Smokers who see graphic warning labels on their packs of cigarettes have more negative feelings about smoking, and are more likely to remember the health risks than those who just see text warnings, a new study suggests. According to the Ohio State University researchers, people who view graphic images are also more likely to consider quitting.

In the United States, cigarette smoking causes nearly half a million deaths each year, explain the authors, while other nations report similar high mortality figures. In an attempt to reduce these big numbers, 77 countries around the world require graphic warning labels on cigarette packs, a practice the U.S. decided to follow in 2009 when they became mandatory here as well. However, the D.C. Circuit Court, a judicial body with the authority to invalidate laws deemed unconstitutional, soon blocked the graphic warning requirement.

Specifically, the D.C. Circuit Court ruled “the images proposed by the Food and Drug Administration were unconstitutional and ‘unabashed attempts to evoke emotion… and browbeat consumers into quitting,’” wrote Dr. Abigail Evans, lead author and a postdoctoral researcher in psychology at Ohio State, and her colleagues.

Evans along with Dr. Ellen Peters, a professor of psychology at Ohio State, and their colleagues from University of Missouri, University of Pennsylvania, and Northwestern University decided to investigate the nature of the influence of graphic warning labels.

Do Ugly Pictures Work?

For the study, the researchers recruited 293 adult smokers as participants. For four weeks, participants were provided with their favorite brand of cigarettes in modified packages. While all the packages had the same text messages, some participants received packs with only these messages while others received packs with text warnings plus one of nine graphic, somewhat disturbing images showing the dangers of smoking — these had been created by the FDA. (One of the labels, for instance, included an image of a man smoking through a hole in his throat, called a tracheostomy.) A third group of participants received both the text and the image, plus additional details about how each cigarette entails health risks. Each week, participants returned to the lab for additional cigarettes and at that time they answered questions from a survey.

So how did the experiment turn out? Smokers given packs with graphic warning labels were more likely than those who received text-only warnings to report they felt worse about smoking, the researchers discovered. They were more likely to look closely at the information and better remember it, plus they saw the warnings as more credible. “Policies requiring such labels have the potential to reduce the number of Americans who smoke,” concluded the authors.

Ultimately, is it wrong to stir emotions, if strong feelings are what lead people to think more carefully about the health risks of their behavior? Smoking cigarettes will raise your risk of developing all types of cancer, not just lung and throat cancers, while also raising your risk of heart disease and other illnesses. With the new year upon us, quitting the cancer sticks is a perfect go-to resolution for 2016.

Source: Evans AT, Peters E, Strasser AA, et al. Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial. PLoS One. 2015.