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E-cigarette use among youth presents a public health risk. Yet, cigarette smokers who substantially reduce their smoking or switch completely from traditional combustible cigarettes could benefit. As science about e-cigarettes is continually emerging, any potential warnings are likely to contain uncertain language. Hedged verbiage may impact decision making. To assess reactions, we conducted 16 online focus groups; 8 with youth (n = 32, grouped by gender and by vaping experience) and 8 with adult tobacco users (n = 37, grouped by smokers, dual users of e-cigarettes and cigarettes, and former smokers who switched to e-cigarettes). Each focus group viewed and discussed 8 potential warnings messages. We conducted an inductive thematic analysis of the reactions to warning messages that contain uncertain language. Respondents’ reactions were often negative, but varied based on specific usages of uncertainty, existing beliefs about uncertainty in law and science, and smoking/vaping use patterns that supported the use of uncertainty related to e-cigarettes. Many youth (and some adults) believed that uncertain language enabled audiences to minimize the likelihood of harm or interpreted it as meaning there are both healthy and unhealthy e-cigarettes. This qualitative study provides evidence that the use of types of uncertain language, the frequency of that use, and/or the selection of particular words in warnings, might not achieve the intended public health aims of increasing understanding of risk, deterring youth uptake, and/or facilitating a substantial switch from cigarettes. The use of certain types of uncertain language appears to have significant potential to bring unintended consequences. Suggestions for research and policy are included. [ABSTRACT FROM AUTHOR]

Aims: A warning on e-cigarette packaging is one way the U.S. government can inform the public of known harms of e-cigarette use. Currently, the only required warning on these products is: "WARNING: This product contains nicotine. Nicotine is an addictive chemical." This exploratory study aims to inform potential future investigations and FDA decisions regarding alternative warnings that may generate fear in addition to being intentionally informational. Method: Data were obtained from responses by 16 online focus groups with adult (N = 47, age range = 18–64) and youth (N = 32, age range 14–16) participants with various smoking and vaping experiences. We showed each focus group a set of hypothetical e-cigarette warning labels to determine how they respond to currently existing public statements that communicate information on the toxicity of ingredients in e-cigarettes, potential health risks, addiction to nicotine, and the uncertainty of the science regarding health effects of using these products. The focus group interviews were audio recorded and transcribed. Transcripts were subjected to a multiphase coding process to identify common response themes. Codes derived from the Extended Parallel Processing Model were then applied to understand impact of potentially fear-inducing language by warning category and age group. Results: For adults, all warnings—except those about addiction—gave rise to spontaneous danger control (intended) responses, such as quit intentions. Warnings highlighting cognitive and uncertain effects may be particularly promising for adult consumers of tobacco products because both gengerated danger control and response efficacy without evidence of fear control. However, responses also suggest that warnings risk discouraging some adults who use combustible cigarettes from transitioning to e-cigarettes for harm reduction. For youth, while evidence of response efficacy and danger control emerged among youth exposed to messages in all warning categories but one–addiction—unproductive reactions indicative of fear control were also prevalent among youth respondent across most warning types. On average, youth were more skeptical than adults about the harms of using e-cigarettes. Policy implications: Implications of study findings for the development of future effective e-cigarette warning messages are explored. [ABSTRACT FROM AUTHOR]

This study advances research on media literacy by comparing the effectiveness of two versions of a media literacy intervention over time. Participants (156 children in 4th or 5th grade) were randomly assigned to one of two treatment groups or a control group. Both treatment groups were exposed to an instructional intervention designed to reduce the negative effects of media violence. One of the groups was given an additional cognitive activity immediately following the instructional intervention. Participants in all 3 groups had their aggressive tendencies measured at 4 points in time. Results indicate that when the children participated in a cognitive activity after receiving the media literacy intervention, they experienced an immediate reduction in willingness to use aggression after exposure to violent media. However, the same media literacy intervention without the cognitive activity led to an increase in willingness to use aggression. Our longitudinal results indicate that children receiving an intervention without a cognitive activity might also remain more willing to use aggression over time. (Contains 3 figures.)

The third-person perception is the tendency for people to believe that others are more influenced by media content than themselves (W. P. Davison, 1983). The current study provides a critical test of self-enhancement, exposure, and self-categorization explanations for first- (i.e., self more influenced than others) and third-person perceptions. Male and female participants (N = 323) judged the extent to which pornography elicited "aroused and excited" (i.e., male normative) versus "repulsed and offended" (i.e., female normative) reactions in themselves relative to average men and women. Men perceived an average woman to be more repulsed and offended by pornography than themselves, and women perceived an average man to be more aroused and excited than themselves (i.e., large third-person perceptions). Further, men perceived themselves to be more aroused and excited by pornography than an average woman (independent of the degree to which pornography was judged as antisocial), and women perceived themselves to be more repulsed and offended than an average man (i.e., large first-person perceptions). There were relatively small effects for same sex comparisons independent of norm. The pattern and magnitude of first- and third-person perceptions are consistent with self-categorization theory, irreconcilable with the exposure hypothesis, and difficult to reconcile with the self-enhancement explanation.

Introduction: Under the US Family Smoking Prevention and Tobacco Control Act, the US Food and Drug Administration (FDA) has the authority to implement graphic warning labels (GWLs) on cigarette packages. Neither the original labels proposed by the FDA nor the revised labels include a source to indicate sponsorship of the warnings. This study tests the potential impact of adding a sponsor to the content of GWLs.Methods: We recruited adult smokers (N = 245) and middle-school youth (N = 242) from low-income areas in the Northeastern US. We randomly assigned participants to view one of three versions of the original FDA-proposed warning labels in a between-subjects experiment: no sponsor, "US Food and Drug Administration," or "American Cancer Society" sponsor. We tested the effect of varying sponsorship on source attribution and source credibility.Results: Compared to unsponsored labels, FDA sponsorship increased source attributions that the FDA sponsored the labels among both middle-school, largely nonsmoking youth and adult smokers. However, sponsorship had no effect on source credibility among either population.Conclusions: We found no evidence that adding FDA as the source is likely to boost source credibility judgments, at least in the short term; though doing so would not appear to have adverse effects on credibility judgments. As such, our data are largely consistent with the Tobacco Control Act's provisions that allow, but do not require, FDA sponsorship on the labels.Implications: This study addresses the FDA's regulatory efforts by informing the possible design and content of future cigarette warning labels. Our results do not offer compelling evidence that adding the FDA name on GWLs will directly increase source credibility. Future work may test more explicit FDA source labeling and continue to examine the credibility of tobacco message content among high-priority populations. [ABSTRACT FROM AUTHOR]

This paper tests how certainty conveyed through language can be harnessed to enhance the effectiveness of health risk messages. We conducted experiments with low-income, adult smokers (n = 317) and middle schoolers (n = 321) on pictorial cigarette warning labels. We manipulated hypotheticality of risk through verb modality: present tense, may, can, and will. For adult smokers, present tense led to greater health risk beliefs, compared to hypothetical, among adult males but not females. For youth, contrary to what might seem intuitive, the hypothetical may verb was more effective than the present tense language in promoting health risk beliefs, which was associated with reduced susceptibility to use cigarettes. We discuss the findings in relation applications of construal level theory to health communication. [ABSTRACT FROM AUTHOR]

Three studies test several mechanisms of cognitive bridging, or how a strategic communication message functions to connect the abstract goal of an individual with the specific means to achieve the goal. Across all of the experiments (n = 276, n = 209, n = 145), it was demonstrated that participants who received an induced bridging mechanism were more likely to produce cognitive bridging outputs and report more abstract responses than participants who did not receive a bridging technique. We do not find the same pattern of results among participants who received an integrated bridging technique. Taken together, these studies provide evidence that how abstractly or concretely an individual is thinking can be influenced by abstraction cues planted within a strategic message, providing promise for messaging efforts at the moment of decision. In other words, the level of abstract thinking an individual is carrying into an exposure situation is possible to change using cues within the message itself. This is the first article to juxtapose the induced and integrated mechanisms of cognitive bridging. [ABSTRACT FROM AUTHOR]

The U.S. Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) of 2009 paved the way for the Food and Drug Administration (FDA) to propose nine different graphic warning labels (GWLs) intended for prominent placement on the front and back of cigarette packs and on cigarette advertisements. Those GWLs were adjudicated as unconstitutional on the ground that they unnecessarily infringed tobacco companies' free speech without sufficiently advancing the government's public health interests. This study examines whether less extensive alternatives to the original full-color GWLs, including black-and-white GWLs and text-only options, have similar or divergent effects on visual attention, negative affect, and health risk beliefs. We used a mobile media research lab to conduct a randomized experiment with two populations residing in socioeconomically disadvantaged communities: biochemically confirmed adult smokers (N = 313) and middle school youth (N = 340). Results indicate that full-color GWLs capture attention for longer than black-and-white GWLs among both youth and adult smokers. Among adults, packages with GWLs (in either color or black-and-white) engendered more negative affect than those with text-only labels, while text-only produced greater negative affect than the packages with brand imagery only. Among youth, GWLs and text-only labels produced comparable levels of negative affect, albeit more so than brand imagery. We thus offer mixed findings related to the claim that a less extensive alternative could satisfy the government's compelling public health interest to reduce cigarette smoking rates. [ABSTRACT FROM AUTHOR]

This study tested theoretical relationships between key concepts in psychological reactance theory and construal level theory. Through a 3 × 2 × 2 experiment (n = 155), we manipulate (1) how abstractly or concretely participants are processing a message, (2) the psychological distance to the message, and (3) whether or not the message restricts choice. Dependent measures include perceptions of threat to freedom and message effectiveness. Results show that increasing abstraction and/or distance can mitigate the perception of threat to freedom that is experienced when a message restricts choice. Furthermore, this process has a subsequent influence on message effectiveness. As the first study to consider the perception of threat to freedom in the context of construal level theory, this experiment furthers understanding of key theoretical relationships. Strategies for the design of successful persuasive messages are discussed. [ABSTRACT FROM AUTHOR]