“IF you drink alcohol, THEN you will get cancer” –Investigating how reasoning accuracy is affected by pictorially presented graphic alcohol warnings

Aims: To examine variation in reasoning accuracy when evaluating emotive pictorial health warnings and their outcomes. Methods: In Study 1 individuals completed a version of the Wason selection task evaluating warnings in which content type (Alcohol, Non-Alcohol) and emotional valence (Positive, Negative) were manipulated using different images. Study2 presented people with If-Then warnings (alcohol-related or non-alcohol-related) and asked them to evaluate whether certain outcomes followed. Results: Study 1 found that when warning messages were about alcohol, there was no difference in reasoning accuracy between positive and negative content. However, fewer correct reasoning responses followed exposure to negative general health messages (t(152)=3.58, p<.001, d=.19). Study 2 suggested that when a warning involves considering the potential consequences of drinking alcohol, accuracy is improved when the content is negative. However, when considering outcomes that will result from abstaining from consumption, accuracy was greatest when the content was positive. This was supported by an inference by content interaction (F(3,171)=4.11, p< .01, =.07). Conclusions: Negative imagery should be used with caution in health warnings. In some cases the use of pictorial images of negative outcomes may improve reasoning, however, their use in alcohol-related messages does not appear to be consistently beneficial. Goals for using pictorial warnings therefore need to be carefully considered when designing such warnings.