Can’t Get You Out Of My Head: The Effects Of Avoidance Eliciting Anti-Tobacco Warning Messages

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Doctor of Philosophy (PhD)
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Sutton, Jazmyne

BACKGROUND: Previous observational and longitudinal analyses have shown that smokers’ intention to avoid pictorial warning messages (PWMs) on cigarette packs is associated with later quit attempts. However, little research has explored the theoretical and causal mechanism by which avoidance elicitation increases message effectiveness. OBJECTIVE: This dissertation systematically characterized the avoidance elicitation of a large set of anti-tobacco pictorial warning messages (PWMs) and then determine the effects of avoidance elicitation experimentally. METHOD: In the first study, a content analysis procedure for a set of 319 PWMs was conducted. Then ratings of intentions to avoid and perceived effectiveness were gathered from a sample of current smokers. In the next study, a subset of PWMs were used to develop an avoidance elicitation. A new sample of current smokers participated in a variety of tasks with the PWMs and the scores from these tasks were aggregated to create a validated avoidance elicitation measure. In the final experimental study, a set of high and low avoidance eliciting PWMs were selected. Participants were randomly assigned to an exposure session with high or low avoidance eliciting PWMs. Then measures of beliefs about smoking, message recognition, attitudes towards smoking, and intentions to quit were assessed. A follow up survey 10 days later reassessed these measures. RESULTS: Analyses showed that when exposed to high avoidance eliciting PWMs, current smokers had higher levels of recall and recognition of not only the images from the PWMs but also the textual warning statements compared to low avoidance eliciting PWMs. Furthermore, recognition of the images and text statements had lasting effects up to 10 days after initial exposure. Recognition of both images and text statements was also positively associated with negative beliefs about smoking, attitudes towards smoking, and intention to quit. CONCLUSIONS: Avoidance elicitation is an underlying message characteristic that can be efficiently assessed. Moreover, high levels of avoidance elicitation can be integrated into cigarette pack messages as well as other warning messages in order to increase message processing.

Joseph N. Cappella
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