Tailored cigarette warning messages: How individualized loss aversion and delay discounting rates can influence perceived message effectiveness

Abstract

Current text-only cigarette warning labels (long-term, loss-framed messages) may not motivate positive changes in smoking behavior. The current project was a cross-sectional study examining the effects of tailored cigarette warnings on perceived message effectiveness (PME) in adult smokers (n = 512) conducted using Amazon Mechanical Turk (M-Turk) in January–February 2020. Participants were an average age of 40.7 (SD = 11.6), with the majority of the sample being female (62.2%) and White (88.9%). Participants reported smoking an average of 14.6 cigarettes/day (SD = 9.2) with an average FTND score of 4.6 (SD = 2.2). Participants were asked to complete a tobacco use history questionnaire, and mixed gambles and delay discounting tasks before random assignment to one of five message groups. The groups were based on a 2 (gain versus loss framing) × 2 (short-term versus long-term framing) between-subject design; a fifth group served as the control group. All experimental messages reported higher PME scores than the control (p values < 0.001, Cohen’s d = 1.88–2.48). Participants with shallower delayed reward discounting and lower loss aversion rates reported higher total PME scores, p values < 0.05. Our findings also suggest that loss aversion rates vary widely among smokers and that individuals are more responsive to messages congruent with their behavioral economic profile. Specifically, smokers who viewed messages congruent with their loss aversion and delay discounting rates reported higher PME scores than those who viewed in-congruent messages (p = 0.04, Cohen’s d = 0.24). These preliminary findings suggest that anti-smok-ing campaigns may best impact smokers by tailoring messages based on individual loss aversion and delay discounting rates versus a one-size-fits-all approach.