Examining reactions to smoking and COVID-19 risk messages: An experimental study with people who smoke

Abstract

Background Smoking cigarettes worsens COVID-19 outcomes, and news media and health agencies have been communicating about that. However, few studies have examined how these messages affects attitudes, beliefs, and behavioral intentions of people who smoke. These are critical variables that can inform public health campaigns to motivate quitting smoking during the COVID-19 crisis. Methods In August 2020, we conducted an online experiment in the U.S. with 1,004 adults who smoke. Participants were randomized to one of four message conditions: COVID-19 risk, smoking risk, combined risk of smoking for COVID-19 severity, or a non-risk control. Outcomes were message reactions (emotions and reactance), attitudes and beliefs (severity, susceptibility, self-efficacy, response efficacy for smoking and COVID-19, and conspiracy beliefs), and behavioral intentions (smoking intentions, COVID-protective intentions, and information-seeking). Results Multivariate analysis of covariance (MANCOVA) showed that combined risk messages elicited higher perceived severity of smoking-related disease than control messages. Similarly, the combined risk condition resulted in greater intentions to quit smoking in the next month (vs. COVID-19 risk condition) and intentions to reduce smoking in the next 6 months (vs. smoking risk and control; ps < .05). Multivariate logistic regression found that exposure to the combined risk messages (vs. control as referent) was associated with higher odds of mask-wearing intentions in the next 2 weeks (AOR = 1.97). Conclusions Health agencies can possibly use messages that communicate about the combined risk of smoking and COVID-19 as a novel strategy to motivate people who smoke to quit and take protective action for COVID-19.

Effect of smoking-related COVID-19 risk messaging on smoking cessation in community smokers: A pragmatic randomized controlled trial

“…An experiment showed that messages on smoking-related COVID-19 risk (vs traditional risk) elicited similar levels of reactions (e.g. attention, negative affect) and were perceived to be similarly effective in discouraging smoking 14 . Likewise, another experiment showed no difference in valence or arousal elicited by COVID-19 or traditional graphic health warnings on cigarette packaging 34 .…”

“…smoking reduction, quit attempts, and intentions) 10 , 11 , also shown in our study in Hong Kong 12 . Several online experiments have found that exposure to messaging on smoking-related COVID-19 risk can increase smokers’ motivations to quit 13 , 14 , which may be mediated by fear arousal 15 . Nevertheless, our PubMed search (until March 2023) using the keywords ‘risk communication’, ‘health communication’, ‘health warning’, ‘messaging’, ‘COVID-19’, and ‘smoking’ did not identify any randomized clinical trial (RCT) testing the effectiveness of such messaging on smoking abstinence in a real-world setting.…”

Tobacco smoking, second‐hand smoking exposure in relation to psychotic‐like experiences in adolescents

“…This situation might increase smokers' concerns about serious illnesses caused by coronavirus infection (Yang & Ma, 2021). Such worries might motivate some smokers to stop smoking (Massey et al, 2022). Meanwhile, adolescents might be less likely to be exposed to SHS due to the social distancing policy during the outbreak of the pandemic (Lee et al, 2022).…”

Has interest in smoking cessation declined during the COVID-19 pandemic?

“…[5][6][7][8][9] this greater risk has led many smokers to express renewed interest in smoking cessation 8 and a number of health agencies and experts have recommended using the pandemic as an impetus to encourage smokers to make attempts to quit, 8,10 as it is an established theory of behaviour change that an increased perceived risk can increase an individual's motivation to change a behaviour. 8,11 During the pandemic, there have been targeted education campaigns; however, the actual effectiveness of the messaging remains unclear. one study found that a combined message that explained the role of smoking in increasing CoViD-19 severity was most effective at increasing intentions to quit in the next month and in reducing smoking in the next six months, compared to those where the message only focused on the risks associated with CoViD-19 exposure.…”

“…people who smoke appear to be at greater risk of infection from CoViD-19 and if infected are at greater risk of experiencing severe complications including hospitalisation, needing mechanical ventilation, intensive care, and/or having the infection result in death. [5][6][7][8][9] this greater risk has led many smokers to express renewed interest in smoking cessation 8 and a number of health agencies and experts have recommended using the pandemic as an impetus to encourage smokers to make attempts to quit, 8,10 as it is an established theory of behaviour change that an increased perceived risk can increase an individual's motivation to change a behaviour. 8,11 During the pandemic, there have been targeted education campaigns; however, the actual effectiveness of the messaging remains unclear.…”