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January 6, 1989, Vol 261, No. 1 >
ARTICLE | January 6, 1989

The Surgeon General's Warnings in Outdoor Cigarette Advertising: Title and subTitle BreakAre They Readable? FREE

Ronald M. Davis, MD; Juliette S. Kendrick, MD
[+] Author Affiliations

Reprint requests to Office on Smoking and Health, Centers for Disease Control, 5600 Fishers Lane, Rockville, MD 20857 (Dr Davis).


JAMA. 1989;261(1):90-94. doi:10.1001/jama.1989.03420010100041
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References

Outdoor advertising media represent a major vehicle by which cigarette companies promote their products. We investigated the readability of the Surgeon General's warning in cigarette advertisements (ads) in two outdoor media: billboards and taxicab ads. In an experiment in metropolitan Atlanta under typical driving conditions, observers were able to read the entire health warning on 18 (46%) of 39 street billboards but on only two (5%) of 39 highway billboards. In contrast, the content of the ads (ie, brand name, other wording, and notable imagery) could be recognized under the same conditions on more than 95% of the billboards. In a similar study of 100 taxicab cigarette ads in New York City, observers were unable to read the health warning in any of the ads but were able to identify the brand name in all ads and notable imagery in 95% of the ads. Significant differences between the readability of the warning and identification of the advertising content persisted even when partially read warnings were considered to have been read. We conclude that the Surgeon General's warning is not readable in its current form in the vast majority of billboard and taxicab ads. Factors contributing to unreadability include the small size of the letters, the excessive length of the warnings, the distance between the viewers and the ads, and movement between the viewers and the ads.

(JAMA 1989;261:90-94)

REFERENCES

1 +
FTC Decis 1972;;80:455-465.
2 +
Report to Congress Pursuant to the Federal Cigarette Labeling and Advertising Act For the Year 1980 . Federal Trade Commission, 1982;.
3 +
U.S.A. v Liggett et al, 76 Civ 811 (SDNY1981).
4 +
U.S.A. v R. J. Reynolds Tobacco Co., 1980-1981 Trade Cas (CCH) ¶63,847 (S. D. N. Y. 1981).
5 +
 The unique harm of cigarette billboards . NY State J Med 1983;;83:1321.
6 +
Advertising of Tobacco Products: Hearings Before the Subcommittee on Health and the Environment, House of Representatives Committee on Energy and Commerce, 99th Cong, 2nd sess (July 18 and Aug 1, 1986), serial No. 99-167, pp 772-779 (testimony of Edward T. McMahon, executive director, Coalition for Scenic Beauty).
7 +
Davis RM:  Current trends in cigarette advertising and marketing . N Engl J Med 1987;;316:725-732.
8 +
Cullingford R, Da Cruz L, Webb S, et al:  Legibility of health warnings on billboards that advertise cigarettes . Med J Aust 1988;;148:336-338.
9 +
Cigarette Labeling and Advertising: Hearings Before the House of Representatives Committee on Interstate and Foreign Commerce, 88th Cong, 2nd sess (June 23-25, 29, and July 2, 1964), pp 137-169 (testimony of Bowman Gray, chairman, Board of Directors, R. J. Reynolds Tobacco Co).
10 +
Report to Congress Pursuant to the Federal Cigarette Labeling and Advertising Act, 1986 . Federal Trade Commission, 1988;.
11 +
Review of the Research Literature on the Effects of Health Warning Labels: A Report to the United States Congress . Office of the Assistant Secretary for Health, US Dept of Health and Human Services, 1987;.
12 +
Fischer PM, Richards JW, Berman EJ, et al:  Recall and eye tracking study of adolescents viewing tobacco advertisements . JAMA 1989;;261:84-89.
13 +
Myers ML, Iscoe C, Jennings C, et al: Federal Trade Commission Staff Report on the Cigarette Advertising Investigation . Federal Trade Commission, 1981;.
14 +
Dumas BK:  The adequacy of federally mandated cigarette package warnings , in Levi J, Walker AG (eds): Language in the Judicial Process . New York, Plenum Press, in press.
15 +
Richards JI, Zakia RD:  Pictures: An advertiser's expressway through FTC regulation . Georgia Law Rev 1981;;16:77-134.
16 +
Zerner C:  Graphic propositions: The efficacy of imagery and the impotence of warnings in cigarette advertising . Tobacco Products Litigation Rep 1986;;1:4:71-4.85.
17 +
Romano F: Practical Typography From A to Z . Arlington, Va, National Composition Association, 1983;.
18 +
Kemp JE: Planning and Producing Audiovisual Materials , ed 2. Scranton, Pa, Chandler Publishing Co, 1968;.
19 +
Comprehensive Smoking Prevention Education Act: Appendix to Hearings Before the Subcommittee on Health and the Environment, House of Representatives Committee on Energy and Commerce, 97th Cong, 2nd sess (March 5, 11, and 12, 1982), serial No. 97-107, pp 64-119 (report by Keenan & McLaughlin Inc).
20 +
 Health warnings . Health Educ J 1985;;44:218-219.
21 +
 Smoking-attributable mortality and years of potential life lost—United States, 1984 . MMWR 1987;;36:693-697.

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1 +
FTC Decis 1972;;80:455-465.
2 +
Report to Congress Pursuant to the Federal Cigarette Labeling and Advertising Act For the Year 1980 . Federal Trade Commission, 1982;.
3 +
U.S.A. v Liggett et al, 76 Civ 811 (SDNY1981).
4 +
U.S.A. v R. J. Reynolds Tobacco Co., 1980-1981 Trade Cas (CCH) ¶63,847 (S. D. N. Y. 1981).
5 +
 The unique harm of cigarette billboards . NY State J Med 1983;;83:1321.
6 +
Advertising of Tobacco Products: Hearings Before the Subcommittee on Health and the Environment, House of Representatives Committee on Energy and Commerce, 99th Cong, 2nd sess (July 18 and Aug 1, 1986), serial No. 99-167, pp 772-779 (testimony of Edward T. McMahon, executive director, Coalition for Scenic Beauty).
7 +
Davis RM:  Current trends in cigarette advertising and marketing . N Engl J Med 1987;;316:725-732.
8 +
Cullingford R, Da Cruz L, Webb S, et al:  Legibility of health warnings on billboards that advertise cigarettes . Med J Aust 1988;;148:336-338.
9 +
Cigarette Labeling and Advertising: Hearings Before the House of Representatives Committee on Interstate and Foreign Commerce, 88th Cong, 2nd sess (June 23-25, 29, and July 2, 1964), pp 137-169 (testimony of Bowman Gray, chairman, Board of Directors, R. J. Reynolds Tobacco Co).
10 +
Report to Congress Pursuant to the Federal Cigarette Labeling and Advertising Act, 1986 . Federal Trade Commission, 1988;.
11 +
Review of the Research Literature on the Effects of Health Warning Labels: A Report to the United States Congress . Office of the Assistant Secretary for Health, US Dept of Health and Human Services, 1987;.
12 +
Fischer PM, Richards JW, Berman EJ, et al:  Recall and eye tracking study of adolescents viewing tobacco advertisements . JAMA 1989;;261:84-89.
13 +
Myers ML, Iscoe C, Jennings C, et al: Federal Trade Commission Staff Report on the Cigarette Advertising Investigation . Federal Trade Commission, 1981;.
14 +
Dumas BK:  The adequacy of federally mandated cigarette package warnings , in Levi J, Walker AG (eds): Language in the Judicial Process . New York, Plenum Press, in press.
15 +
Richards JI, Zakia RD:  Pictures: An advertiser's expressway through FTC regulation . Georgia Law Rev 1981;;16:77-134.
16 +
Zerner C:  Graphic propositions: The efficacy of imagery and the impotence of warnings in cigarette advertising . Tobacco Products Litigation Rep 1986;;1:4:71-4.85.
17 +
Romano F: Practical Typography From A to Z . Arlington, Va, National Composition Association, 1983;.
18 +
Kemp JE: Planning and Producing Audiovisual Materials , ed 2. Scranton, Pa, Chandler Publishing Co, 1968;.
19 +
Comprehensive Smoking Prevention Education Act: Appendix to Hearings Before the Subcommittee on Health and the Environment, House of Representatives Committee on Energy and Commerce, 97th Cong, 2nd sess (March 5, 11, and 12, 1982), serial No. 97-107, pp 64-119 (report by Keenan & McLaughlin Inc).
20 +
 Health warnings . Health Educ J 1985;;44:218-219.
21 +
 Smoking-attributable mortality and years of potential life lost—United States, 1984 . MMWR 1987;;36:693-697.

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