Assessing the Impact of Conflicting Health Warning Information on Intentions to Use E-Cigarettes -An Application of the Heuristic-Systematic Model

Abstract

The purpose of this study is to determine how nonsmokers perceive conflicting information when a modified risk statement is included along with a warning label on e-cigarette packages. We propose an application of the heuristic-systematic model to test whether this conflicting information leads to more or less active processing. As part of a larger inquiry into e-cigarette labeling, we present an experiment (n=303) in which we test this model with nonsmokers, measuring ambiguity perceptions, counter-arguing, reduced effectiveness of the message, and behavioral intentions. Results demonstrate that the addition of a modified risk statement on the package with the warning label increases ambiguity perceptions which can lead to reduced effectiveness of warning labels and reduced behavioral intentions to avoid using e-cigarettes among nonsmokers. While the systematic and heuristic pathways are both explanatory, heuristic processing provides the better fit. Keywords e-cigarettes; warning labels; modified risk statements; heuristic-systematic model Health communication practitioners tailor messages to the intended audience, recognizing that a message will be most effective if it relates to the needs of the recipient (Noar, Benac, & Harris, 2007). However, a challenge arises when there is more than one audience and different needs are being balanced.

Knowledge and Education as Barriers and Facilitators to Nicotine Replacement Therapy Use for Smoking Cessation in Pregnancy: A Qualitative Study with Health Care Professionals

“…Misinformation and misperceptions (the belief that the misinformation claim is true) exist on a range of health issues and can be detrimental to effective treatment options or preventative health behaviours [27]. Misinformation and the inconsistency of health education has been seen to be detrimental in relation to a variety of public health messages including the uptake of childhood vaccinations [28], knowledge around the safe alcohol drinking levels in pregnancy [29], and understanding the risks and safety related to e-cigarettes [30]. The current study has shown that education may be an important factor in why pregnant women are less successful in adhering to NRT, but also how it can be used to assist women to use NRT effectively.…”

Will E-Cigarette Modified Risk Messages with a Nicotine Warning Polarize Smokers’ Beliefs about the Efficacy of Switching Completely to E-Cigarettes in Reducing Smoking-Related Risks?

“…It is possible that smokers perceived MRMs with a warning differently than nonsmokers. Indeed, Katz and colleagues [ 18 ] found that perceptions of ambiguity differed based on smoking status. Nonsmokers perceived MRMs with a warning as ambiguous, while smokers did not.…”

“…However, a combination of an MRM with a nicotine warning could result in a conflicting message (i.e., a message that both supports and opposes the same subject) and could be perceived as ambiguous [ 14 ]. Both qualitative [ 15 , 16 , 17 ] and quantitative studies [ 18 ] have documented such a possibility.…”

“…A national survey [ 23 ] in 2014 found that U.S. adults’ exposure to conflicting information about e-cigarettes was associated with weaker support for several e-cigarette regulation policies, including a policy about enforcing an addiction warning label. An experimental study [ 18 ] among U.S. nonsmokers found that the addition of MRMs to an e-cigarette warning on e-cigarette packaging increased perceived message ambiguity, and in turn reduced perceived warning effectiveness, as well as intentions to stay away from e-cigarettes. In another experiment [ 24 ], 2056 U.S. adults reported no differences between conflicting e-cigarette messages and control messages whereas positive and negative e-cigarette messages produced responses consistent with the messages.…”

Embrace the debate: Goals, de‐marketing overconsumption, and conflicting information

“…In their work on conflicting information and functional food, Naylor, Droms, and Haws (2009) describe the external environment as becoming more and more conflicting–opposing messages are conveyed in various media channels to influence consumer behavior. Although this topic is highly relevant, research on the effect of conflicting information on consumption is limited (Katz, Erkkinen, Lindgren, & Hatsukami, 2018; Naylor et al, 2009; Rogers & Gould, 2015).…”