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November 4, 2015

Public health scare tactics work—but at what cost?

Daily Briefing

They might not make for pretty pictures, but a new paper published in American Psychological Association's Psychological Bulletin finds that fear-based appeals—like photos of diseased lungs on cigarette packs—are effective at influencing people to make healthier choices.

The meta-analysis reviewed more than 50 years of research involving over 27,000 people, Lynne Shallcross writes for NPR's "Shots." Using 127 studies, the researchers concluded that fear-based appeals are almost always effective at influencing attitudes, intentions, and behaviors.

"There are very few circumstances under which they are not effective," according to the study. "There are no identified circumstances under which they backfire and lead to undesirable outcomes."

The best way to overcome vaccine skepticism? Try scaring the parents.

But while these campaigns do work, they only go so far, says Dolores Albarracin, senior author of the study and a professor of psychology and business at the University of Illinois, Urbana-Champaign. Fear-based appeals work better for affecting one-time behaviors, such as getting the flu shot, than long-term changes to behavior.

"Long-term changes to behavior patterns are often produced by changes in skills," Albarracin says. In other words, a photo of a diseased lung is not enough to quit cold turkey. Smokers need resources, like cessation techniques or aids, to finally kick the habit. 

Potential downsides

While fear can be effective, that doesn't mean it is always the best tactic, experts say. Amy Fairchild, a professor of sociomedical sciences at Columbia University, cites the example of a 2010 ad campaign, which highlighted complications that arise from HIV, with the goal of prodding viewers to engage in safe sex to avoid contracting the disease.

But the campaign may have also stigmatized "a population that was already suffering from the burdens of stigma," Fairchild says.

Ronald Bayer, co-chair of the Center for the History and Ethics of Public Health at Columbia, puts it another way: "Everything that's effective is not acceptable," adding that public health officials also need to consider the "human toll" (Shallcross, "Shots", NPR, 11/2).

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