Annenberg School for Communication, University of Pennsylvania , Philadelphia, USA.
J Health Commun. 2020 Aug 2;25(8):613-623. doi: 10.1080/10810730.2020.1827097. Epub 2020 Oct 16.
Graphic cigarette warnings increase quit attempts. Perceived message effectiveness and message avoidance are predictive of later quit attempts. We sought to examine whether randomized exposure to warning messages would inadvertently increase intentions to use alternate tobacco products while enhancing attempts to quit cigarettes. An online survey of 1392 adult smokers in the US asked participants to rate six randomly selected tobacco warnings (from a set of 319) on perceived effectiveness and avoidance intentions. These two indicators of message effectiveness were calculated at the message-level and then at the individual campaign-level to facilitate causal inference. After viewing a message campaign of six warning messages, participants indicated their intentions to use alternate tobacco products. Sixty-eight percent of participants reported some intention to use e-cigarettes and intentions to use other alternate tobacco products ranged from 31% to 40%. Campaigns of messages eliciting higher avoidance increased the odds of intending to use hookah (aOR: 4.32), smokeless tobacco (aOR: 4.88), and snus (aOR: 8.06), but not the intention to use electronic cigarettes. These relationships are mediated by intentions to quit smoking (all <.05). Viewing campaigns with higher campaign-level perceived effectiveness increased the intentions to quit, which in turn increased intentions to try alternate tobacco products. Our findings increase the tobacco control community's understanding of unintended consequences of graphic tobacco warnings.
图形化香烟警示语增加戒烟尝试。感知到的信息有效性和信息回避倾向于预测未来的戒烟尝试。我们试图研究随机接触警示语是否会在无意中增加使用替代烟草产品的意图，同时增强戒烟尝试。一项针对美国 1392 名成年吸烟者的在线调查要求参与者对随机选择的六则烟草警示语（从 319 则中选择）进行感知有效性和回避意图的评估。这两个信息有效性指标在信息层面和整个宣传活动层面进行了计算，以促进因果推断。在观看了六则警示语的宣传活动后，参与者表示了使用替代烟草产品的意图。68%的参与者表示有某种使用电子烟的意图，而使用其他替代烟草产品的意图范围从 31%到 40%。引发更高回避倾向的信息宣传活动增加了使用水烟（aOR：4.32）、无烟气烟草（aOR：4.88）和鼻烟（aOR：8.06）的可能性，但不会增加使用电子烟的意图。这些关系都通过戒烟意图（均<.05）进行了中介。观看感知有效性更高的宣传活动增加了戒烟的意图，而戒烟的意图又增加了尝试替代烟草产品的意图。我们的发现增加了烟草控制界对图形化香烟警示语意外后果的理解。
