Towards consensus on fear appeals: a rejoinder to the commentaries on Kok, Peters, Kessels, ten Hoor, and Ruiter (2018)

Abstract

We were faced with the considerable challenge of responding to so many commentaries. Therefore, this rejoinder has two parts. In this text, we will emphasise our common ground based on a number of major points that pervade across the commentaries, while we provide more comprehensive and detailed responses to each commentary in the supplementary file. 1 We feel it is time for the debate about fear appeal effectiveness to mature into a more collaborative effort for two reasons. First, this debate does not help in achieving our mutual goal: optimally effective behaviour change interventions. Second, while this debate revealed a number of fundamental disagreements (e.g., regarding what constitutes evidence), it also revealed substantial consensus: enough to build on going forward. Although our article concerns threatening communication in general and applies to all behaviours, the ensuing debate centred around the most ubiquitous instance of threatening communication: health communications on tobacco packaging. Presently, this space is used for pictorial warning labels, aiming to promote smoking cessation among smokers and discourage smoking initiation among vulnerable non-smokers, and many of the commentary authors are researchers who have conducted research on warning labels. Therefore, we will also use warning labels as an example; but note that the processing of threatening information is a characteristic of human psychology and so applies to all threatening communications. Consensus 1: the urgency of the problem First, the debate over fear appeal effectiveness made clear how committed all involved are to promoting the health of vulnerable populations. We all agree that current smokers and vulnerable ex-smokers deserve the best possible behaviour change interventions that our discipline of health psychology can devise. That consensus exists regarding this point may seem trivial, but we feel that it is important to keep in mind that we all want the same: promoting health.

Avoidance of tobacco health warnings? An eye-tracking approach

“…In two of the three studies, we found that avoidance and reactance are positively correlated, and recent research suggests that warnings can simultaneously increase avoidance (which is related to increased quit intentions (15)) and reactance (which is related to decreased quit intentions (53)). We suggest that these simultaneous effects of warnings on both adaptive (i.e., self-reported avoidance) and defensive (i.e., reactance) measures may explain, at least in part, the current lack of consensus in the literature regarding the effectiveness of threatening health warnings (45,46). Warnings that promote self-reported avoidance (and visual attention) but minimise self-reported reactance might be important in making warnings maximally effective.…”

“…However, although severe warnings increase quit intentions, there is also evidence that they are more poorly recalled (42). Understanding the extent to which warnings should be severe is important given the widespread global reliance on severe warnings, and the ongoing academic debate regarding their effects (45,46). Here, in addition to measuring visual attention, self-reported avoidance and reactance, we also examine the effect of warning severity on another important higher-order cognitive construct, motivation to quit smoking.…”

Improving preventive health behaviors in the COVID-19 crisis: a messaging intervention in a large nationally representative sample

“…One option is to emphasize that everyone is vulnerable to the disease, thereby appealing to people's fear for themselves. There is an ongoing debate about whether such 'fear appeals' generate long-term behavior change but the emerging consensus is that fear appeals are more effective when perceptions of self-efficacy (the belief that one's own actions make a difference) are high (20). It therefore makes sense to appeal to people's fear in combination with posters providing clear instructions on how to shield oneself from the risks.…”

Avoidance of tobacco health warnings? An eye‐tracking approach

“…However, these warnings are more poorly recalled [2,41]. Understanding the role of message severity is important, given the widespread global reliance on severe warnings and the ongoing academic debate regarding their effects [43,44].…”