Conversations about pictorial cigarette pack warnings: Theoretical mechanisms of influence.

Journal Article

Background

Social interactions are a key mechanism through which health communication campaigns influence behavior. Little research has examined how conversations about pictorial warnings motivate behavior.

Purpose

We sought to establish whether and how smokers' conversations explain the effect of pictorial warnings on quit attempts.

Methods

US adult smokers (n = 2149) participated in a controlled trial that randomly assigned them to have their cigarette packs labeled with pictorial or text-only warnings for four weeks. Surveys assessed the number of conversations sparked by pictorial warnings and the theoretical mechanisms cognitive elaboration and social norms at each visit. Analyses used structural equation modeling to test our theorized mediation models.

Results

The number of conversations about the warnings mediated the relationship between exposure to pictorial warnings and quit attempts (p < .001). In serial mediation analysis examining possible theoretical mechanisms, the number of conversations was associated with greater cognitive elaboration, which in turn was associated with being more likely to make a quit attempt (p < .05). Social norms did not explain the influence of conversations on quit attempts.

Conclusions

Pictorial warnings increased conversations about the warnings, which led to greater cognitive elaboration, which led to greater quit attempts. Our findings suggest designing warnings that increase conversations in order to better inform and motivate smokers. Furthermore, these findings improve our understanding of why conversations matter in health communication.

Full Text

Duke Authors

Cited Authors

  • Morgan, JC; Golden, SD; Noar, SM; Ribisl, KM; Southwell, BG; Jeong, M; Hall, MG; Brewer, NT

Published Date

  • December 2018

Published In

Volume / Issue

  • 218 /

Start / End Page

  • 45 - 51

PubMed ID

  • 30340152

Pubmed Central ID

  • 30340152

Electronic International Standard Serial Number (EISSN)

  • 1873-5347

International Standard Serial Number (ISSN)

  • 0277-9536

Digital Object Identifier (DOI)

  • 10.1016/j.socscimed.2018.09.063

Language

  • eng