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dc.contributor.authorCho, Yoo Jin
dc.contributor.authorThrasher, James F.
dc.contributor.authorYong, Hua-Hie
dc.contributor.authorSzklo, André Salem
dc.contributor.authorO'Connor, Richard J.
dc.contributor.authorBansal-Travers, Maansi
dc.contributor.authorHammond, David
dc.contributor.authorFong, Geoffrey T.
dc.contributor.authorHardin, James
dc.contributor.authorBorland, Ron 19:35:09 (GMT) 19:35:09 (GMT)
dc.description.abstractBackground Cigarette pack health warning labels can elicit negative emotions among smokers, yet little is known about how these negative emotions influence behavior change. Objective Guided by psychological theories emphasizing the role of emotions on risk concern and behavior change, we investigated whether smokers who reported stronger negative emotional responses when viewing warnings reported stronger responses to warnings in daily life and were more likely to try to quit at follow-up. Methods We analyzed data from 5439 adult smokers from Australia, Canada, Mexico, and the US, who were surveyed every four months from September 2012 to September 2014. Participants were shown warnings already implemented on packs in their country and reported negative emotional responses (i.e., fear, disgust, worry), which were averaged (range = 1 to 9). Country-stratified logistic and linear generalized estimating equations were used to analyze the effect of negative emotional responses on self-reported responses to warnings in daily life (i.e., attention, risk concern, avoidance of warnings, forgoing planned cigarettes) and quit attempts at follow-up. Models were adjusted for socio-demographic and smoking-related characteristics, survey wave, and the number of prior surveys answered. Results Smokers who reported stronger negative emotions were more likely to make quit attempts at follow-up (Adjusted ORs ranged from 1.09 [95% CI 1.04 to 1.14] to 1.17 [95% CI 1.12 to 1.23]; p < .001) than those who reported lower negative emotions. This relationship was mediated through attention to warnings and behavioral responses to warnings. There was no significant interaction of negative emotions with self-efficacy or nicotine dependence. Conclusion Negative emotions elicited by warnings encourage behavior change, promoting attention to warnings and behavioral responses that positively predict quit attempts.en
dc.description.sponsorshipNational Cancer Institute (R01 CA167067)en
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectFear appealsen
dc.subjectHealth communicationen
dc.subjectProduct labelingen
dc.subjectSmoking cessationen
dc.subjectTobacco productsen
dc.titlePath analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the USen
dcterms.bibliographicCitationCho, Y. J., Thrasher, J. F., Yong, H.-H., Szklo, A. S., O’Connor, R. J., Bansal-Travers, M., … Borland, R. (2018). Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US. Social Science & Medicine, 197, 226–234.
uws.contributor.affiliation1Faculty of Artsen
uws.contributor.affiliation1Faculty of Applied Health Sciencesen
uws.contributor.affiliation2Public Health and Health Systemsen

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