Conversations about pictorial cigarette pack warnings: Theoretical mechanisms of influence

Morgan, Jennifer C.; Golden, Shelley D.; Noar, Seth M.; Ribisl, Kurt M.; Southwell, Brian; Jeong, Michelle; Hall, Marissa G.; Brewer, Noel T.

doi:10.1016/j.socscimed.2018.09.063

Cited by 16 publications

(11 citation statements)

References 69 publications

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“…Our results are consistent with the conceptual framework and hypothesis 3 that a portion of the effect of exposure to the messages from the 3 intervention components was received and shared in mothers’ social networks, which in turn affected social norms and then practices. A similar effect has been studied in another type of intervention, where conversations about the warnings were a key mechanism through which pictorial warnings influenced smoking quit attempts (13). These results provide evidence to support that messages from interventions (e.g., IPC) and campaigns (e.g., MM or social mobilization) are filtered through social networks (12), which then spread information and translate messages into norms (13, 14), leading to changes in practices.…”

Section: Discussionmentioning

confidence: 82%

“…A similar effect has been studied in another type of intervention, where conversations about the warnings were a key mechanism through which pictorial warnings influenced smoking quit attempts (13). These results provide evidence to support that messages from interventions (e.g., IPC) and campaigns (e.g., MM or social mobilization) are filtered through social networks (12), which then spread information and translate messages into norms (13, 14), leading to changes in practices. The current study only measured social norms as reported by mothers and not by other members of their social network.…”

Section: Discussionmentioning

confidence: 82%

“…Information from interventions and campaigns is received through social networks, within which individuals exchange messages with others who may influence interpretation and reinterpretation of the messages (12). Interaction among individuals within social networks can contribute to spreading information and translating messages into norms (13, 14).…”

Section: Introductionmentioning

confidence: 99%

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Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh

Nguyen

Frongillo

Kim

et al. 2019

The Journal of Nutrition

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Background Interaction within mothers’ social networks can theoretically diffuse messages from interventions and campaigns into norms and practices for infant and young child feeding (IYCF). Objectives We hypothesized that mothers’ social networks, diffusion of information, and social norms differed in intensive [intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM)] compared with nonintensive (standard IPC and less-intensive CM and MM) intervention areas, were associated with IYCF practices, and partly explained practice improvement. Methods We conducted household surveys at endline in 2014 and follow-up in 2016 (n = ∼2000 each round). We used multiple regression to test differences and changes in networks, diffusion, and norms within intervention areas. We analyzed paths from intervention exposure to IYCF practices through networks, diffusion, and norms. Results Mothers’ networks were larger in intensive than in nonintensive areas in 2014 and increased in both areas over time [25–38 percentage points (pp)]. The prevalence of receipt of IYCF information was high, with no changes over time in intensive areas but an increase in nonintensive areas (8–16 pp). In both areas, more family members and health workers provided IYCF information over time. Sharing of information increased 17–23 pp in intensive and 11–41 pp in nonintensive areas over time. Perceived descriptive norms improved 8–16 pp in intensive and 17–28 pp in nonintensive areas. Perceived injunctive norms were high in both areas. Breastfeeding practices were associated with networks, diffusion, and norms (OR: 1.6–4.4 times larger comparing highest with lowest quartile). Minimum dietary diversity was associated with larger networks and diffusion (OR: 1.5–2.2) but not with social norms. Indirect paths from intervention exposure to practices explained 34–78% of total effects. Conclusions Diffusion of IYCF information through social networks, reinforced by positive social norms for messages promoted over time, will contribute to positive changes in IYCF practices that may be achieved and sustained through large-scale social and behavior change interventions. This trial was registered at clinicaltrials.gov as NCT0274084.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh

Nguyen

Frongillo

Kim

et al. 2019

The Journal of Nutrition

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“…For example, preexisting attitudes towards a particular food, associations with the label from previous exposures, and current nutritional knowledge may affect the label's acceptance and perceived effectiveness. In addition, substantial literature has found that social norms-often measured by interpersonal communication and perceived social approval-exert a powerful influence on behavioral intentions [54,55]. Thus, labels that trigger conversation and that signal social disapproval are likely to be more effective.…”

Section: Conceptual Modelmentioning

confidence: 99%

Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review

et al. 2020

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Policies that require front-of-package (FoP) nutrient warnings are becoming increasingly common across the globe as a strategy to discourage excess consumption of sugary drinks and ultra-processed food. However, a better understanding of the pathway through which FoP nutrient warnings work, as well as a review of how outcomes being measured in recent studies map onto this pathway, are needed in order to inform policy on the most effective FoP label design for reducing purchases of ultra-processed foods. This scoping review describes a conceptual model for how FoP nutrient warnings affect consumer behavior, examines which of these outcomes are currently being measured, and summarizes evidence from randomized controlled experiments. Twenty-two studies which experimentally tested nutrient warnings against a control label or other labeling systems were included for full-text review. Our conceptual model includes attention; comprehension, cognitive elaboration, and message acceptance; negative affect and risk perception; behavioral intentions, and behavioral response, along with other elements such as external factors and interpersonal communications. We found that many studies focused on outcomes such as attention, comprehension, and behavioral intentions, but considerable gaps in the evidence remain, particularly for intermediary steps on the pathway to behavioral change, such as negative affect and social interactions. FoP nutrient warnings were visually attended to by consumers, easy to understand, helped consumers identify products high in nutrients of concern, and discouraged them from purchasing these products, although other labeling systems were perceived as containing more information and performed better at helping consumers rank the healthfulness of products. More research is needed to understand whether and how nutrient warnings work in the real world to discourage consumer purchases of sugary drinks and ultra-processed food.

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“…[34][35][36] We also assessed warnings' impacts on constructs from the University of North Carolina (UNC) Tobacco Warnings Model 37 (TWM), an empirically driven model explaining how cigarette and e-cigarette warnings influence behaviour change, because these outcomes are also good proxies for actual message effectiveness. [38][39][40][41] Finally, we examined smoking and vaping warnings' effects on discouragement and thinking about harms of the non-focal behaviour (eg, smoking warnings' impact on discouragement from vaping) to evaluate whether messages about one product spill over to affect perceptions of the other product.…”

Section: Original Researchmentioning

confidence: 99%

Reactions to messages about smoking, vaping and COVID-19: two national experiments

et al. 2020

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IntroductionThe pace and scale of the COVID-19 pandemic, coupled with ongoing efforts by health agencies to communicate harms, have created a pressing need for data to inform messaging about smoking, vaping, and COVID-19. We examined reactions to COVID-19 and traditional health harms messages discouraging smoking and vaping.MethodsParticipants were a national convenience sample of 810 US adults recruited online in May 2020. All participated in a smoking message experiment and a vaping message experiment, presented in a random order. In each experiment, participants viewed one message formatted as a Twitter post. The experiments adopted a 3 (traditional health harms of smoking or vaping: three harms, one harm, absent) × 2 (COVID-19 harms: one harm, absent) between-subjects design. Outcomes included perceived message effectiveness (primary) and constructs from the Tobacco Warnings Model (secondary: attention, negative affect, cognitive elaboration, social interactions).ResultsSmoking messages with traditional or COVID-19 harms elicited higher perceived effectiveness for discouraging smoking than control messages without these harms (all p <0.001). However, including both traditional and COVID-19 harms in smoking messages had no benefit beyond including either alone. Smoking messages affected Tobacco Warnings Model constructs and did not elicit more reactance than control messages. Smoking messages also elicited higher perceived effectiveness for discouraging vaping. Including traditional harms in messages about vaping elicited higher perceived effectiveness for discouraging vaping (p <0.05), but including COVID-19 harms did not.ConclusionsMessages linking smoking with COVID-19 may hold promise for discouraging smoking and may have the added benefit of also discouraging vaping.

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Conversations about pictorial cigarette pack warnings: Theoretical mechanisms of influence

Cited by 16 publications

References 69 publications

Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh

Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh

Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review

Reactions to messages about smoking, vaping and COVID-19: two national experiments

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