路径分析：警示标签对负面情绪和戒烟尝试的影响——对澳大利亚、加拿大、墨西哥和美国吸烟者的纵向研究。
Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US.
机构信息
Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA; Department of Tobacco Research, National Institute of Public Health, Cuernavaca, Mexico.
出版信息
Soc Sci Med. 2018 Jan;197:226-234. doi: 10.1016/j.socscimed.2017.10.003. Epub 2017 Oct 30.
BACKGROUND
Cigarette pack health warning labels can elicit negative emotions among smokers, yet little is known about how these negative emotions influence behavior change.
OBJECTIVE
Guided by psychological theories emphasizing the role of emotions on risk concern and behavior change, we investigated whether smokers who reported stronger negative emotional responses when viewing warnings reported stronger responses to warnings in daily life and were more likely to try to quit at follow-up.
METHODS
We analyzed data from 5439 adult smokers from Australia, Canada, Mexico, and the US, who were surveyed every four months from September 2012 to September 2014. Participants were shown warnings already implemented on packs in their country and reported negative emotional responses (i.e., fear, disgust, worry), which were averaged (range = 1 to 9). Country-stratified logistic and linear generalized estimating equations were used to analyze the effect of negative emotional responses on self-reported responses to warnings in daily life (i.e., attention, risk concern, avoidance of warnings, forgoing planned cigarettes) and quit attempts at follow-up. Models were adjusted for socio-demographic and smoking-related characteristics, survey wave, and the number of prior surveys answered.
RESULTS
Smokers who reported stronger negative emotions were more likely to make quit attempts at follow-up (Adjusted ORs ranged from 1.09 [95% CI 1.04 to 1.14] to 1.17 [95% CI 1.12 to 1.23]; p < .001) than those who reported lower negative emotions. This relationship was mediated through attention to warnings and behavioral responses to warnings. There was no significant interaction of negative emotions with self-efficacy or nicotine dependence.
CONCLUSION
Negative emotions elicited by warnings encourage behavior change, promoting attention to warnings and behavioral responses that positively predict quit attempts.
背景
香烟盒上的健康警示标签会引起吸烟者的负面情绪，但人们对这些负面情绪如何影响行为改变知之甚少。
目的
本研究以强调情绪对风险关注和行为改变作用的心理学理论为指导，调查了当吸烟者看到警示时报告的负面情绪反应较强时，他们在日常生活中对警示的反应是否更强，以及在随访时更有可能尝试戒烟。
方法
我们分析了来自澳大利亚、加拿大、墨西哥和美国的 5439 名成年吸烟者的数据，这些吸烟者在 2012 年 9 月至 2014 年 9 月期间每四个月接受一次调查。参与者观看了本国包装上已实施的警示，并报告了负面情绪反应（即恐惧、厌恶、担忧），这些反应的平均值（范围为 1 到 9）。采用分层逻辑回归和线性广义估计方程分析了负面情绪反应对日常生活中对警示的自我报告反应（即关注、风险关注、避免警示、放弃计划吸烟）和随访时戒烟尝试的影响。模型调整了社会人口统计学和吸烟相关特征、调查波次以及之前回答的调查次数。
结果
与报告负面情绪较低的吸烟者相比，报告负面情绪较强的吸烟者更有可能在随访时尝试戒烟（调整后的比值比范围为 1.09 [95%置信区间 1.04 至 1.14] 至 1.17 [95%置信区间 1.12 至 1.23]；p<0.001）。这种关系通过对警示的关注和对警示的行为反应来介导。负面情绪与自我效能感或尼古丁依赖之间没有显著的相互作用。
结论
警示引起的负面情绪鼓励行为改变，促进对警示的关注和积极预测戒烟尝试的行为反应。
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