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Tao R, Wang X, Wang Y, Yao H, Wu S, Liu J, Yang S. Emotional Appeals and Norms: How Normative Perceptions Moderate the Persuasive Impacts of Discrete Emotional Appeals within Tobacco Pictorial Warnings in China. HEALTH COMMUNICATION 2023:1-16. [PMID: 37947022 DOI: 10.1080/10410236.2023.2277036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Tobacco pictorial warnings could employ a variety of emotional appeals to enhance effectiveness; however, little research exists to guide the selection of discrete emotional appeals. Further, it remains unclear how contextual pro-smoking norms might influence the persuasive impacts of discrete emotional appeals within pictorial warnings, especially in China, where the overall smoking rate and social acceptance remain high. To fill these gaps, this study leveraged the largest set of pictorial warnings (K = 510) tested to date. Using a randomized large-K multiple-message design, we evaluated the impacts of disgust, fear, self-anger, contempt, shame, and hope appeals among Chinese adult male smokers (N = 2,306) on perceived message effectiveness (PME). Results showed that fear, self-anger, shame, and hope appeals significantly increased PME, while disgust and contempt appeals appeared less effective. Importantly, the PME of nearly all emotional appeals - except hope appeals - was weakened for Chinese adult male smokers with higher pro-smoking normative perceptions, highlighting the importance of considering local contextual influences when implementing pictorial warnings.
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Affiliation(s)
- Ran Tao
- School of Journalism and Mass Communication, University of Wisconsin-Madison
| | - Xinyi Wang
- Annenberg School for Communication, University of Pennsylvania
| | - Yidi Wang
- Department of Communication, University of California Santa Barbara
| | - Heyu Yao
- Center for Studies of Media Development, School of Journalism and Communication, Wuhan University
| | - Shiwen Wu
- Center for Studies of Media Development, School of Journalism and Communication, Wuhan University
| | - Jiaying Liu
- Department of Communication, University of California Santa Barbara
| | - Sijia Yang
- School of Journalism and Mass Communication, University of Wisconsin-Madison
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Tregobov N, Poureslami I, Shum J, Aran N, McMillan A, FitzGerald JM. Assessing factors influencing smoking and smoking cessation within Chinese communities in the Greater Vancouver Area: A qualitative exploratory study. Tob Prev Cessat 2020; 6:57. [PMID: 33163703 PMCID: PMC7643582 DOI: 10.18332/tpc/126631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of smoking is high within Chinese-Canadian communities and there is a lack of culturally and linguistically appropriate smoking cessation resources and services. We aimed to ascertain factors affecting smoking and smoking cessation from the perspectives of current smokers and key informants. METHODS As part of a multistage mixed-methods study taking place from January 2013 to June 2014, a qualitative exploratory study design was conducted applying a community-based participatory research approach. Focus groups and interviews were conducted with adult (aged ≥19 years) Chinese-Canadian current smokers (≥5 cigarettes per day for the past 30 days) and interviews were held with key informants in Vancouver, Canada. A constant comparison method was applied to code data, and an inductive approach was used to identify emergent themes. RESULTS In all, 35 smokers from the target communities (11 female, 24 male) participated in 4 focus group sessions and 17 key informants (14 female, 3 male) were individually interviewed. Internal and external factors influencing smoking onset, continuation, and cessation from the perspectives of smokers and key informants were identified. Male smokers thought that the most influential factor influencing smoking initiation was social pressure, while female smokers thought that it was stress. Female smokers reported refraining from seeking cessation assistance due to a perceived negative image of female smokers within the community. Both key informants and participants indicated that involving friends and family in the quitting process may help to motivate smokers. CONCLUSIONS Smokers from Chinese-Canadian communities may benefit from linguistically appropriate and culturally relevant smoking cessation interventions that consider prevailing attitudes, perceptions, and beliefs. The knowledge gained may inform the development of future smoking cessation programs and resources for the target community, while our approach may be applicable to other ethnocultural or immigrant communities.
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Affiliation(s)
- Noah Tregobov
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada.,Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Iraj Poureslami
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Jessica Shum
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Niloufar Aran
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Austin McMillan
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
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Chido-Amajuoyi OG, Agaku I, Mantey DS, Yu RK, Shete S. Association of Exposure to Court-Ordered Tobacco Industry Antismoking Advertisements With Intentions and Attempts to Quit Smoking Among US Adults. JAMA Netw Open 2020; 3:e209504. [PMID: 32633765 PMCID: PMC7341176 DOI: 10.1001/jamanetworkopen.2020.9504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In 2006, a US district court judge ordered tobacco companies to sponsor nationwide antismoking advertising campaigns. This landmark ruling and its subsequent execution represent an unprecedented tobacco control event; however, the association of this campaign with intentions and/or attempts to quit smoking is unknown. OBJECTIVES To assess the reach of the expanded court-ordered tobacco industry antismoking advertisements (via television, newspapers, tobacco company websites, and/or cigarette packages), to examine associations between exposure to industry antismoking advertisements and intentions and/or attempts to quit smoking among cigarette smokers, and to calculate the numbers of US smokers who would have quit intentions associated with exposure to multiple advertisements. DESIGN, SETTING, AND PARTICIPANTS Data for this study were obtained from 5309 US adults, including 610 smokers, who responded to the Health Information National Trends Survey, a nationally representative cross-sectional survey conducted from January 22 to April 30, 2019. Respondents were representatives of households selected by equal-probability sampling of a database of US residential addresses. EXPOSURE Reported exposure to antismoking messages. MAIN OUTCOMES AND MEASURES Cigarette smoking cessation attempt in the past 12 months and intentions to quit cigarette smoking in the next 6 months. Covariates were age, sex, household annual income, race/ethnicity, educational level, and geographical residence. Data were weighted to be nationally representative after applying survey weights specified for the survey cycle. RESULTS The overall sample of 5309 respondents were a mean (SD) age of 55.6 (19.1) years and included 3073 women (51.2%), 3037 non-Hispanic white respondents (59.1%), 4645 respondents who lived in urban US areas (84.7%), and 610 current smokers (12.5%). Findings indicate that 2464 US adults (45.8%; 95% CI, 43.2%-48.5%) and 410 current smokers (66.8%; 95% CI, 61.1%-72.4%) were exposed to antismoking advertisements. Exposure to multiple antismoking messages was associated with 2.19 (95% CI, 1.10-4.34) greater odds of having intentions to quit cigarette smoking but was not associated with attempts to quit (adjusted odds ratio, 1.31; 95% CI, 0.69-2.52). Furthermore, an examination of the association of cumulative exposure to antismoking messages with cessation intentions revealed that, with each additional exposure to an antismoking message, the odds of smoking cessation intentions increased by 1.21 (95% CI, 1.02-1.44). If all smokers were to be exposed to multiple antitobacco messages, there could be an estimated 3.98 million (95% CI, 492 480-7 223 040) current smokers in the United States with intentions to quit. CONCLUSIONS AND RELEVANCE Although the reach of court-ordered industry advertisements increased among smokers, the reach of these advertisements within the general population remains suboptimal. The finding that industry advertisements helped smokers consider quitting highlights their potential to aid smoking cessation. However, the lack of association with actual attempts to quit suggests that the industry antismoking advertisement campaigns were inadequate. The design and content of industry antismoking advertisement campaigns should be enhanced to help smokers quit.
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Affiliation(s)
| | - Israel Agaku
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Dale S. Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Houston
| | - Robert K. Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston
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Levy DT, Tam J, Kuo C, Fong GT, Chaloupka F. The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 24:448-457. [PMID: 29346189 PMCID: PMC6050159 DOI: 10.1097/phh.0000000000000780] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The Tobacco Control Scorecard, published in 2004, presented estimates of the effectiveness of different policies on smoking rates. Since its publication, new evidence has emerged. We update the Scorecard to include recent studies of demand-reducing tobacco policies for high-income countries. We include cigarette taxes, smoke-free air laws, media campaigns, comprehensive tobacco control programs, marketing bans, health warnings, and cessation treatment policies. To update the 2004 Scorecard, a narrative review was conducted on reviews and studies published after 2000, with additional focus on 3 policies in which previous evidence was limited: tobacco control programs, graphic health warnings, and marketing bans. We consider evaluation studies that measured the effects of policies on smoking behaviors. Based on these findings, we derive estimates of short-term and long-term policy effect sizes. Cigarette taxes, smoke-free air laws, marketing restrictions, and comprehensive tobacco control programs are each found to play important roles in reducing smoking prevalence. Cessation treatment policies and graphic health warnings also reduce smoking and, when combined with policies that increase quit attempts, can improve quit success. The effect sizes are broadly consistent with those previously reported for the 2004 Scorecard but now reflect the larger evidence base evaluating the impact of health warnings and advertising restrictions.
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Affiliation(s)
- David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia (Dr Levy and Ms Kou); Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan (Ms Tam); Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada (Dr Fong); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (Dr Fong); and Health Policy Center, Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois (Dr Chaloupka)
| | - Jamie Tam
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia (Dr Levy and Ms Kou); Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan (Ms Tam); Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada (Dr Fong); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (Dr Fong); and Health Policy Center, Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois (Dr Chaloupka)
| | - Charlene Kuo
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia (Dr Levy and Ms Kou); Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan (Ms Tam); Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada (Dr Fong); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (Dr Fong); and Health Policy Center, Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois (Dr Chaloupka)
| | - Geoffrey T. Fong
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia (Dr Levy and Ms Kou); Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan (Ms Tam); Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada (Dr Fong); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (Dr Fong); and Health Policy Center, Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois (Dr Chaloupka)
| | - Frank Chaloupka
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia (Dr Levy and Ms Kou); Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan (Ms Tam); Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada (Dr Fong); Ontario Institute for Cancer Research, Toronto, Ontario, Canada (Dr Fong); and Health Policy Center, Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, Illinois (Dr Chaloupka)
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Madewell ZJ, Kolaja CA. Smokeless Tobacco Warnings in Indian Mass Media: Intention and Attempts to Quit. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_135_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Introduction: In India, over 200 million people use smokeless tobacco (SLT), which increases the risk of cancers. Studies have demonstrated mass media campaigns effectively reduce smoking tobacco prevalence, but few have assessed their impact on SLT cessation. Objectives: This study used data from the Global Adult Tobacco Surveys (GATS) in 2009–2010 and 2016–2017 to examine associations between SLT health warnings in mass media, and intention and attempts to quit using SLT. We also compared the proportion of SLT users who noticed mass media warnings between 2009–2010 and 2016–2017. Materials and Methods: Over 16,000 and 15,000 current SLT users from the GATS-1 and GATS-2, respectively, were used for analysis. Weighted logistic regression models were used to analyze associations between noticed health warnings on SLT packages, newspapers/magazines, television, radio, billboards, cinemas, internet, vehicles, and walls, and intention and attempts to quit SLT. Results: In final models, the odds of intention and attempts to quit were highest among those who noticed warnings in newspapers/magazines (adjusted odds ratio [AOR]: 1.50; 95% confidence interval [CI]: 1.30–1.74) and the internet (AOR: 1.60; 95% CI: 1.12–2.29), respectively. Warnings on SLT packages, television, billboards, radio, vehicles, and walls were also associated with increased cessation behavior. More noticed warnings on SLT packages, television, billboards, and newspapers/magazines in GATS-2 than GATS-1, but fewer heard radio warnings. Conclusions: Among Indian SLT users, we found evidence that SLT warnings in mass media may promote cessation behavior. Health warnings in mass media could play an important role in the overall strategy to reduce the morbidity and mortality associated with SLT use.
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Affiliation(s)
- Zachary J. Madewell
- University of California, San Diego/San Diego State University, PhD Program in Public Health (Epidemiology), Department of Family Medicine and Public Health, La Jolla, CA 92093, USA
| | - Claire A. Kolaja
- University of California, San Diego/San Diego State University, PhD Program in Public Health (Epidemiology), Department of Family Medicine and Public Health, San Diego, CA 92107, USA
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6
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Noar SM, Francis DB, Bridges C, Sontag JM, Brewer NT, Ribisl KM. Effects of Strengthening Cigarette Pack Warnings on Attention and Message Processing: A Systematic Review. JOURNALISM & MASS COMMUNICATION QUARTERLY 2017; 94:416-442. [PMID: 29975497 PMCID: PMC5483339 DOI: 10.1177/1077699016674188] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The current study sought to examine the impact of strengthening cigarette pack warnings on attention, message processing, and perceived effectiveness, through a systematic review of longitudinal observational studies. The review included 22 studies (N = 81,824 participants). Strengthened warnings increased attention to warnings, recall of warnings, and thinking about the health risks of smoking. Strengthened warnings also increased several perceived effectiveness outcomes, including perceptions that warnings reduce smoking and motivate quitting. Strengthened cigarette pack warnings achieve their goal of attracting attention and enhancing motivation to act. Strengthening warning policies should be a priority for tobacco control globally.
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Affiliation(s)
- Seth M. Noar
- The University of North Carolina at Chapel Hill, USA
- Seth M. Noar, School of Media and Journalism, The University of North Carolina at Chapel Hill, 382 Carroll Hall, CB 3365, Chapel Hill, NC 27599-3365, USA.
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Stone ECA, Zhou C. Slowing the Titanic: China's Epic Struggle with Tobacco. J Thorac Oncol 2016; 11:2053-2065. [PMID: 27498288 DOI: 10.1016/j.jtho.2016.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 06/28/2016] [Accepted: 07/15/2016] [Indexed: 12/18/2022]
Abstract
China is home to a third of the world's smokers and, correspondingly, to a third of the world's cases of lung cancer. Beginning in the mid-1990s, a generation or so later than in many Western countries, the Chinese government commenced measures to control tobacco, limiting advertising, banning smoking in many public venues, and increasing taxation. At the time of this review, there are signs that these policies are having some effect, but hundreds of millions of Chinese continue to smoke and rates of diagnosis of lung cancer continue to rise. There is much work to be done and much premature death to be suffered before the epidemic is slowed to the levels reached in Australia or the United States. This article aims to provide, particularly for practicing lung cancer clinicians, a description of patterns of smoking in China, the lung cancer epidemic there, and the stimuli for and barriers to tobacco control imposed by the highly complex and unique regulatory setting of the Chinese tobacco industry. A particular challenge in developing this description has come from the variability of studies published about a huge nation that has enormous diversity in wealth, education, urbanization, and tradition. The studies vary because the data vary. Much information on lung cancer and smoking rates in China comes, for example, from studies of cohorts that may number in the millions yet represent only a small percentage of the population and sometimes only a tiny geographic area of such a vast nation. National registry data on lung cancer in China do not yet cover even a fifth of the national population. Even so, we argue that several major trends can be identified: (1) more than 50% of men smoke regularly; (2) there are more than 300 million smokers in China; (3) almost half a million new cases of lung cancer are diagnosed in China each year; (4) secondhand smoking is a significant problem in China (as elsewhere), accounting for a high proportion of lung cancer cases among women, most of whom do not smoke; (5) corrected for age and sex, lung cancer rates in the Chinese population are as least as high as in Western countries and arguably higher; and (6) a shift over time from squamous cell carcinoma (SCC) to adenocarcinoma is occurring in parallel with that noted in Western populations. Looking to the future, measures to control tobacco in China are strengthening but remain relatively weak. The reinforcement of control is hampered by the circumstance that the tobacco industry remains a powerful state-owned monopoly that participates, through its membership of key government bodies, in the processes that oversee the implementation of tobacco control. The conflict between the government's dual responsibilities for both the production and distribution of tobacco and for the implementation of tobacco control carries inherent contradictions and bias. How long the Chinese government chooses to live with these contradictions will determine how quickly the smoking of tobacco will be reduced and how soon the burden of disease that tobacco inflicts on individuals and society as a whole will be eased.
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Affiliation(s)
- Emily C A Stone
- Department of Thoracic Medicine, St. Vincent's Hospital, Kinghorn Cancer Centre, Sydney, Australia; University of New South Wales, Sydney, Australia.
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Cancer Institute of Tongji University Medical School, Shanghai, China
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8
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Wong TJ, King JL, Pomeranz JL. Cultural variation in antismoking video ads between the United States, Taiwan, and China. HEALTH EDUCATION RESEARCH 2016; 31:603-613. [PMID: 27484065 DOI: 10.1093/her/cyw034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 06/25/2016] [Indexed: 06/06/2023]
Abstract
Antitobacco advertisement components, including types of messages and advertising appeals, have not been evaluated among multinational groups. This study identified and compared the content of antismoking video ads across three countries. We reviewed 86 antismoking video advertisements for the following information: severity of the consequences of smoking, types of risks, appeals to audiences' self-efficacy, benefits of not smoking, targeted social-ecological level and types of message appeal used. Two researchers independently coded each advertisement with an average inter-coder reliability of 0.79.Analyses showed a variety of focuses: smoking-related health risks (86%), severe consequences of smoking (54.7%), self-efficacy beliefs (40.7%) and benefits of not smoking (84.9%). Compared to the United States and Taiwanese ads, Chinese ads were more likely to target at the community level (10% versus 23.3% versus 47.2%). Additionally, 55% of the United States ads used the fear approach, whereas 61.1% of Chinese ads used the social approach. Taiwanese ads were evenly distributed among both approaches. In conclusion, the countries used different targeting strategies and approaches during message delivery. Although China's neighboring country, Taiwan, has many similar cultural aspects, including the same language, they are greatly influenced by US antitobacco campaigns. As a result, Taiwan's tobacco campaigns appear to have similar components to both China and the United States. Further research is warranted to understand the reasons for each method and to examine the effectiveness of the ads in reducing smoking rates.
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Affiliation(s)
- Tzu-Jung Wong
- Department of Behavioral Science and Community Health, College of Public Health and Public Professions, University of Florida, 1225 Center Drive, Room 4160, Gainesville, FL 32611, USA
| | - Jessica L King
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Jamie L Pomeranz
- Department of Behavioral Science and Community Health, College of Public Health and Public Professions, University of Florida, 1225 Center Drive, Room 4160, Gainesville, FL 32611, USA
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Jiang S, Beaudoin CE. Smoking Prevention in China: A Content Analysis of an Anti-Smoking Social Media Campaign. JOURNAL OF HEALTH COMMUNICATION 2016; 21:755-764. [PMID: 27232655 DOI: 10.1080/10810730.2016.1157653] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The China Tobacco Control Media Campaign on Sina Weibo is novel in the context of smoking prevention and cessation in China and has not to date been evaluated. This study draws on health behavior theories and dialogic theory in public relations to analyze microblog campaign postings and their relationships with the outcome of online audience engagement. Microblog postings from May 2011 to January 2015 were content analyzed, showing that the most common persuasive content characteristic was perceived risk, followed by subjective norms and self-efficacy. Perceived risk and self-efficacy postings positively influenced online audience engagement, whereas subjective norm postings was a nonsignificant predictor. Postings were more likely to share information than aim to interact with audience members. However, both information sharing and audience interaction postings were positive predictors of online audience engagement. There was also evidence of main and interactive effects of message originality on online audience engagement. The current study has, to the best of our knowledge, broken new ground in 2 regards: (a) using health behavior theories as a basis for analyzing the content of an anti-smoking social media campaign and (b) examining the content of an anti-smoking media campaign of any type in China.
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Affiliation(s)
- Shaohai Jiang
- a Department of Communication , Texas A&M University , College Station , Texas , USA
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Coletti DJ, Brunette M, John M, Kane JM, Malhotra AK, Robinson DG. Responses to Tobacco Smoking-Related Health Messages in Young People With Recent-Onset Schizophrenia. Schizophr Bull 2015; 41:1256-65. [PMID: 26316595 PMCID: PMC4601721 DOI: 10.1093/schbul/sbv122] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Virtually no research has examined the responses of youth with recent-onset psychosis (ROP) to smoking-related health warnings. We examined predictors of response and tested hypotheses that participants with ROP would (a) assess warnings as less effective than a healthy comparison (HC) group, and (b) assess video warnings as more effective than pictures. ROP participants (n = 69) had <2 years of prior antipsychotic treatment; the HC group (n = 79) had no major mental illness. Participants viewed 10 pictorial warnings, 8 videos depicting similar messages, and were interviewed regarding tobacco use, health literacy, and smoking knowledge. We assessed response at baseline and at 4-week follow-up. ROP participants were more likely than HC to smoke tobacco (49.3% vs 10.1%) and had lower levels of health literacy and smoking-related knowledge. Cannabis was used by 46.4% of ROP participants. Effectiveness ratings were high for both picture and video warnings with no differences between media. ROP participants compared to HC and nonsmokers compared to smokers were more likely to perceive warnings as effective. Effectiveness was associated with negative affect and greater emotional arousal. We assessed 33 smokers at follow-up; 5 (15%) identified as nonsmokers, 15 (45%) made a quit attempt, and 16 (49%) reported that the warnings influenced their smoking. Results indicate that young people with psychotic disorders respond favorably to health warnings. Effective messages depict health consequences clearly, elicit negative emotions, and may impact smoking behavior. Future research is needed to understand the effects of mode of presentation and message comprehension on smoking behavior.
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Affiliation(s)
- Daniel J. Coletti
- *To whom correspondence should be addressed; North Shore-LIJ Division of General Internal Medicine, 865 Northern Blvd, Suite 102, Great Neck, NY 11021, US; tel: 718-470-4606, fax: 516-622-5005, e-mail:
| | - Mary Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Majnu John
- The Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY
| | - John M. Kane
- The Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY;,Departments of Psychiatry and Molecular Medicine, Hofstra-LIJ School of Medicine, Hempstead, NY
| | - Anil K. Malhotra
- The Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY;,Departments of Psychiatry and Molecular Medicine, Hofstra-LIJ School of Medicine, Hempstead, NY
| | - Delbert G. Robinson
- The Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY;,Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY;,Departments of Psychiatry and Molecular Medicine, Hofstra-LIJ School of Medicine, Hempstead, NY
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11
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Goren A, Gupta S, Dong P, Feng Y, Chen C, Liu D. Burden of smoking among adults with COPD, chronic bronchitis, and emphysema in urban China. Int J Clin Pract 2015; 69:1015-28. [PMID: 26136208 DOI: 10.1111/ijcp.12680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Tobacco, widely used in China, poses a major risk for chronic obstructive pulmonary disease (COPD). This study assessed health outcomes of COPD-diagnosed smokers vs. never smokers and examined treatment patterns of patients attempting to quit smoking in urban China. METHODS National Health and Wellness Survey (NHWS) 2010 and 2012 China data were analysed. Respondents self-reporting diagnosis with COPD, chronic bronchitis, or emphysema were categorised: quit attempters (current smokers 'trying to quit' or non-smokers 'in the process of quitting'), smokers (including quit attempters) and those who never smoked. Respondents reported smoking cessation treatment utilisation; health status: SF-36v2-based scores and SF-6D health utilities; Work Productivity and Activity Impairment questionnaire-based metrics; and resource utilisation. Regression modelling assessed health outcomes, controlling for covariates. RESULTS Among 1421 (3.6%) diagnosed respondents, 51.6% never smoked and 35.5% smoked (of whom, 43.8% were attempting to quit). After adjustments, smokers vs. never smokers had significantly lower health utilities, lower mental/physical health status and greater absenteeism, presenteeism, overall work impairment, activity impairment, emergency room visits, hospitalisations and provider visits. Quit attempters were diagnosed an average 6.9 years (SD = 7.7) previously, with 25.3% reporting moderate/severe COPD. Most-reported main causes of COPD were: smoking (57.5%), illnesses/conditions (53.8%) and pollutants (44.3%). Among quit attempters, 82.8% smoked currently. Use of prescription cessation treatments was reported by 12.7%. CONCLUSIONS Smokers experienced poorer health outcomes, reinforcing importance of prevention in mitigating disease burden. Among quit attempters, few reported using prescription cessation treatments. Given the high burden imposed by smoking in China, effective interventions may be beneficial.
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Affiliation(s)
- A Goren
- Kantar Health, New York, NY, USA
| | - S Gupta
- Kantar Health, Princeton, NJ, USA
| | - P Dong
- Pfizer Investment Co., Ltd., Beijing, China
| | - Y Feng
- Pfizer Investment Co., Ltd., Beijing, China
| | - C Chen
- Pfizer Investment Co., Ltd., Beijing, China
| | - D Liu
- Pfizer Investment Co., Ltd., Beijing, China
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Li L, Borland R, Fong GT, Jiang Y, Yang Y, Wang L, Partos TR, Thrasher JF. Smoking-related thoughts and microbehaviours, and their predictive power for quitting. Tob Control 2015; 24:354-61. [PMID: 24570098 PMCID: PMC4532545 DOI: 10.1136/tobaccocontrol-2013-051384] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/29/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Negative attitudes to smoking are well-established predictors of intentions to quit and quit behaviours, but less attention has been given to whether quitting is influenced by smoking-related thoughts and microbehaviours that reflect a concern about smoking. OBJECTIVES This paper aimed to describe the occurrence of smoking-related thoughts and microbehaviours among Chinese smokers, and to examine their predictive power for making quit attempts and sustained abstinence. METHODS The data came from the first three waves of the International Tobacco Control China Survey. Four measures of recent thoughts about smoking and two microbehaviour measures (collectively referred to as microindicators) were examined. RESULTS Most smokers (around three-quarters) reported thinking about harms of smoking to themselves or to others at least occasionally, and an increasing minority reported the two microbehaviours of prematurely butting out cigarettes and forgoing them. All microindicators were positively related to subsequent quit attempts in individual predictor analyses, but only serious thoughts about quitting and butting out cigarettes had independent relationships. Overall, there was no clear relationship between these microindicators and sustained abstinence. CONCLUSIONS There was a moderately high level of occurrence of recent smoking-related thoughts and microbehaviours among the Chinese adult smokers in the six cities studied. Like in the West, microindicators of concern about smoking were positively associated with subsequent quit attempts, but unlike in the West, they were largely unrelated to sustained abstinence.
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Affiliation(s)
- Lin Li
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - Ron Borland
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Yang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lili Wang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Timea R. Partos
- Research Division, Cancer Council Victoria, Melbourne, Australia
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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13
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Im PK, McNeill A, Thompson ME, Fong GT, Xu S, Quah ACK, Jiang Y, Shahab L. Individual and interpersonal triggers to quit smoking in China: a cross-sectional analysis. Tob Control 2015; 24 Suppl 4:iv40-7. [PMID: 25888422 DOI: 10.1136/tobaccocontrol-2014-052198] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/31/2015] [Indexed: 11/04/2022]
Abstract
AIMS To determine the most prominent individual and interpersonal triggers to quit smoking in China and their associations with sociodemographic characteristics. METHODS Data come from Waves 1-3 (2006-2009) of the International Tobacco Control (ITC) China Survey, analysed cross-sectionally as person-waves (N=14,358). Measures included sociodemographic and smoking characteristics. Those who quit between waves (4.3%) were asked about triggers that 'very much' led them to stop smoking, and continuing smokers about triggers that 'very much' made them think about quitting. Triggers covered individual (personal health concerns, cigarette price, smoking restrictions, advertisements, warning labels) and interpersonal factors (family/societal disapproval of smoking, setting an example to children, concerns about secondhand smoke). RESULTS Over a third of respondents (34.9%) endorsed at least one trigger strongly; quitters were more likely than smokers to mention any trigger. While similar proportions of smokers endorsed individual (24.4%) and interpersonal triggers (24.0%), quitters endorsed more individual (61.1%) than interpersonal (48.3%) triggers. However, the most common triggers (personal health concerns; setting an example to children) were the same, endorsed by two-thirds of quitters and a quarter of smokers, as were the least common triggers (warning labels; cigarette price), endorsed by 1 in 10 quitters and 1 in 20 smokers. Lower dependence among smokers and greater education among all respondents were associated with endorsing any trigger. CONCLUSIONS Individual rather than interpersonal triggers appear more important for quitters. Major opportunities to motivate quit attempts are missed in China, particularly with regard to taxation and risk communication. Interventions need to focus on more dependent and less-educated smokers.
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Affiliation(s)
- Pek Kei Im
- Department of Anthropology, University College London, London, UK Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ann McNeill
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Steve Xu
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Yuan Jiang
- National Tobacco Control Office, Chinese Center for Disease Control and Prevention, China
| | - Lion Shahab
- Department of Epidemiology and Public Health, University College London, London, UK
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14
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Aboaziza E, Eissenberg T. Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence? Tob Control 2015; 24 Suppl 1:i44-i53. [PMID: 25492935 PMCID: PMC4345797 DOI: 10.1136/tobaccocontrol-2014-051910] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/20/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) involves passing tobacco smoke through water prior to inhalation, and has spread worldwide. This spread becomes a public health concern if it is associated with tobacco-caused disease and if WTS supports tobacco/nicotine dependence. A growing literature demonstrates that WTS is associated with disability, disease and death. This narrative review examines if WTS supports nicotine/tobacco dependence, and is intended to help guide tobacco control efforts worldwide. DATA SOURCES PUBMED search using: (("waterpipe" or "narghile" or "arghile" or "shisha" or "goza" or "narkeela" or "hookah" or "hubble bubble")) AND ("dependence" or "addiction"). STUDY SELECTION Excluded were articles not in English, without original data, and that were not topic-related. Thirty-two articles were included with others identified by inspecting reference lists and other sources. DATA SYNTHESIS WTS and the delivery of the dependence-producing drug nicotine were examined, and then the extent to which the articles addressed WTS-induced nicotine/dependence explicitly, as well as implicitly with reference to criteria for dependence outlined by the WHO. CONCLUSIONS WTS supports nicotine/tobacco dependence because it is associated with nicotine delivery, and because some smokers experience withdrawal when they abstain from waterpipe, alter their behaviour in order to access a waterpipe and have difficulty quitting, even when motivated to do so. There is a strong need to support research investigating measurement of WTS-induced tobacco dependence, to inform the public of the risks of WTS, which include dependence, disability, disease and death, and to include WTS in the same public health policies that address tobacco cigarettes.
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Affiliation(s)
- Eiman Aboaziza
- Center for Clinical and Translational Research and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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15
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Behavioral medicine in China. Int J Behav Med 2014; 21:571-3. [PMID: 24898631 DOI: 10.1007/s12529-014-9419-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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