Jochim Hansen and colleagues first measured how important smoking was to the self-esteem of 39 student smokers. Example questionnaire items included 'smoking allows me to feel valued by others'. Next, the smokers were divided into two groups: one group looked at two cigarette packs that featured death-related warnings, such as 'Smokers die earlier'. The other group looked at cigarette packs that featured death-neutral warnings, such as 'Smoking makes you unattractive.'
Fifteen minutes later all the students reported their attitudes to smoking; the questionnaire included items such as 'Do you intend to quit smoking?'. Among the students for whom smoking was important to their self-esteem, those who looked at packets with death-related warnings subsequently reported more positive attitudes to smoking compared with those who looked at death-neutral packets. The exact opposite pattern was found for students for whom smoking was not important for their self-esteem.
In other words, for smokers who derive a self-esteem boost from smoking - perhaps they see it as a key part of their identity or they think it makes them look cool - a death-related cigarette packet warning can have the ironic effect of making them want to smoke more, so as to buffer themselves against the depressing reminder of their own mortality. The findings suggest that for these kinds of smokers, packet warnings that target positive beliefs about smoking (e.g. 'Smoking makes you look unattractive') could well be more effective.
'To succeed with anti-smoking messages on cigarette packs one thus has to take into account that considering death may make some people smoke,' the researchers concluded.
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Hansen, J., Winzeler, S., & Topolinski, S. (2010). When the death makes you smoke: A terror management perspective on the effectiveness of cigarette on-pack warnings. Journal of Experimental Social Psychology, 46 (1), 226-228 DOI: 10.1016/j.jesp.2009.09.007
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I don't think there's a lack of awareness that smoking kills. People start to smoke mostly down to their social interactions with their peer group.
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