Public Preferences for an Attribution to Government or to Medical Research Versus Unattributed Messages in Cigarette Warning Labels in Israel

The history of cigarette warning labels is fraught with dispute, and in many instances official anti-smoking warnings that appear on cigarette packets are the result of political compromise. Despite mixed findings on the effectiveness of these warning labels, they are viewed as a cost-effective anti-smoking measure by their mere presence and as an important part of larger anti-smoking efforts. Israel's Ministry of Health, in its recent initiative to introduce a new series of warning labels, has grappled with the attribution issue. A committee established by the Ministry to revise the warnings decided to survey public opinion to guide its decision regarding to whom warnings should be attributed and to counter tobacco lobby oppositions. Two surveys were conducted: a limited phone survey of the adult population (n = 1000) and a face-to-face survey of 200 adult smokers. Findings indicate there was little support for unattributed warnings and that smokers, when presented with actual warnings, tended to favor the attribution to "medical studies." Nonsmokers were somewhat more likely to prefer an attribution to the Ministry of Health, explaining that it is "responsible for the topic" or "has the authority." Attributional preferences were found to be associated to some extent with educational level. Discrepancies found between preferences of light smokers across the 2 surveys suggest that the method of preference elicitation may play an important role. The discussion of the attributional preferences draws from the persuasion literature and it is suggested that warning messages should be matched with selected sources.