Graphic anti-smoking advertisements are designed to discourage smoking by highlighting its serious health consequences. However, new research suggests that these campaigns may have an unintended effect: encouraging some smokers to switch to vaping rather than quit nicotine altogether. Researchers found that when smokers are exposed to highly graphic warnings on cigarette packaging, but only mild text warnings on e-cigarettes, they may perceive vaping as a safer and less threatening alternative.

The study, published in the Journal of Business Ethics, was led by Elizabeth Howlett and colleagues from Utah Valley University. According to Howlett, the research examined the unintended consequences of fear-based anti-smoking messaging. The findings suggest that graphic cigarette warnings reduce the perceived risks associated with e-cigarettes because vaping products do not carry similarly vivid health warnings. As a result, some smokers become more inclined to try vaping instead of quitting tobacco use entirely.

Graphic health warnings have long been used in public health campaigns because they effectively capture attention and create fear about the consequences of smoking. Many countries already require disturbing visual images on cigarette packaging, and the U.S. Food and Drug Administration has approved regulations mandating graphic images showing the effects of smoking-related diseases such as cancer, stroke, and heart disease. By contrast, warnings on e-cigarette products are typically limited to brief statements noting that nicotine is addictive.

To better understand consumer reactions, researchers conducted four online experiments examining how smokers responded to different warning environments. Participants exposed to strong graphic warnings on cigarettes, alongside minimal warnings on vaping products, showed more favourable attitudes toward e-cigarettes and greater intentions to vape rather than quit smoking. However, when participants were shown more balanced warnings across both cigarettes and e-cigarettes, positive attitudes toward vaping were reduced. The findings suggest that consumers interpret differences in warning styles as signals about relative safety.

The study highlights the importance of clear and balanced public health communication, particularly as vaping continues to grow in popularity. Smoking remains the leading cause of preventable disease and death in the United States, causing nearly half a million deaths annually. Although some evidence suggests vaping may be less harmful than smoking traditional cigarettes, researchers caution that “less harmful” does not mean safe. Emerging evidence has linked vaping to cardiovascular, respiratory, and gastrointestinal problems, while nicotine itself continues to pose significant health risks. At the same time, public understanding of vaping risks remains limited compared with awareness of smoking dangers.

Researchers also warned that health messaging does not affect only current smokers. Young people who may never have considered smoking can still be influenced by perceptions that vaping is relatively harmless. While e-cigarettes were initially promoted as a potential harm-reduction tool for adult smokers, the rapid growth of vaping among youth has become a major public health concern. The authors argue that policymakers should consider the broader messaging environment across all nicotine products rather than evaluating warnings in isolation. Providing stronger and more consistent health warnings on both cigarettes and e-cigarettes may help consumers make more informed decisions about the risks associated with tobacco and nicotine use.

More information: Kamal Ahmmad et al, Unintended Consequences: The Effects of Cigarette Graphic Health Warnings on Electronic Cigarette Risk Perceptions and Intentions, Journal of Business Ethics. DOI: 10.1007/s10551-026-06325-5

Journal information: Journal of Business Ethics Provided by Washington State University