Association between felt ambivalence and the desire to quit waterpipe use among college students

Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults

Objective: We examined effects of hookah tobacco risk messages on risk appraisals, attitudes towards hookah, ambivalence about hookah use, and willingness to smoke in young adults aged 18–30 years (n = 234).

Design: In an online experiment, participants completed pre-exposure measures and were randomized to hookah tobacco risk messages or to a no message control condition.

Main Outcome Measures: Risk appraisals, attitudes, ambivalence, and willingness to smoke hookah.

Results: Those who viewed risk messages reported greater risk appraisals (M 4.50, SD 1.17 vs. M 3.87, SD 1.16, p < .001), less positive attitudes (M −0.56, SD 1.24, vs. M 0.39, SD 1.35, p < .001), greater ambivalence (M 3.86, SD 1.26, vs. M 3.08, SD 1.32, p < .001), and less willingness to smoke than controls (M 4.48, SD 1.27, vs. M 4.85, SD 1.37, p = .034). Structural equation modeling demonstrated messages reduced willingness to smoke by evoking less positive attitudes (b = −0.15, 95% CI −0.32, −0.05) and by the effect of heightened risk appraisals on less positive attitudes (b = −0.14, 95% CI −0.30, −0.07).

Conclusions: Honing messages and understanding their mechanisms of action are necessary to produce more effective interventions to address hookah and other tobacco use in young adults.

Examining the vulnerability of ambivalent young adults to e-cigarette messages

This study used a randomized online experiment to understand the interrelationships between e-cigarette benefit and harm perceptions, e-cigarette use ambivalence, and e-cigarette message exposure and perceived effectiveness. A high prevalence of ambivalent attitudes toward e-cigarettes at baseline was reported. Ambivalent individuals reported significantly higher benefits and lower harm perceptions compared to univalent individuals. Contrary to past findings, ambivalence was not responsive to persuasive messages in this study. This study situates e-cigarette use perceptions in a realistic setting. High baseline ambivalence in this study calls for more unequivocal messages from the FDA about the risks of e-cigarette use.