moreover, insufficient attention has been devoted to explaining why health education campaigns using fear-arousing communications are sometimes ineffective in changing individual’s health impairing behaviors.

Although to date little research has been done to assess the effectiveness of cigarette warning labels on quitting smoking, the limited research that is available shows that these warnings mainly affect smokers who already intended to quit within the next year.

More importantly, only stressing the negative consequences of a certain behavior is not enough in changing individuals’ intentions and behaviors. That leaves us with the question what should be put on a cigarette pack to convince smokers to quit smoking.