Tailored Cigarette Warning Messages: How Individualized Loss Aversion and Delay Discounting Rates Can Influence Perceived Message Effectiveness

Abstract

Current text-only cigarette warning labels (long-term, loss-framed messages) may not motivate positive changes in smoking behavior. The current project was a cross-sectional study examining the effects of tailored cigarette warnings on perceived message effectiveness (PME) in adult smokers (n = 512) conducted using Amazon Mechanical Turk (M-Turk) in January–February 2020. Participants were an average age of 40.7 (SD = 11.6), with the majority of the sample being female (62.2%) and White (88.9%). Participants reported smoking an average of 14.6 cigarettes/day (SD = 9.2) with an average FTND score of 4.6 (SD = 2.2). Participants were asked to complete a tobacco use history questionnaire, and mixed gambles and delay discounting tasks before random assignment to one of five message groups. The groups were based on a 2 (gain versus loss framing) × 2 (short-term versus long-term framing) between-subject design; a fifth group served as the control group. All experimental messages reported higher PME scores than the control (p values < 0.001, Cohen’s d = 1.88–2.48). Participants with shallower delayed reward discounting and lower loss aversion rates reported higher total PME scores, p values < 0.05. Our findings also suggest that loss aversion rates vary widely among smokers and that individuals are more responsive to messages congruent with their behavioral economic profile. Specifically, smokers who viewed messages congruent with their loss aversion and delay discounting rates reported higher PME scores than those who viewed incongruent messages (p = 0.04, Cohen’s d = 0.24). These preliminary findings suggest that anti-smoking campaigns may best impact smokers by tailoring messages based on individual loss aversion and delay discounting rates versus a one-size-fits-all approach.

The Influence of Episodic Future Thinking and Graphic Warning Labels on Delay Discounting and Cigarette Demand

“…For example, evidence suggests that incorporating graphic warning labels (GWLs) on packs of cigarettes in behavioral economic decision tasks can reduce the reinforcing value of cigarettes, presumably by increasing the salience of delayed outcomes [ 29 ]. There is also recent research linking perceived effectiveness of cigarette warning labels to lower rates of delay discounting of monetary rewards [ 30 ]. It thereby follows that GWLs may implicitly invoke EFT similarly to other approaches associated with lower rates of delay discounting (e.g., the effects of explicit-zero framing on delay discounting of monetary gains and losses [ 31 ]).…”

Nudging Interventions on Alcohol and Tobacco Consumption in Adults: A Scoping Review of the Literature

“…Of the total number, after the two rounds of screening (i.e., titles, abstracts, and full texts), 3031 studies were screened out due to an incompatibility with the inclusion criteria (e.g., wrong intervention, no outcome measurement, wrong study design, or publication type). As a result, 20 studies [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] were included in the review. The full selection process is shown in Figure 1.…”

“…Of the 20 studies in the final review, 10 (50%) [49,50,53,54,[56][57][58][60][61][62] were conducted in the USA, 6 (30%) in the UK [45,46,48,52,55,59], 2 (10%) in South Africa [44,51], and 2 in Bangladesh (10%) [43,47]. 55% of the included studies focused their interventions on smoking cessation [43,45,47,50,54,[56][57][58][59]61,62], 35% on alcohol drinking cessation [46,48,49,52,53,55,60], and 10% targeted both risk factors [44,51]. Table S1 in the Supplementary Materials provides further details on the characteristics of the studies.…”

“…Furthermore, seven (35%) studies [44,45,51,53,54,57,61] involved the use of a nudge strategy as part of a multi-component intervention whereas the remainder (65%) adopted nudge strategies as single-component interventions [43,[46][47][48][49][50]52,55,56,[58][59][60]62].…”