Work

Reframing cigarettes as social currency: A randomized survey experiment on the role of warning images and pricing

Year: 2025

Type: article

Abstract: INTRODUCTION: In China, cigarettes function as both consumer goods and 'social currency'. Despite increased awareness of smoking risks, cigarette gifting persists. This study examines whether graphic warning images and price increases can reduce the social value of cigarettes in gifting contexts. METHODS: A survey experiment was conducted (n=744), randomly assigning participants to a control group (n=189), a price treatment group (n=285), and an image warning group (n=270). Eligible participants were adults with stable incomes. Participants in the price treatment group viewed the same cigarette brands as in the control condition but with retail prices doubled relative to the market price, whereas those in the image treatment group viewed cigarette packs with added graphic warning images while prices remained unchanged. The primary outcomes were willingness to gift or receive cigarettes in strong and weak relationships (1=very unwilling to 5=very willing) and brand tier preference (1=low, 2=mid, 3=high), and logistic regressions were applied to assess treatment effects. All comparisons were made against the control group, and logistic regression results are presented as coefficients (β) with 95% confidence intervals (CI). RESULTS: Graphic warning images significantly reduced willingness to gift cigarettes (β= -0.88; 95% CI: -1.33 - -0.42, p<0.001) and expectations to receive cigarettes (β= -0.62; 95% CI: -1.08 - -0.16, p<0.01) in weak relationships but had no significant effect in strong relationships. Price increases did not affect gifting willingness but reduced brand preference in weak relationships (β= -0.67; 95% CI: -1.11 - -0.23, p<0.01). CONCLUSIONS: Graphic warnings effectively weaken the symbolic value of cigarettes in non-intimate relationships, while price increases alone are insufficient. Tobacco control strategies should prioritize altering symbolic meanings rather than relying solely on economic measures.

Source: Tobacco Induced Diseases

DOI: 10.18332/tid/211071

Authors: Yabin Xing, Wei Wen, Gang Wang, Kecheng Du

Institutions: Wuhan University, Tongji Hospital, Huazhong University of Science and Technology, Ningbo University

Language: English

Topic: Smoking Behavior and Cessation

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,372