262313 “We're not gonna take it anymore!”: Smokers reactions to anti-tobacco messages

Monday, October 29, 2012

Ashley Sanders-Jackson, PhD , Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
Cati Brown-Johnson, PhD , Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
Rachel A. Grana, PhD, MPH , Center for Tobacco Control Research & Education, University of California, San Francisco, San Francisco, CA
Nicolas M. Sheon, PhD , Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA
Pamela Ling, MD, MPH , Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Background: Public Service Announcements (PSAs) encouraging tobacco cessation or avoidance may produce unintended outcomes, including reactance---resistance to the message and attempts to re-establish control, and boomerang effects---unintended attitudes or behaviors against the message. Though frustration at smoking or tobacco companies may be persuasive, reactance and boomerang effects are not.

Methods: Seventy-five current and former adult smokers evaluated anti-tobacco message concepts in 8 online focus groups in summer 2011. Qualitative grounded theory analysis was used to identify the main types of reactions to the message concepts.

Results: Reactions to anti-smoking message concepts comprised five main themes 1) anger at being stigmatized, 2) disagreement with government control over individual freedom or tobacco companies 3) desire to quit but feeling unable to quit, coupled with resistance to labeling oneself “addicted” 4) expressions of support and pride for participants who discussed their own quit attempts 5) frustration at tobacco companies for being dishonest. For example, in response to an anti-tobacco ad concept containing tobacco warning labels, participants frequently complained about governmental interference in their lives. A message including “this is your brain on nicotine” evoked anger, contrasts with street drugs, and claims that smoking was a “habit”, not an addiction.

Conclusion: Focus group participants expressed conflicted attitudes about their smoking status and desire or ability to quit. The social stigma of smoking is a strong factor in smokers' attitudes towards smoking, quitting, cigarette alternatives and regulation. Identifying thematic and linguistic mechanisms leading to reactance and boomerang effects can improve campaign messaging.

Learning Areas:
Chronic disease management and prevention
Communication and informatics
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe five responses to anti-tobacco messages expressed by current and former smokers.

Keywords: Health Promotion, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Ph.D. from the Annenberg School for Communication with a focus in health communication where I studied cancer communication messaging. I am a postdoctoral fellow on an NIH funded training grant at the Center for Tobacco Control Research and education at UCSF. I have written the majority of the abstract and have completed the majority of the analysis and therefore am responsible for the content.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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