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Lee JGL, Cristello JV, Buckton CH, Carey RN, Trucco EM, Schenk PM, Ikegwuonu T, Hilton S, Golden SD, Conway DI. Message framing to inform cancer prevention pricing interventions in the UK and USA: a factorial experiment, 2019. BMJ Open 2021; 11:e041324. [PMID: 33495253 PMCID: PMC7839858 DOI: 10.1136/bmjopen-2020-041324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To advance understanding of how message framing can be used to maximise public support across different pricing policies for alcohol, tobacco and sugary drinks/foods that prevent consumption of cancer-causing products. DESIGN We designed a 3×4×3 randomised factorial experiment to test responses to messages with three pricing policies, four message frames and three products. SETTING Online survey panel (Qualtrics) in 2019. PARTICIPANTS Adults (N=1850) from the UK and USA. INTERVENTIONS Participants randomly viewed one of 36 separate messages that varied by pricing policy (increasing taxes, getting rid of price discounts, getting rid of low-cost products), four frames and product (alcohol, tobacco, sugary drinks/foods). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the relationship between the message characteristics and four dependent variables. Three were related to policy support: (1) increasing taxes on the product mentioned in the message, (2) getting rid of price discounts and special offers on the product mentioned in the message and (3) getting rid of low-cost versions of the product mentioned in the message. One was related to reactance, a psychological response to having one's freedom limited. RESULTS We found no effect for pricing policy in the message. Frames regarding children and reducing cancer risk moderated some outcomes, showing promise for real-world use. We found differences in support by product and reactance with greatest support and least reactance for tobacco policies, less support and more reactance for alcohol policies, and the least support and most reactance for sugary drinks/foods policies. CONCLUSIONS Cancer prevention efforts using policy interventions can be informed by the message framing literature. Our results offer insights for cancer prevention advocacy efforts across the UK and USA and highlight that tax versus non-tax approaches to increasing the cost of cancer-causing products result in similar responses from consumers.
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Affiliation(s)
- Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Julie V Cristello
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Christina H Buckton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rachel N Carey
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Elisa M Trucco
- Department of Psychology and Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Paulina M Schenk
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Theresa Ikegwuonu
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shelley D Golden
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David I Conway
- School of Medicine, Dentistry, and Nursing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Soneji S, Wills TA. Challenges and Opportunities for Tobacco Control Policies in the 21st Century. JAMA Pediatr 2019; 173:723-725. [PMID: 31180475 DOI: 10.1001/jamapediatrics.2019.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Samir Soneji
- Dartmouth-Hitchcock Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.,The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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Berg CJ, Fong GT, Thrasher JF, Cohen JE, Maziak W, Lando H, Drope J, Mejia R, Barnoya J, Nakkash R, Salloum RG, Parascandola M. The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US. Addict Behav 2018; 87:162-168. [PMID: 30041132 DOI: 10.1016/j.addbeh.2018.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 11/15/2022]
Abstract
International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L G1 Canada, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States; Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Baltimore, MD 21205, United States.
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8h Street, AHC5 505, Miami, FL 33199, United States.
| | - Harry Lando
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454, United States.
| | - Jeffrey Drope
- Department of Economic and Health Policy Research, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, United States.
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina.
| | - Joaquin Barnoya
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, 660 South Euclid Ave, St. Louis, MS 63110, United States.
| | - Rima Nakkash
- Department of Health Promotion and Community Health, American University of Beirut, PO, Box 11-0236, Beirut, Lebanon.
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States.
| | - Mark Parascandola
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, United States.
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Berg CJ, Topuridze M, Maglakelidze N, Starua L, Shishniashvili M, Kegler MC. Reactions to smoke-free public policies and smoke-free home policies in the Republic of Georgia: results from a 2014 national survey. Int J Public Health 2016; 61:409-16. [PMID: 26841891 DOI: 10.1007/s00038-016-0793-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We examined receptivity to public smoke-free policies and smoke-free home status among adults in the Republic of Georgia. METHODS In Spring 2014, we conducted a national household survey of 1163 adults. RESULTS Our sample was on average 42.4 years old, 51.1 % male, and 43.2 % urban. Current smoking prevalence was 54.2 % in men and 6.5 % in women. Notably, 42.2 % reported daily secondhand smoke exposure (SHSe). Past week SHSe was 29.9 % in indoor public places and 33.0 % in outdoor public places. The majority reported no opposition to public smoke-free policies. Correlates of greater receptivity to public policies included being older, female, and a nonsmoker. Past week SHSe in homes was 54.2 %; 38.8 % reported daily SHSe at home. Only 14.3 % reported complete smoke-free home policies; 39.0 % had partial policies. The only correlate of allowing smoking in the home was being a smoker. Among smokers, correlates of allowing smoking in the home were being male and lower confidence in quitting. CONCLUSIONS SHSe is prevalent in various settings in Georgia, requiring efforts to promote support for public smoke-free policies and implementation of personal policies.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA, 30322, USA.
| | | | | | - Lela Starua
- National Center for Disease Control, Tbilisi, Georgia
| | | | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA, 30322, USA
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Berg CJ, Ribisl KM, Thrasher JF, Haardörfer R, O'Connor J, Kegler MC. Reactions to Cigarette Taxes and Related Messaging: Is the South Different? Am J Health Behav 2015; 39:721-31. [PMID: 26248181 DOI: 10.5993/ajhb.39.5.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Given the lag in tobacco control policies in the southeastern US, we examined differences in reactions to tobacco taxes and related messaging among Southeasterners vs. non-Southeasterners. METHODS In 2013, a cross-sectional online survey using quota-based sampling was conducted assessing tobacco use, attitudes/knowledge regarding tobacco taxation, and reactions to related messaging (health, youth prevention, economic impact, individual rights/responsibility, morality/religion, hospitality). RESULTS Of 2501 participants, 36.7% were past 30-day smokers; 26.7% were Southeasterners. Compared to others, Southeasterners more likely believed that their state was in the bottom 20 states in tobacco taxes (p < .001) and less likely reported that their taxes were too high (p < .001). Regression analysis indicated that correlates of opposition to increased taxes included being older, having less education, being an infrequent church-attender, and being a current smoker (p's < .001); being a Southeasterner was not associated. Compared to others, Southeasterners were more likely to find pro-tobacco tax messages related to prevention and hospitality as more persuasive (p < .05) and anti-tobacco tax messaging related to the unfairness of tobacco taxes to smokers (p = .050) less persuasive. CONCLUSIONS Given that Southeasterners are receptive to increased taxation, other factors must contribute to lagging policy and must be addressed.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Kurt M Ribisl
- Lineberger Comprehensive Cancer Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Jean O'Connor
- Georgia Department of Public Health, Office of Applied Public Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
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