This paper presents part of a survey which investigated people's response to different approaches to health education campaigns. The main objective of the original study was to find out whether the respondents preferred a fear-inducing campaign or a positive image advertising. Two anti-smoking advertisement produced by the Health Education Board for Scotland (HEBS), one using a fear appeal and the other, using a positive image were examined. A sample of 394 subjects in three age groups took part in the study and they were interviewed by means of a questionnaire. A high proportion in each group, including smokers indicated that they preferred the fear-inducing campaign. To investigate why people prefer this type of image, respondents were asked to explain their reasons. It was found that effective communication requires: (1) reality, (2) clear cut message, (3) simplicity, and (4) thought provoking nature and impact of the message. In addition, with regard to the advertising appeals it was found that both positive image and negative image campaigns could be used to attract attention and consequently communicate with the target population. Finally, the findings of this study in the light of psychosocial theories are discussed, and the Preference Model is proposed as providing a better understanding of the process behind people's preferences.