Using Self-affirmation to Increase the Effects of Emotive Health Warnings on Smoking: A Randomized Exploratory Trial.
BACKGROUND
Emotive health messages are widely used tools in tobacco control. However, under some circumstances, they can be less effective than desired by eliciting defensive responses in smokers.


OBJECTIVE
This study tests whether enhancing a currently used emotive graphic smoking health warning with a self-affirmation component reduces cigarette consumption and whether potential effects are stronger in heavier smokers, as suggested by previous research.


METHODS
Participants (n = 265) were randomly allocated to a self-affirmation (reflecting on personal values and positive traits using a questionnaire) or matched control condition before viewing an emotive graphic health message from a current Australian government public health campaign. The primary outcome (cigarettes per day [CPD]) was assessed both before and a week following the intervention.


RESULTS
No main effect of self-affirmation on smoking, but as hypothesized, a significant interaction between baseline smoking and self-affirmation was found that showed that heavier smokers (>21 CPD) who self-affirmed significantly reduced CPD compared to nonaffirmed smokers.


CONCLUSIONS
These findings support the use of self-affirmation to enhance smoking awareness campaigns in heavier smokers.


CONCLUSIONS
This study shows that enhancing emotive graphic smoking health messages with self-affirmation (the act of reflecting on positive aspects of oneself) increases their effectiveness in heavier smokers. This suggests that self-affirmation might be a particularly useful tool for health promotion targeting heavier smokers. This study adds to previous research in that it is the first to test the add-on effects of self-affirmation to current graphic health messages on smoking rather than smoking-related cognitions.
School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Kate E
KE
Memish
School of Health Sciences, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Natalie
N
Schüz
School of Health Sciences, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Mai
M
Frandsen
School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Stuart G
SG
Ferguson
School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
Benjamin
B
Schüz
D000328:Adult; D001315:Australia; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D011356:Product Labeling; D012649:Self Concept; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000009:adverse effects*