Cigarette packages in Canada come with horrifying images and statistics about the damage they can cause to an individual's health. The picture below shows a graphic picture of mouth disease on a cigarette pack with a warning that cigarettes do indeed cause mouth diseases:
Another package of cigarettes I saw recently contained pictures of diseased lungs on the outside, and contained a card of statistics inside about the grim chances of survival after contracting lung cancer:
Interestingly, the card focuses on the high chances of dying once lung cancer is diagnosed, and doesn't state the less shocking statistic that only 17.2% of male smokers and 11.6% of female smokers can be expected to develop lung cancer at some point during their life.
Interestingly, the card focuses on the high chances of dying once lung cancer is diagnosed, and doesn't state the less shocking statistic that only 17.2% of male smokers and 11.6% of female smokers can be expected to develop lung cancer at some point during their life.
Obviously, these warnings serve as a useful deterrent or "nudge" to stop people from smoking. But it occurred to me that there might also a negative placebo effect associated with the warnings. If people see messages on cigarette packages about how harmful smoking is, perhaps they'll believe they're destined to become sick by smoking, compounding the negative physical effects actually caused by the cigarette.
This may sound far-fetched, but the placebo effect seems to be becoming more and more powerful — at least as far as drugs are concerned. And research into nicotine patches to help smokers quit has found that people who think they received a nicotine patch but actually receive a placebo have more success quitting than people who received an actual nicotine patch but thought it was just a placebo.
The idea of a placebo effect having negative consequences — also called a "nocebo effect" — seems to have some merit. A fascinating Washington Post article highlights some studies that show that people who believe they are more susceptible to a disease actually get it and people who are informed of a negative side effect of a drug are far more likely to actually develop that side effect. So maybe shoving reminders about lung cancer and mouth disease in smokers' faces actually makes the problem worse, not better.
A quick internet search did not turn up any studies on whether dire warnings on cigarette packs might cause a nocebo effect. It might be a worthwhile question for a researcher in the field to try and answer.
I don't believe in such a physical nocebo effect. Probably what is happening is that people who know about certain negative effects observe them more acutely. Also, you should make a distinction between side-effects like nausea and headaches (which to some extent can be self-induced and whose severity is subjective) and actual diseases such as lung cancer.
ReplyDeleteNonetheless, it doesn't really matter if you're actually unhealthy or just feel unhealthy -- the outcome is the same. Also, if you think you're about to die of lung cancer you'll be more likely to make unhealthy decisions. I think this is the real danger, and a serious moral concern for the government agency publishing these warnings.
It is taboo to call someone "fat" or even to mention that they're overweight, but as a society we seem to have no problem calling people idiots for smoking. (Though I don't think it will be long before fast food wrappers contain warnings about heart disease and late-onset diabetes accompanied by pictures of morbidly obese people.) This may prevent more people from starting to smoke in the first place, but it's not doing much good for those who already smoke.
Incidentally, smoking is very common in Moscow, and cigarettes are very cheap (about $1 a pack).
The brain does not get unwell when presented with negative information all the time?
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