Anti-smoking Messages Research Articles

Electronic cigarette marketers manipulate antitobacco advertisements to promote vaping

A device commonly used by public health advocates is the alteration of cigarette advertisements to convey an antismoking message.1 ,2 Well-known examples include ‘Joe Chemo’ for Joe Camel and ‘Fool’...

Hooked on a feeling: affective anti-smoking messages are more effective than cognitive messages at changing implicit evaluations of smoking.

Because implicit evaluations are thought to underlie many aspects of behavior, researchers have started looking for ways to change them. We examine whether and when persuasive messages alter strongly held implicit evaluations of smoking. In smokers, an affective anti-smoking message led to more negative implicit evaluations on four different implicit measures as compared to a cognitive anti-smoking message which seemed to backfire. Additional analyses suggested that the observed effects were mediated by the feelings and emotions raised by the messages. In non-smokers, both the affective and cognitive message engendered slightly more negative implicit evaluations. We conclude that persuasive messages change implicit evaluations in a way that depends on properties of the message and of the participant. Thus, our data open new avenues for research directed at tailoring persuasive messages to change implicit evaluations.

Health communication and rhetorical challenges for the anti-smoking policy in Russia

Smoking regulation constitutes a challenging issue for both developed and developing countries that aim to improve their state of public health and constituent wellbeing. Anti-smoking information and communication campaigns accompanying regulation acts can either enhance or sabotage national policy initiatives. This is especially salient in countries like Russia, where smoking is one of the top public health threats and causes of population decline. As such, critical analysis of the message effectiveness of Russia's anti-smoking campaign is warranted. This study employs frame analysis to examine the anti-smoking messages embedded in the sections of Federal Law No. 15 that regulate the information and communication campaigns. The study's results illustrate that in addition to the lack of a comprehensive, effective public relations campaign promoting smoking cessation, the rhetoric guiding the enforcement of the anti-smoking legislation enforcement is doomed to yield desired results. This study suggests recommendations for reframing existing messages to enable a more comprehensive and effective Russian anti-smoking.

Brain Activity in Self- and Value-Related Regions in Response to Online Antismoking Messages Predicts Behavior Change.

In this study, we combined approaches from media psychology and neuroscience to ask whether brain activity in response to online antismoking messages can predict smoking behavior change. In particular, we examined activity in subregions of the medial prefrontal cortex linked to self- and value-related processing, to test whether these neurocognitive processes play a role in message-consistent behavior change. We observed significant relationships between activity in both brain regions of interest and behavior change (such that higher activity predicted a larger reduction in smoking). Furthermore, activity in these brain regions predicted variance independent of traditional, theory-driven self-report metrics such as intention, self-efficacy, and risk perceptions. We propose that valuation is an additional cognitive process that should be investigated further as we search for a mechanistic explanation of the relationship between brain activity and media effects relevant to health behavior change.

A proposed integrated model of resistance to anti-smoking messages

We propose and test an extension of the planned behavior model to reflect resistance to preventive public health messages. Our results relate to an anti-smoking advertisement and show that the detection of persuasive intent, a promotion-oriented regulatory focus and perceived behavioral control lead to an increase in resistance to persuasion.

Warning about the harms of tobacco use in 22 countries: findings from a cross-sectional household survey

BackgroundKnowledge about the harms of tobacco use deters initiation and is associated with cessation. Most studies on this knowledge in the general population have been in high-income countries, but the...

Disgust in fear appeal anti-smoking advertisements: The effects on attitudes and abstinence motivation

Aims: The use of fear appeals with disgusting graphical content is part of current practice in health campaigns. Previous studies have suggested both a detrimental and a beneficial effect of disgust in fear appeals on different types of outcome measures. We were interested in whether disgust in anti-smoking messages decreases or increases persuasion as measured by motivation to abstain from smoking and attitudes towards smoking. Methods: In two online experiments (total N = 1045), smokers (26%) and non-smokers were randomly assigned to watch fear appeal anti-smoking ads that elicited high versus moderate levels of disgust but similar levels of fear. Smokers reported motivation to quit, while non-smokers reported motivation to not start smoking. All participants reported explicit attitudes toward smoking and performed an Implicit Association Test that measures implicit attitudes toward smoking and cigarettes. Findings: There were no differences between these conditions, except on a measure of implicit attitudes. However, this effect was not replicated in the second study, and analyses across studies revealed no substantial difference between the conditions. Conclusions: In the current context, there were no or potentially very small benefits of using disgust elements when level of fear was held constant (i.e. compared to other means of inducing negative emotions).

Stigma as a barrier to diagnosis of lung cancer: patient and general practitioner perspectives.

The prognosis for people with lung cancer may be worsened by delays in seeking medical help following the onset of symptoms. Previous research has highlighted that patients' experiences of stigma and blame may contribute to these delays. This short report focuses on stigma as a barrier to diagnosis of lung cancer, from patient and general practitioner (GP) perspectives. Semi-structured interviews were conducted with people diagnosed with lung cancer (n=20) and with GPs (n=10) in New South Wales, Australia. Participants' experiences of blame and stigma, GPs preconceptions of lung cancer risk and the impact of anti-smoking messaging were explored. Participants reported experiencing stigma owing to a diagnosis of lung cancer. For some, the anticipation of stigma resulted in delays in seeking diagnosis and hence treatment. The sense of blame associated with a lung cancer diagnosis was also reflected in GP interviews. Successful tobacco control activities have increased societal awareness of lung cancer as smoking related and potentially contributed to the participants' experiences of stigma. Removing blame associated with smoking is central to reducing delays in diagnosis of lung cancer.

Communication through Advocacy Advertising for Public Health Promotion

This research work is an investigation into the reception of anti-smoking advertisements that make use of The objective of the research is to bring audience perceptions, interpretations and making sense processes of such advertising campaigns to the limelight. Instead of measuring effects or effectiveness of anti-smoking messages using shocking images, this project has at its basis the assumption of an active audience that interprets, makes sense and decodes media texts in various ways. Research methods used in this study are qualitative by nature. Research findings show that the prospective audience champion the use of anti-smoking advertisements and see the use of fear appeals as a one-way road to drawing the audience's attention, they nevertheless perceive these communication efforts in a highly individualized manner, resisting to advertising techniques of persuasion and showing signs of desensitization towards fear appeals. Findings show that advocacy advertising using fear appeals are always decoded within the wider media context and the identity of smokers themselves often nourished by media representations of smoking, which plays an role in the way the audience gives different interpretations and relates to these messages.

Positive and instructive anti-smoking messages speak to older smokers: a focus group study.

BackgroundSmokers over the age of 45 are the only group with an increase in smoking prevalence, are the least likely to quit smoking, and bear most of the burden of tobacco-related disease. Research characterizing older adult perceptions of warning labels and anti-tobacco messages has not been reported in the literature. The purpose of this study was to describe whether older smokers perceived warning labels and anti-tobacco messages as effective for the promotion of smoking cessation. A secondary aim was to explore what types of messages and message delivery formats are most relevant to older adult smokers.MethodsThis focus group study is part of a larger study to characterize older smokers’ perceptions of the risks and benefits associated with conventional and emerging tobacco products and determine the extent to which these perceptions relate to exposure to pro- and anti-tobacco messages. From April 2013 to August 2014 we conducted eight focus groups with 51 current and former smokers a focus group study in urban and suburban California. A semi-structured format about current use of conventional and emerging tobacco products was used. Participants were asked to recall and comment on examples of warning labels and anti-tobacco messages. Data were transcribed and thematically coded.ResultsWarning labels and anti-smoking messages were seen as ineffective for smoking cessation motivation among older California smokers. Positive framed anti-tobacco messages were identified as most effective. Text-only warnings were seen as ineffective due to desensitizing effects of repeated exposure. Negative messages were described as easy to ignore, and some trigger urges to smoke. Older adults are knowledgeable about the risks and health effects of smoking. However, they tend to be less knowledgeable about the benefits of cessation and may underestimate their ability to quit.ConclusionThese findings suggest that messages with a positive frame that outline immediate and long-term benefits of cessation would be an effective approach for long-term smokers.Current anti-tobacco messaging was generally not seen as effective for smoking cessation among long-term smokers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12971-015-0027-x) contains supplementary material, which is available to authorized users.

Prevalence and Predictors of Cigarette Smoking among Adolescents of Ethiopia: School Based Cross Sectional Survey

Abstract Background: Tobacco use is one of the leading public health threats in the world causing different health, and psychosocial risks. At a moment the spread of tobacco use is growing at fast in the adolescents, who are the future of the country. However, little information is known about the magnitude and predictors of tobacco use in Ethiopia. Objective: This study was aiming to assess the prevalence and associated factors of cigarette smoking among adolescents of Ethiopia Methods:school based cross sectional study was conducted from April 10 to April 15,2014 in 12 high schools selected randomly from public and private sectors, three from each in Hawassa town, and Jimma town, Ethiopia. Students [n = 1673] from grade 9-12, in the age limit of 13-19 were included in the study. Data were collected by self-administered questionnaire that is adapted from global youth tobacco survey questionnaire. Bivariate and multivariate analysis were made using logistic regression on SPSS version 20.0 software in order to predict factors associated with tobacco use. Result: The prevalence of cigarette smoking among adolescents were found to be 28.6% ever smokers, and 17.2% current smokers. In addition, more than half [60.8%]of adolescents were exposed to tobacco smoke from others in public places. In the multivariate analysis sex, alcohol use, parent smoking, peer smoking, exposure to movie with actors smoking, not being exposed to anti-smoking media messages, not discussing in the class about danger of smoking, and having perception that smoking is not dangerous to healthwere seen significantly associated with current cigarette smoking among adolescents. Conclusion and Recommendations: The prevalence rate is increasing in its spread, the gap between male and female is decreasing and exposure to environmental tobacco exposure is widespread. Therefore the government of Ethiopia should legislate, enact, and enforce laws that decrease accessibility of cigarette, totally ban smoking in the public places, and prohibit tobacco advertisement and promotions in Medias and movies. Moreover adolescents of the country should be enriched with the knowledge on the dangers of tobacco use.

Prevalence and correlates of tobacco use among school-going adolescents in Madagascar

Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents’ tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13–15years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors.Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females’ tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents’ tobacco use.

Predictors of Cigarette Smoking across Five Countries: A Cross Sectional Study

Background: Tobacco use continues to be the leading cause of death and disability in both developed and developing countries and is expected to remain so in 2020. Our research team has collected and analyzed survey based data on smoking habits from several countries around the world including China, India, Jordan, Saudi Arabia, and Taiwan. Our objectives here are to identify correlates of cigarette smoking that are common across these countries. Methods: A cross-sectional study conducted among 3,658 participants from a convenience sample of adults from each country collected between 2008-2011. The survey included questions on socio-demographic characteristics, current and history of cigarette smoking, family and peer smoking, and perceived harm. Multivariate logistic regression was used to determine predictors of cigarette smoking in the past 24 hours as well as in the past month. Results: Approximately 40% of the sample had smoked a cigarette in the past day and 44% in the past month. Significant predictors included male gender, aged 25 years or more, lower education level and school performance, medical profession, dyspepsia, feeling lonely and bothered by events, using other tobacco products, alcohol use and family and friend smoking. Those who received anti-smoking messages from teachers in schools were less likely to be smokers. Conclusions: Results underscore the importance of teachers and school based anti-smoking programs in smoking prevention across cultures and highlights the prominence of social peer pressure and smoking family members as major predictors of smoking that must be incorporated in any tobacco prevention or cessation program.

Family Interactions Regarding Fathers' Smoking and Cessation in Shanghai, China.

Spousal support predicts smoking cessation. China is the world's largest consumer of tobacco, with drastic differences in smoking prevalence among men and women. Thus, understanding marital interactions around husbands' smoking has implications for cultures with similarly large gender disparities in smoking. We examined interactions among family members regarding husbands' smoking in homes with small children in Shanghai. In Spring 2013, we conducted in-person semi-structured interviews among 13 male smokers and 17 female nonsmokers recruited from an urban and a suburban community in Shanghai. To encourage husbands' cessation or reduction, some women reported intervening either directly or indirectly through their children, emphasizing the health consequences for the smoker and the family. Some women reported not conversing about cessation due to concern about conflict, tolerance, or resignation. Women reported that their husbands' responses to anti-smoking messages from family members included promises to quit in the future or noting the strength of the nicotine addiction and the disadvantages of quitting. Men reported the importance of smoking in work/culture and argued against the research about the harms of smoking. Interventions targeting motivators for cessation among men and to support women in encouraging their husbands' cessation should be developed.

Operation Smoke Storm: qualitative evaluation of a novel intervention to prevent uptake of smoking in schoolchildren

Background40% of smokers become addicted before age 16 years and those who start at an early age are less likely to quit and more likely to die from their habit than are those who start later. Evidence from the US truth campaign suggests that interventions focusing on the tactics of the tobacco industry can be effective in preventing smoking uptake by children. Operation Smoke Storm is the first UK intervention based on this premise and we report an evaluation of its acceptability and effectiveness. This resource comprises three classroom sessions in which students act as secret agents uncovering tobacco industry tactics through videos, quizzes, discussions, and presentations. MethodsEight focus groups were conducted with 80 students in year 7 (aged 11–12 years) who had participated in Operation Smoke Storm at two schools in the East Midlands, UK. 18 interviews were conducted with teachers who delivered the intervention. The focus groups and interviews were digitally audiorecorded, transcribed verbatim, and analysed with the Framework method. The study was approved by the University of Nottingham's medical school research ethics committee (reference C13122012 CHS EPH Smoking). FindingsStudents enjoyed the secret agent scenario and reported acquiring new knowledge about smoking and the tobacco industry, which seemed to strengthen their aversion to smoking. Most teachers felt confident about delivering the resource, but would have welcomed more background information about the topic and guidance on how to steer discussions. Teachers highlighted a need for the resource to be flexible and not dependent on lesson length, teacher confidence, or expertise. Students and teachers endorsed the idea of developing a booster component for year 8 students (12–13 years), though stressed practical considerations including computer access. Participants also supported the development of printed information complementing the resource to encourage parents to support their child to not experiment with tobacco. InterpretationAlthough data were only collected from two schools, this rigorously conducted study highlights that Operation Smoke Storm can be delivered by teachers to raise awareness about smoking-related issues. These promising findings are relevant for anyone looking to deliver a novel anti-smoking message to young people and for health policy makers aiming to reduce uptake of smoking. The ideas and issues raised by students and teachers are now being used to improve and extend the resource for further evaluation. FundingNational Institute for Health Research Public Health Research Programme (project number 11/3010/02). The funder had no role in the writing of this abstract or the decision to submit.

Tobacco health warning messages on plain cigarette packs and in television campaigns: a qualitative study with Australian socioeconomically disadvantaged smokers.

Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few studies have examined how high smoking prevalence groups respond to these warnings. This study explored how socioeconomically disadvantaged smokers engage with health risk and cessation benefit messages. Six focus groups were conducted over September 2012-April 2013 with adult clients of welfare organizations in regional New South Wales, Australia who were current smokers (n = 51). Participants discussed HWLs, plain packaging and anti-smoking television advertisements. Discussions were audio-taped, transcribed verbatim and analysed using thematic analysis. Highly emotive warnings delivering messages of negative health effects were most likely to capture the attention of the study participants; however, these warning messages did not prompt quit attempts and participants were sceptical about the effectiveness of cessation programmes such as telephone quitlines. Active avoidance of health warning messages was common, and many expressed false and self-exempting beliefs towards the harms of tobacco. Careful consideration of message content and medium is required to communicate the anti-smoking message to disadvantaged smokers who consider themselves desensitized to warnings. Health communication strategies should continue to address false beliefs about smoking and educate on cessation services that are currently underutilized.

African American Young Adult Smoking Initiation: Identifying Intervention Points and Prevention Opportunities

Background African Americans have one of the lowest smoking rates as teens yet have one of the highest smoking rates as adults. Approximately 40% of African Americans who have ever smoked started smoking between the ages of 18 and 21. Purpose This study aimed to identify why African American young adults began smoking in young adulthood and what personal, social, and environmental influences promoted the transition to regular smoking. Methods Twelve focus groups were conducted with African American young adults (n = 99) between the ages of 18 and 29 who began smoking regularly after the age of 18. Results Participants did not smoke while they were younger because of strong maternal antismoking messages, out of respect for elders, or because they smoked marijuana instead. Factors influencing smoking initiation were perceived smoking social norms, changing parental messages about smoking, believing that smoking was an adult coping strategy, and extending a marijuana high. Discussion African American young adult smokers described multiple levels of influences on smoking initiation and the transition to regular smoking. Translation to Health Education Practice Recommendations include continuing strong parental messages against smoking, preparing youth for the transition to young adulthood, targeting normative smoking beliefs, and delinking smoking from marijuana use.

Young children’s perceptions of health warning labels on cigarette packages: a study in six countries

AimHealth warning labels on cigarette packages are one way to reach youth thinking about initiating tobacco use. The purpose of this study was to examine awareness and understanding of current health warning labels among 5 and 6 year old children.Subjects and methodsResearchers conducted one-on-one interviews with urban and rural 5 and 6 year olds from Brazil, China, India, Nigeria, Pakistan, and Russia.ResultsAmong the 2,423 participating children, 62 % were unaware of the health warnings currently featured on cigarette packages, with the lowest levels of awareness in India and the highest levels in Brazil. When shown the messages, the same percentage of participating children (62 %) showed no level of message understanding.ConclusionWhile youth are receiving social and informational messages promoting tobacco use, health warning labels featured on cigarette packages are not effectively reaching young children with anti-smoking messages.

Anti-smoking initiatives and current smoking among 19,643 adolescents in South Asia: findings from the Global Youth Tobacco Survey

BackgroundCigarette smoking habit usually begins in adolescence. The developing countries in South Asia like Pakistan, India, Bangladesh, and Nepal, where the largest segment of the population is comprised of adolescents, are more susceptible to smoking epidemic and its consequences. Therefore, it is important to identify the association between anti-smoking initiatives and current smoking status in order to design effective interventions to curtail the smoking epidemic in this region.MethodsThis is a secondary analysis of national data from the Global Youth Tobacco Survey (GYTS) conducted in Pakistan (year 2003), India (year 2006), Bangladesh (year 2007), and Nepal (year 2007). GYTS is a school-based survey of students targeting adolescents of age 13–15 years. We examined the association of different ways of delivering anti-smoking messages with students’ current smoking status.ResultsA total of 19,643 schoolchildren were included in this study. The prevalence of current smoking was 5.4% with male predominance. No exposure to school teachings, family discussions regarding smoking hazards, and anti-smoking media messages was significantly associated with current smoking among male students. Participants who were deprived of family discussion regarding smoking hazards (girls: odds ratio (OR) 1.56, 95% confidence interval (CI) 0.84–2.89, p value 0.152; boys: OR 1.37, 95% CI 1.04–1.80, p value 0.025), those who had not seen media messages (girls: OR 2.89, 95% CI 1.58–5.28, p value <0.001; boys: OR 1.32, 95% CI 0.91–1.88, p value 0.134), and those who were not taught the harmful effects of smoking at school (girls: OR 2.00, 95% CI 0.95–4.21, p value 0.066; boys: OR 1.89, 95% CI 1.44–2.48, p value <0.001) had higher odds of being current smokers after multivariate adjustment.ConclusionSchool-going adolescents in South Asia (Pakistan, India, Nepal, and Bangladesh) who were not exposed to anti-tobacco media messages or were not taught about the harmful effects in school or at home had higher odds of being current smokers than their counterparts.

Do disgusting and fearful anti-smoking advertisements increase or decrease support for tobacco control policies?

Previous studies have reported mixed results in reducing the prevalence of tobacco use among young people. The present study investigates the influence of a combined emotions (fear and anger) approach to strengthen the persuasive impact of anti-smoking messages aimed at young smokers.The study adopts a between-subject design experiment.Participants were exposed to either a fear appeal or a fear and anger appeal message, after which they answered questions about their emotions, perceived message effectiveness, and intention to reduce cigarette consumption and to quit smoking. An original measure of the co-occurrence of emotions felt by the participants (minimum [MIN] score) was used and mediation analyses were conducted to test the relationship between the emotional content of the message and behavioral intentions through the co-occurrence of fear and anger and perceived message effectiveness.The findings show that the co-occurrence of fear and anger felt by individuals and perceived message effectiveness serially mediate the positive influence of a fear and anger appeal message compared to a fear alone appeal on changes in intention behavior (intention to reduce cigarette consumption, indirect effect = 0.152, 95% confidence interval (CI) [0.014, 0.340], and intention to quit smoking, indirect effect = 0.236, 95% CI [0.096, 0.413]).The study shows the interest of combining negative emotions in prevention messages and offers guidance for government agencies responsible for tobacco control policies to help them improve the effectiveness of anti-smoking messages.