Comparing gain- and loss-framed messages for smoking cessation with sustained-release bupropion: A randomized controlled trial.

Abstract

Prospect theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome, gain-framed messages will be more persuasive than loss-framed messages when attempting to encourage smoking cessation. To test this hypothesis, the authors randomly assigned participants (N = 258) in a clinical trial to either a gain-or loss-framed condition, in which they received factually equivalent video and printed messages encouraging smoking cessation that emphasized either the benefits of quitting (gains) or the costs of continuing to smoke (losses), respectively. All participants received open label sustained-release bupropion (300 mg/day) for 7 weeks. In the intent-to-treat analysis, the difference between the experimental groups by either point prevalence or continuous abstinence was not statistically significant. Among 170 treatment completers, however, a significantly higher proportion of participants were continuously abstinent in the gain-framed condition as compared with the loss-framed condition. These data suggest that gain-framed messages may be more persuasive than loss-framed messages in promoting early success in smoking cessation for participants who are engaged in treatment.Keywords message framing; smoking cessation; bupropion Prospect theory describes the nonlinear relationship between objective outcomes (in terms of gains and losses from some reference point) and one's subjective reactions to them (Tversky & Kahneman, 1981). The framing implications of prospect theory suggest that individuals respond differently to factually equivalent messages depending on whether they are framed so as to emphasize benefits (gain-framed) or costs (loss-framed). This idea is applicable to messages intended to promote health (Rothman & Salovey, 1997). For example, with respect to sunscreen use, a gain-framed message is "Don't expose yourself to the sun, and you won't risk becoming sick," and a loss-framed message is "Don't protect yourself from the sun, and you won't help yourself stay healthy." Regarding smoking cessation, "You will live longer if Correspondence concerning this article should be addressed to Benjamin A. Toll, Yale University School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511. E-mail: benjamin.toll@yale.edu. NIH Public Access Author ManuscriptPsychol Addict Behav. Author manuscript; available in PMC 2008 December 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript you quit smoking" is a gain-framed message, and "You will die sooner if you do not quit smoking" is a loss-framed message. Prospect theory suggests that if gains are made salient, people are averse to risk, and when losses are made prominent, individuals are risk-seeking. Even though the messages may be equivalent factually, the framing of the message can influence an individual's willingness to incur risk either to encourage a desirable outcome or avoid an outcome that is unwanted (Tversky & Kahneman, 1981).A review of the literature on mes...

Randomized Trial: Quitline Specialist Training in Gain-Framed vs Standard-Care Messages for Smoking Cessation

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Motivational factors predict quit attempts but not maintenance of smoking cessation: Findings from the International Tobacco Control Four country project

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History and symptom taking in contact lens fitting and aftercare

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