Reactions to messages about smoking, vaping and COVID-19: two national experiments

Abstract

IntroductionThe pace and scale of the COVID-19 pandemic, coupled with ongoing efforts by health agencies to communicate harms, have created a pressing need for data to inform messaging about smoking, vaping, and COVID-19. We examined reactions to COVID-19 and traditional health harms messages discouraging smoking and vaping.MethodsParticipants were a national convenience sample of 810 US adults recruited online in May 2020. All participated in a smoking message experiment and a vaping message experiment, presented in a random order. In each experiment, participants viewed one message formatted as a Twitter post. The experiments adopted a 3 (traditional health harms of smoking or vaping: three harms, one harm, absent) × 2 (COVID-19 harms: one harm, absent) between-subjects design. Outcomes included perceived message effectiveness (primary) and constructs from the Tobacco Warnings Model (secondary: attention, negative affect, cognitive elaboration, social interactions).ResultsSmoking messages with traditional or COVID-19 harms elicited higher perceived effectiveness for discouraging smoking than control messages without these harms (all p <0.001). However, including both traditional and COVID-19 harms in smoking messages had no benefit beyond including either alone. Smoking messages affected Tobacco Warnings Model constructs and did not elicit more reactance than control messages. Smoking messages also elicited higher perceived effectiveness for discouraging vaping. Including traditional harms in messages about vaping elicited higher perceived effectiveness for discouraging vaping (p <0.05), but including COVID-19 harms did not.ConclusionsMessages linking smoking with COVID-19 may hold promise for discouraging smoking and may have the added benefit of also discouraging vaping.

Smokers’ Affective Responses to COVID-19-Related Health Warnings on Cigarette Packets: The Influence of Delay Discounting

“…The fact that including COVID-19-related warnings on cigarette packets did not substantially increase negative affective ratings across all smokers, is consistent with other recent findings that smokers reported equal emotional ratings (ie, fear, anxiety, sadness) of social media messages that contained THWs versus those that also contained C19HWs. [14] Therefore, despite the recent evidence that COVID-19 has prompted an increase in the motivation to quit, [12] the current evidence suggests that C19HWs may not be more effective than THWs in eliciting a negative affective response, and subsequent cessation, when ignoring the influence of impulsivity on participants' responses.…”

“…Currently, only one study has explored reactions to health messages highlighting the elevated COVID-19 severity for smokers. [14] In this study, participants viewed traditional health warnings (THW) and COVID-19-related health warnings (C19HW) as social media posts. Based on self-reported perceived effectiveness, negative emotion, and perceived harm, the authors report that C19HW messages were no more or less effective than THW messages.…”

Smoking and Vaping Among a National Sample of U.S. Adults During the COVID-19 Pandemic

“…In line with our findings related to perceived risk of COVID-19 and attempts to quit, prior work by Grummon et al using a convenience sample of U.S. adults found that both messaging related to traditional harms of smoking and those specifically related to COVID-19 had higher perceived effectiveness for discouraging smoking compared to control messages. 21 In contrast, while messaging about traditional harms of vaping were associated with higher perceived effectiveness for discouraging vaping compared to control, the same was not seen for COVID-19 related messages. 21 Thus, education of smokers on the relationship between smoking and COVID-19 risk may serve as an important motivator for cessation and/or reducing potential increases in product use.…”

“…21 In contrast, while messaging about traditional harms of vaping were associated with higher perceived effectiveness for discouraging vaping compared to control, the same was not seen for COVID-19 related messages. 21 Thus, education of smokers on the relationship between smoking and COVID-19 risk may serve as an important motivator for cessation and/or reducing potential increases in product use. Further research is necessary to assess the effects of public health messaging on smoking and vaping during the pandemic and optimize messaging content for these individuals.…”

The relationship between COVID-19-specific health risk beliefs and the motivation to quit smoking: a UK-based survey

“…Future work is now required to determine whether the higher motivation to quit smoking in some smokers persists beyond the peak of the pandemic and is transferred into lasting change in actual smoking behaviour, as motivation alone is not enough to result in long-lasting cessation (Borland et al, 2010). It may be that interventions can be utilised to enhance any increase in motivation to quit in response to the novel harm posed by COVID-19, though this will be dependent upon the progression of the virus globally (Grummon et al, 2020). It should be noted that the findings may be limited to a UK based sample, as the international response to COVID-19 has varied (Hale et al, 2020), meaning that replication is other samples is required.…”