Abstract
BackgroundWe examined whether enhancing self-affirmation among a population of drinkers, prior to viewing threatening alcohol pictorial health warning labels, would reduce defensive reactions and promote reactions related to behaviour change. We also examined how health warning severity influences these reactions and whether there is an interaction between self-affirmation and severity.MethodsIn this experimental human laboratory study, participants (n = 128) were randomised to a self-affirmation or control group. After the self-affirmation manipulation was administered, we tracked participants’ eye movements while they viewed images of six moderately-severe and six highly-severe pictorial health warning labels presented on large beer cans. Self-reported responses to the pictorial health warning labels were then measured, including avoidance, reactance, effectiveness, susceptibility and motivation to drink less. Finally, participants reported their self-efficacy to drink less and their alcohol use.ResultsThere was no clear evidence that enhancing self-affirmation influenced any outcome. In comparison to moderately-severe health warnings, highly-severe health warnings increased avoidance and reactance and were perceived as more effective and increased motivation to drink less.ConclusionsThese findings call into question the validity of the self-affirmation manipulation, which is purported to reduce defensive reactions to threatening warnings. We discuss possible explanations for this null effect, including the impact of participants’ low perceived susceptibility to the risks shown on these pictorial health warning labels. Our finding that highly-severe health warnings increase avoidance and reactance but are also perceived as being more effective and more likely to motivate people to drink less will inform future health warning design and have implications for health warning label theory.
Highlights
We examined whether enhancing self-affirmation among a population of drinkers, prior to viewing threatening alcohol pictorial health warning labels, would reduce defensive reactions and promote reactions related to behaviour change
The main aim of this study is to examine whether enhancing self-affirmation among drinkers prior to viewing alcohol pictorial health warning labels reduces defensive reactions and promotes positive responses to these warnings
The average Alcohol Use Disorders Identification Test (AUDIT) score was 14 (SD = 5), which is towards the upper limit of Zone II which suggests a medium level of alcohol problems [40]
Summary
We examined whether enhancing self-affirmation among a population of drinkers, prior to viewing threatening alcohol pictorial health warning labels, would reduce defensive reactions and promote reactions related to behaviour change. We examined how health warning severity influences these reactions and whether there is an interaction between self-affirmation and severity. While tobacco health warning labels have been shown to. In 2011, alcohol companies in the United Kingdom (UK) pledged to put health warnings on 80% of alcohol containers as part of the Responsibility Deal, this pledge has not been fully met [10]. We have observed similar effects among daily smokers who actively avoid pictorial health warnings on cigarette packs [12]. Consumers have low awareness of the current voluntary warnings on alcohol containers and are unable to recall and recognise them [13]
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