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Seaman EL, Robinson CD, Crane D, Taber JM, Ferrer RA, Harris PR, Klein WMP. Association of Spontaneous and Induced Self-Affirmation With Smoking Cessation in Users of a Mobile App: Randomized Controlled Trial. J Med Internet Res 2021; 23:e18433. [PMID: 33666561 PMCID: PMC7980123 DOI: 10.2196/18433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/21/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
Background Most smokers attempt to stop using cigarettes numerous times before successfully quitting. Cigarette cravings may undermine perceived competence to quit and thus constitute psychological threats to the individual’s self-concept. Self-affirmation may promote smoking cessation by offsetting these threats. Objective This study examines whether self-affirmation is associated with smoking cessation in the context of a cessation app. Two types of self-affirmation are examined: tendency to spontaneously self-affirm, and self-affirmation inductions added to a publicly available smoking cessation app (Smoke-Free Quit Smoking Now). In addition, this study explores whether optimism and emotional states (happiness, anger, anxiousness, hopefulness, sadness) predict smoking cessation. Methods All users who met the inclusion criteria, provided consent to participate, and completed a baseline assessment, including all individual difference measures, were randomized to 1 of 4 conditions. Half of the participants were randomly assigned to complete a self-affirmation induction upon study entry. Orthogonally, half of the participants were randomly assigned to receive self-affirming text notifications during their quit attempt or to receive conventional notifications. The induction and the text notifications were fully automated, and all data were collected through self-assessments in the app. Self-reported smoking cessation was assessed 1 month and 3 months following study entry. Results The study enrolled 7899 participants; 647 completed the 1-month follow-up. Using an intent-to-treat analysis at the 1-month follow-up, 7.2% (569/7899) of participants self-reported not smoking in the previous week and 6.4% (503/7899) self-reported not smoking in the previous month. Greater tendency to spontaneously self-affirm predicted a greater likelihood of cessation (P<.001) at 1 month after controlling for smoking-related variables. Neither self-affirmation induction influenced cessation. In addition, spontaneous self-affirmation did not moderate the relationship between self-affirmation inductions and cessation. Greater baseline sadness was associated with a lower likelihood of reporting successful cessation. Optimism predicted past-week cessation at the 1-month follow-up, and both happiness and anger predicted past-month cessation at the 1-month follow-up; however, none of these potential predictors moderated the relationship between self-affirmation conditions and successful cessation. Conclusions Spontaneous self-affirmation may be an important psychological resource for managing threats to self-concept during the smoking cessation process. Sadness may hinder quit attempts. Future research can explicate how spontaneous versus induced self-affirmation can promote smoking cessation and examine boundary conditions for the effectiveness of disseminated self-affirmation interventions. Trial Registration ISRCTN Registry 56646695; https://www.isrctn.com/ISRCTN56646695
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Affiliation(s)
| | - Cendrine D Robinson
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | | | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Rebecca A Ferrer
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Peter R Harris
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - William M P Klein
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
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Begum M, Urquhart I, Lewison G, Fouad F, Sullivan R. Research on lung cancer and its funding, 2004-2018. Ecancermedicalscience 2020; 14:1132. [PMID: 33281924 PMCID: PMC7685768 DOI: 10.3332/ecancer.2020.1132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Indexed: 12/26/2022] Open
Abstract
Although smoking is declining in high-income countries, the relative burden from its most well-known consequence, lung cancer, continues to increase, especially in low-income countries. We examined the amount, types, geographical origins and funding of research on lung cancer as revealed by papers in the Web of Science over the 15 years, 2004–2018. The annual number of lung cancer research papers increased over the study period from 2,157 to 8,202, but as a percentage of all biomedical research in Western Europe and North America they only accounted for one-eighth of the percentage of the disease burden. Lung cancer increased its share of cancer research from 4.4% to 6.5%, mainly because of the greatly expanded output from China in 2014–2018 which published almost one-third of the world’s total on a fractional count basis. For almost all other countries, their lung cancer presence in cancer research has declined over the 15 years. However, only 15% of the Chinese papers were co-authored internationally and its research was focussed on treatment rather than prevention. Support for lung cancer research is primarily from the government rather than charity. There is therefore an urgent need to increase support for lung cancer research, and for more international collaboration, especially in low-income countries where the disease burden is growing rapidly, and in neglected domains, such as screening and palliative care.
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Affiliation(s)
- Mursheda Begum
- Queen Mary University of London, Business School, Mile End Road, London E1 4NS, UK.,King's College London, Institute of Cancer Policy, Guy's Hospital, London SE1 9RT, UK
| | - Isobel Urquhart
- University of Bristol, School of Geographical Sciences, University Road, Bristol BS8 1SS, UK
| | - Grant Lewison
- King's College London, Institute of Cancer Policy, Guy's Hospital, London SE1 9RT, UK
| | - Fouad Fouad
- Faculty of Health Science, American University of Beirut, Beirut, Lebanon
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Guy's Hospital, London SE1 9RT, UK.,https://orcid.org/0000-0002-4493-1216
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Schmälzle R, Cooper N, O’Donnell MB, Tompson S, Lee S, Cantrell J, Vettel JM, Falk EB. The Effectiveness of Online Messages for Promoting Smoking Cessation Resources: Predicting Nationwide Campaign Effects From Neural Responses in the EX Campaign. Front Hum Neurosci 2020; 14:565772. [PMID: 33100997 PMCID: PMC7546826 DOI: 10.3389/fnhum.2020.565772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/20/2020] [Indexed: 01/14/2023] Open
Abstract
What are the key ingredients that make some persuasive messages resonate with audiences and elicit action, while others fail? Billions of dollars per year are put towards changing human behavior, but it is difficult to know which messages will be the most persuasive in the field. By combining novel neuroimaging techniques and large-scale online data, we examine the role of key health communication variables relevant to motivating action at scale. We exposed a sample of smokers to anti-smoking web-banner messages from a real-world campaign while measuring message-evoked brain response patterns via fMRI, and we also obtained subjective evaluations of each banner. Neural indices were derived based on: (i) message-evoked activity in specific brain regions; and (ii) spatially distributed response patterns, both selected based on prior research and theoretical considerations. Next, we connected the neural and subjective data with an independent, objective outcome of message success, which is the per-banner click-through rate in the real-world campaign. Results show that messages evoking brain responses more similar to signatures of negative emotion and vividness had lower online click-through-rates. This strategy helps to connect and integrate the rapidly growing body of knowledge about brain function with formative research and outcome evaluation of health campaigns, and could ultimately further disease prevention efforts.
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Affiliation(s)
- Ralf Schmälzle
- Department of Communication, College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, United States
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States
- U.S. Army Research Laboratory, Aberdeen Proving Ground, Adelphi, MD, United States
| | - Matthew Brook O’Donnell
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States
| | - Steven Tompson
- U.S. Army Research Laboratory, Aberdeen Proving Ground, Adelphi, MD, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Sangil Lee
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer Cantrell
- New York University School of Global Public Health, New York, NY, United States
| | - Jean M. Vettel
- U.S. Army Research Laboratory, Aberdeen Proving Ground, Adelphi, MD, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Emily B. Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, PA, United States
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Taber JM, McQueen A, Simonovic N, Waters EA. Adapting a self-affirmation intervention for use in a mobile application for smokers. J Behav Med 2019; 42:1050-1061. [PMID: 30903442 DOI: 10.1007/s10865-019-00028-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/12/2019] [Indexed: 12/15/2022]
Abstract
Self-affirmation interventions can reduce defensive responses to threats to the self, but have had limited reach to the general population. We sought to create an effective and feasible version of the Kindness Questionnaire self-affirmation intervention for use on a mobile device outside the traditional university laboratory setting and by non-student participants. In an online experiment, 603 cigarette smokers (Mage= 37.5 years, SD = 10.2) were randomly assigned to one of six conditions in a 2 (Self-Affirmation: Self-Affirmation, No Self-Affirmation Control) × 3 (Example Type: Written, Imagined, No Examples) fully-crossed design. Participants read a message about the health harms of smoking. None of the self-affirmation variations were effective or feasible: the self-affirmation showed null effects on the primary outcomes of message acceptance, perceived message effectiveness, and reactance. It also backfired by reducing intentions to quit smoking and risk perceptions. Participants spent little time reading the health message, and those in the written self-affirmation condition infrequently provided detailed responses. Translating interventions developed and tested for efficacy in laboratory settings to "real-world" settings is necessary but challenging.
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Affiliation(s)
- Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242-0001, USA.
| | - Amy McQueen
- School of Medicine, Washington University in Saint Louis, Saint Louis, MO, 63110, USA
| | - Nicolle Simonovic
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242-0001, USA
| | - Erika A Waters
- School of Medicine, Washington University in Saint Louis, Saint Louis, MO, 63110, USA
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Sillero-Rejon C, Attwood AS, Blackwell AKM, Ibáñez-Zapata JA, Munafò MR, Maynard OM. Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity. BMC Public Health 2018; 18:1403. [PMID: 30577730 PMCID: PMC6303887 DOI: 10.1186/s12889-018-6243-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 11/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We examined whether enhancing self-affirmation among a population of drinkers, prior to viewing threatening alcohol pictorial health warning labels, would reduce defensive reactions and promote reactions related to behaviour change. We also examined how health warning severity influences these reactions and whether there is an interaction between self-affirmation and severity. METHODS In this experimental human laboratory study, participants (n = 128) were randomised to a self-affirmation or control group. After the self-affirmation manipulation was administered, we tracked participants' eye movements while they viewed images of six moderately-severe and six highly-severe pictorial health warning labels presented on large beer cans. Self-reported responses to the pictorial health warning labels were then measured, including avoidance, reactance, effectiveness, susceptibility and motivation to drink less. Finally, participants reported their self-efficacy to drink less and their alcohol use. RESULTS There was no clear evidence that enhancing self-affirmation influenced any outcome. In comparison to moderately-severe health warnings, highly-severe health warnings increased avoidance and reactance and were perceived as more effective and increased motivation to drink less. CONCLUSIONS These findings call into question the validity of the self-affirmation manipulation, which is purported to reduce defensive reactions to threatening warnings. We discuss possible explanations for this null effect, including the impact of participants' low perceived susceptibility to the risks shown on these pictorial health warning labels. Our finding that highly-severe health warnings increase avoidance and reactance but are also perceived as being more effective and more likely to motivate people to drink less will inform future health warning design and have implications for health warning label theory.
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Affiliation(s)
- Carlos Sillero-Rejon
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
- Department of Marketing and Market Research, University of Granada, Granada, Spain
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU UK
| | - Angela S. Attwood
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
| | - Anna K. M. Blackwell
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
| | | | - Marcus R. Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
| | - Olivia M. Maynard
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
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The Conceptualization and Measurement of Values: A Review of the Psychometric Properties of Measures Developed to Inform Values Work with Adults. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9679-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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