Mediational Pathways of the Impact of Cigarette Warning Labels on Quit Attempts.
Yong, Hua-Hie 1; Borland, Ron 1; Thrasher, James F. 2; Thompson, Mary E. 3; Nagelhout, Gera E. 4; Fong, Geoffrey T. 5; Hammond, David 6; Cummings, Michael K. 7
[Article]
Health Psychology.
33(11):1410-1420, November 2014.
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Objective: To test and develop, using structural equation modeling, a robust model of the mediational pathways through which health warning labels exert their influence on smokers' subsequent quitting behavior.
Method: Data come from the International Tobacco Control Four-Country Survey, a longitudinal cohort study conducted in Australia, Canada, the United Kingdom, and the United States. Waves 5-6 data (n = 4,988) were used to calibrate the hypothesized model of warning label impact on subsequent quit attempts via a set of policy-specific and general psychosocial mediators. The finalized model was validated using Waves 6-7 data (n = 5065).
Results: As hypothesized, warning label salience was positively associated with thoughts about risks of smoking stimulated by the warnings ([beta] = .58, p < .001), which in turn were positively related to increased worry about negative outcomes of smoking ([beta] = .52, p < .001); increased worry in turn predicted stronger intention to quit ([beta] = .39, p < .001), which was a strong predictor of subsequent quit attempts ([beta] = .39, p < .001). This calibrated model was successfully replicated using Waves 6-7 data.
Conclusion: Health warning labels seem to influence future quitting attempts primarily through their ability to stimulate thoughts about the risks of smoking, which in turn help to raise smoking-related health concerns, which lead to stronger intentions to quit, a known key predictor of future quit attempts for smokers. By making warning labels more salient and engaging, they should have a greater chance to change behavior.
(C) 2014 by the American Psychological Association