On SAGE Insight: Disgust – the way forwards for effective health campaigns?

GEIs disgust the driver behind the selection of images for UK tobacco packets?

From Health Education Journal

Health campaigns sometimes use scare tactics, deploying fear to steer us towards changing our ways to avoid future illness. But what if disgust, rather than fear, has a greater impact? This study based on UK cigarette packaging, reveals the most disgusting smoking-related images also have the greatest potential to persuade smokers to quit. The researchers surveyed 291 participants – including medical students, psychology students, and members of the public attending a science fair – to gauge their disgust ratings for a series of images. In addition, they analyzed results from a further 19,812 participants, who had given their responses to the same images as part of a national public consultation exercise relating to cigarette packaging. consultation aimed to identify the images most likely to encourage smokers to give up – but the data also offered the authors an ideal opportunity to explore the possible role of the disgust emotion. There was a strong association between images selected by the public consultation to dissuade smokers, and the survey participants’ disgust ratings. The authors ask whether there is an optimal level of disgust, what the limitations of disgusting images might be, and whether they will continue to have a sustained effect on those who see them. The article suggests “Policymakers should seriously investigate the introduction of vivid, graphic warnings from the perspective of generating disgust emotion as well as fear to promote tobacco cessation.” Improved understanding of all factors could lead to “better” nasty images out there in future, steering us, the researchers conclude, towards healthier behaviour.




Objective: The use of pictorial warning labels on tobacco packets has gained almost universal international acceptance. In a public consultation exercise in 2006, the Department of Health in England, through a web-based answering system, asked people’s preferences of 42 images, asking which images might be effective to encourage tobacco cessation in smokers. On cursory inspection of the rank order of preference, a pattern appeared to suggest that effectiveness was associated with the level of disgust emotion generated; that is, the images rated the most likely to persuade smokers to quit tobacco consumption appeared revolting. The objective of this study was to confirm that disgust emotion generated by United Kingdom (UK) tobacco packet images was associated with the public’s selection of possible effective images.

Design: Three cross-sectional opinion surveys were conducted including students from medicine and psychology disciplines and a section of the public. In addition, a web opinion consultation database was made available for secondary analysis.

Method: A total of 291 participants were involved in the three convenience surveys and 19,812 participants gave complete replies to the public consultation website. Each individual rated every image on a five-category rating scale ranging from ‘extremely disgusting’ to ‘not disgusting’.

Results: Significant correlations (ranging from 0.91 to 0.94) existed between the image rank order aggregated preference ratings from the original public consultation and the average final score of the disgust ratings for specific items for the three groups.

Conclusion: The emotion of disgust may be a possible intervening variable to explain the initial reactions to health promotion materials and smoking cessation


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Article details
Gerry Humphris and Brian Williams
Is disgust the driver behind the selection of images for UK tobacco packets? Health Education Journal 0017896913496399, first published on August 27, 2013 doi:10.1177/0017896913496399


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