Influences of Self-Efficacy, Response Efficacy, and Reactance on Responses to Cigarette Health Warnings: A Longitudinal Study of Adult Smokers in Australia and Canada

Abstract

Guided by the extended parallel process model (EPPM) and reactance theory, this study examined the relationship between efficacy beliefs, reactance, and adult smokers’ responses to pictorial health warning labels (HWL) on cigarette packaging, including whether efficacy beliefs or reactance modify the relationship between HWL responses and subsequent smoking cessation behavior. Four waves of data were analyzed from prospective cohorts of smokers in Australia and Canada (n = 7,120 observations) over a period of time after implementation of more prominent, pictorial HWLs. Three types of HWL responses were studied: psychological threat responses (i.e., thinking about risks from smoking), forgoing cigarettes due to HWLs, and avoiding HWLs. The results from Generalized Estimating Equation models indicated that stronger efficacy beliefs and lower trait reactance were significantly associated with greater psychological threat responses to HWLs. Similar results were found for models predicting forgoing behavior, although response efficacy was inversely associated with it. Only response efficacy was significantly associated with avoiding HWLs, showing a positive relationship. Higher self-efficacy and stronger responses to HWLs, no matter the type, were associated with attempting to quit in the follow-up period; reactance was unassociated. No statistically significant interactions were found. These results suggest that stronger efficacy beliefs and lower trait reactance are associated with some stronger responses to fear-arousing HWL responses; however, these HWL responses appear no less likely to lead to cessation attempts among smokers with different levels of self-efficacy to quit, of response efficacy beliefs, or of trait reactance against attempts to control their behavior.

The role of negative affect and message credibility in perceived effectiveness of smokeless tobacco health warning labels in Navi Mumbai, India and Dhaka, Bangladesh: A moderated-mediation analysis

“…They found that large, graphic warnings work indirectly through several underlying factors: they encouraged smokers to think about the risks of smoking, which elicited emotional responses such as worry about health risks, which in turn increased intentions to quit and encouraged subsequent quitting behavior. In addition, contrary to the idea that extreme fear arousal results in message rejection (Kessels, Ruiter, Wouters, & Jansma, 2014; Kessels, Ruiter, & Jansma, 2010), avoidance behavior was associated with increased frequency of thinking about health risks (Yong et al 2014) and subsequent cessation attempts (Thrasher et al 2016). Together, these findings support the use of graphic, fear-arousing tobacco health warnings.…”

La Autoeficacia en el Cuidado de la Salud en la Predicción de la Satisfacción con la Vida

“…En dicho modelo se han establecido relaciones directas e indirectas con los aspectos de autoeficacia en el cuidado de la salud evaluados mediante el cuestionario EACASF. Dada la importancia de la autoeficacia en la adquisición de hábitos saludables (Luszczynskay & Schwarzer, 2005) y su capacidad predictiva en la realización de conductas de autocuidado de la salud (Thrasher, et al, 2016), se ha considerado fundamental asegurar que el instrumento de evaluación es válido y fiable en la muestra evaluada. En este sentido, los análisis factoriales confirmatorios para el cuestionario de autoeficacia en el cuidado de la alimentación y la salud física (EACASF) muestran que una estructura pentafactorial es viable y adecuada.…”

“…Una de las variables estudiadas ha sido la autoeficacia, concepto ampliamente descrito desde la teoría de Bandura, donde se enfatiza que la autoeficacia es un aspecto clave, entre otros, para adquirir o mejorar, conductas saludables (Luszczynska & Schwarzer, 2005). De esta forma, las creencias sobre la capacidad de cuidar la propia salud pueden predecir la realización de dicho autocuidado (Thrasher, et al, 2016). En esta línea, algunos autores han señalado a la autoeficacia como una variable predictora en la intención de ingerir alimentos bajos en calorías, frutas y verduras (Povey, Conner, Sparks, James, & Shepherd, 2000) mencionándola como uno de los elementos para fomentar el estilo de vida saludable (González-Cantero, et al, 2017), reducir el peso en personas adultas con sobrepeso (Annesi & Tennant, 2014) y mantenerlo en personas con normopeso (Teixeira, et al, 2010).…”

Social cognitions and smoking behaviour: Temporal resolution matters

“…In particular, the extended parallel process model (EPPM; Witte, 1992) proposes that in order to respond to health risks adaptively, people will need to perceive themselves at risk (risk perception) and have confidence in their ability to mitigate that risk (self-efficacy). This model has previously been applied to smoking behaviour, particularly in the context of health risk communication (e.g., Thrasher et al, 2016). This model has previously been applied to smoking behaviour, particularly in the context of health risk communication (e.g., Thrasher et al, 2016).…”

“…The model proposes that intentions to change are unlikely to develop unless one considers oneself susceptible to a threat of sufficient severity and simultaneously capable of averting it. This model has previously been applied to smoking behaviour, particularly in the context of health risk communication (e.g., Thrasher et al, 2016). However, like most theories of health behaviour, the EPPM is silent on the role of time in the conceptualization of these constructs (cf., Scholz, 2019).…”