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Does reactance against cigarette warning labels matter? Warning label responses and downstream smoking cessation amongst adult smokers in Australia, Canada, Mexico and the United States

Cho, Yoo Jin, Thrasher, James F., Swayampakala, Kamala, Yong, Hua, McKeever, Robert, Hammond, David, Anshari, Dien, Cummings, K. Michael and Borland, Ron 2016, Does reactance against cigarette warning labels matter? Warning label responses and downstream smoking cessation amongst adult smokers in Australia, Canada, Mexico and the United States, PLoS One, vol. 11, no. 7, pp. 1-16, doi: 10.1371/journal.pone.0159245.

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Title Does reactance against cigarette warning labels matter? Warning label responses and downstream smoking cessation amongst adult smokers in Australia, Canada, Mexico and the United States
Author(s) Cho, Yoo Jin
Thrasher, James F.
Swayampakala, Kamala
Yong, HuaORCID iD for Yong, Hua orcid.org/0000-0001-8167-6173
McKeever, Robert
Hammond, David
Anshari, Dien
Cummings, K. Michael
Borland, Ron
Journal name PLoS One
Volume number 11
Issue number 7
Article ID e0159245
Start page 1
End page 16
Total pages 16
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2016-07-13
ISSN 1932-6203
Keyword(s) Adolescent
Adult
Australia
Canada
Female
Health Promotion
Humans
Male
Mexico
Middle Aged
Product Labeling
Smoking
Smoking Cessation
Surveys and Questionnaires
United States
Young Adult
Summary OBJECTIVE: Some researchers have raised concerns that pictorial health warning labels (HWLs) on cigarette packages may lead to message rejection and reduced effectiveness of HWL messages. This study aimed to determine how state reactance (i.e., negative affect due to perceived manipulation) in response to both pictorial and text-only HWLs is associated with other types of HWL responses and with subsequent cessation attempts.

METHODS: Survey data were collected every 4 months between September 2013 and 2014 from online panels of adult smokers in Australia, Canada, Mexico, and the US were analyzed. Participants with at least one wave of follow-up were included in the analysis (n = 4,072 smokers; 7,459 observations). Surveys assessed psychological and behavioral responses to HWLs (i.e., attention to HWLs, cognitive elaboration of risks due to HWLs, avoiding HWLs, and forgoing cigarettes because of HWLs) and cessation attempts. Participants then viewed specific HWLs from their countries and were queried about affective state reactance. Logistic and linear Generalized Estimating Equation (GEE) models regressed each of the psychological and behavioral HWL responses on reactance, while controlling for socio-demographic and smoking-related variables. Logistic GEE models also regressed having attempted to quit by the subsequent survey on reactance, each of the psychological and behavioral HWL responses (analyzed separately), adjustment variables. Data from all countries were initially pooled, with interactions between country and reactance assessed; when interactions were statistically significant, country-stratified models were estimated.

RESULTS: Interactions between country and reactance were found in all models that regressed psychological and behavioral HWL responses on study variables. In the US, stronger reactance was associated with more frequent reading of HWLs and thinking about health risks. Smokers from all four countries with stronger reactance reported greater likelihood of avoiding warnings and forgoing cigarettes due to warnings, although the association appeared stronger in the US. Both stronger HWLs responses and reactance were positively associated with subsequent cessation attempts, with no significant interaction between country and reactance.

CONCLUSIONS: Reactance towards HWLs does not appear to interfere with quitting, which is consistent with its being an indicator of concern, not a systematic effort to avoid HWL message engagement.
Language eng
DOI 10.1371/journal.pone.0159245
Field of Research MD Multidisciplinary
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2016, Cho et al.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108348

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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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.