Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults

Objective: We examined effects of hookah tobacco risk messages on risk appraisals, attitudes towards hookah, ambivalence about hookah use, and willingness to smoke in young adults aged 18–30 years (n = 234). Design: In an online experiment, participants completed pre-exposure measures and were randomized to hookah tobacco risk messages or to a no message control condition. Main Outcome Measures: Risk appraisals, attitudes, ambivalence, and willingness to smoke hookah. Results: Those who viewed risk messages reported greater risk appraisals (M 4.50, SD 1.17 vs. M 3.87, SD 1.16, p <.001), less positive attitudes (M −0.56, SD 1.24, vs. M 0.39, SD 1.35, p <.001), greater ambivalence (M 3.86, SD 1.26, vs. M 3.08, SD 1.32, p <.001), and less willingness to smoke than controls (M 4.48, SD 1.27, vs. M 4.85, SD 1.37, p =.034). Structural equation modeling demonstrated messages reduced willingness to smoke by evoking less positive attitudes (b = −0.15, 95% CI −0.32, −0.05) and by the effect of heightened risk appraisals on less positive attitudes (b = −0.14, 95% CI −0.30, −0.07). Conclusions: Honing messages and understanding their mechanisms of action are necessary to produce more effective interventions to address hookah and other tobacco use in young adults.

Duke Scholars

Author Isaac Marcelo Lipkus School of Nursing