In a study into the effectiveness of shock visuals on cigarette packets, American researchers showed that anxiety-provoking images had a positive impact on regular smokers' behavior.

Since 2012, cigarette packets in the U.S. have displayed shocking photos produced by the FDA that show serious diseases caused by smoking. The aim is to encourage smokers to stop.

For four months, American researchers followed 244 adults who smoked between 5 and 40 cigarettes per day to assess the impact of these disturbing photos on the smokers. One of these images was of a man smoking through a hole in his throat (a tracheostomy procedure which is required in some cases of smoking-induced severe respiratory impairment).

The study, which was published in "PLOS", involved some of the participants receiving packets of their preferred brand of cigarettes containing the warning text message "Cigarettes cause fatal lung disease." A second group received packets of cigarettes with the same message plus one of nine photos showing the damage caused by smoking. A third group was given packets with the text, the photo and an additional message explaining the risks entailed with every cigarette smoked.

To give their feedback, the participants filled in a questionnaire at the lab each week.

The findings showed that the smokers with the packets that had a photo and a warning text message felt much worse about smoking, while continuing to smoke, than the first group. They said they were more receptive to information on the warning labels about smoking, more conscious of the health risks, and remembered what was on the labels for longer. They even mentioned the idea of quitting.

"The graphic images motivated smokers to think more deeply about their habit and the risks associated with smoking," said Ellen Peters, co-author of the study and Psychologist Professor at Ohio State University.

The researchers believe that the impact of these photos is real, because emotions come into play. They are crucial in pushing us to act and make decisions. "For a health issue like smoking, which causes about half a million deaths a year in the United States, even small effects can have a large impact in the population," commented Dr Peters.