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Path analysis of warning label effects on negative emotions and quit attempts: a longitudinal study of smokers in Australia, Canada, Mexico, and the US

Cho, Yoo Jin, Thrasher, James F., Yong, Hua-Hie, Szklo, André Salem, O'Connor, Richard J., Bansal-Travers, Maansi, Hammond, David, Fong, Geoffrey T., Hardin, James and Borland, Ron 2018, Path analysis of warning label effects on negative emotions and quit attempts: a longitudinal study of smokers in Australia, Canada, Mexico, and the US, Social science and medicine, vol. 197, pp. 226-234, doi: 10.1016/j.socscimed.2017.10.003.

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Title Path analysis of warning label effects on negative emotions and quit attempts: a longitudinal study of smokers in Australia, Canada, Mexico, and the US
Author(s) Cho, Yoo Jin
Thrasher, James F.
Yong, Hua-HieORCID iD for Yong, Hua-Hie orcid.org/0000-0001-8167-6173
Szklo, André Salem
O'Connor, Richard J.
Bansal-Travers, Maansi
Hammond, David
Fong, Geoffrey T.
Hardin, James
Borland, Ron
Journal name Social science and medicine
Volume number 197
Start page 226
End page 234
Total pages 9
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2018-01
ISSN 0277-9536
1873-5347
Summary 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.
Language eng
DOI 10.1016/j.socscimed.2017.10.003
Field of Research 1117 Public Health And Health Services
1601 Anthropology
1608 Sociology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108326

Document type: Journal Article
Collections: School of Psychology
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.