Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults

Authors

Andrea C. Johnson, Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Monique M. Turner, Department of Communication, Michigan State University, East Lansing, MI, USA.
Samuel J. Simmens, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
W Douglas Evans, Prevention and Community Health Department, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Andrew A. Strasser, Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Darren Mays, Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.

Document Type

Journal Article

Publication Date

7-12-2022

Journal

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine

Volume

56

Issue

7

DOI

10.1093/abm/kaab073

Keywords

Young adults; affect; emotion; mediation; pictorial warning; risk perceptions

Abstract

BACKGROUND: Young adults are vulnerable to cigarette package marketing. Pictorial warning labels are recommended for tobacco control. Research should address questions raised in legal challenges including causal mechanisms. Evidence is mixed and understudied among young adults (e.g., discrete emotions and risk perceptions). PURPOSE: This study investigated mediators of pictorial warning label effects on motivation to quit smoking among young adult smokers. METHODS: This study analyzed data from a randomized trial with a 4 week exposure to a cigarette pictorial warning among young adult smokers (N = 229) aged 18-30 with assessments at baseline, immediately post-intervention, and 3 months. Mediation analyses used latent change scores to test the effects post-intervention on fear, anger, and risk perceptions. We also examined whether post-intervention measures predicted change in motivation to quit smoking at 3 months. The first model assessed aggregate risk perceptions and the second model assessed discrete risk perceptions (deliberative, affective). RESULTS: Pictorial warning label exposure led to increases in fear which led to increased motivation to quit smoking for the first (B = 0.12, 95% CI = 0.04, 0.26) and second (B = 0.12, 95% CI = 0.03, 0.25) model. Exposure modestly increased motivation to quit by way of fear and affective risk perceptions (B = 0.01, 95% CI = 0.00, 0.04). Exposure had a direct relationship on increased motivation to quit as well. CONCLUSIONS: Findings demonstrate factors contributing to change in motivation to quit smoking among young adult smokers after pictorial warning label exposure. Affective processes are mediators of pictorial warning label effects.

APA Citation

Johnson, Andrea C.; Turner, Monique M.; Simmens, Samuel J.; Evans, W Douglas; Strasser, Andrew A.; and Mays, Darren, "Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults" (2022). GW Authored Works. Paper 1314.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1314

Department

Biostatistics and Bioinformatics