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Financial versus health motivation to quit smoking: a randomized field study.

ABSTRACT: Smoking is the most preventable cause of death, thus justifying efforts to effectively motivate quitting. We compared the effectiveness of financial versus health messages to motivate smoking cessation. Low-income individuals disproportionately smoke and, given their greater income constraints, we hypothesized that making financial costs of smoking more salient would encourage more smokers to try quitting. Further, we predicted that financial messages would be stronger in financial settings where pecuniary constraints are most salient.We conducted a field study in low-income areas of New Haven, Connecticut using brochures with separate health vs. financial messages to motivate smoking cessation. Displays were rotated among community settings-check-cashing, health clinics, and grocery stores. We randomized brochure displays with gain-framed cessation messages across locations.Our predictions were confirmed. Financial messages attracted significantly more attention than health messages, especially in financial settings.These findings suggest that greater emphasis on the financial gains to quitting and use of financial settings to provide cessation messages may be more effective in motivating quitting. Importantly, use of financial settings could open new, non-medical venues for encouraging cessation. Encouraging quitting could improve health, enhance spending power of low-income smokers, and reduce health disparities in both health and purchasing power.

SUBMITTER: Sindelar JL

PROVIDER: S-EPMC4869074 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Financial versus health motivation to quit smoking: a randomized field study.

Sindelar Jody L JL O'Malley Stephanie S SS

Preventive medicine 20131016

<h4>Objective</h4>Smoking is the most preventable cause of death, thus justifying efforts to effectively motivate quitting. We compared the effectiveness of financial versus health messages to motivate smoking cessation. Low-income individuals disproportionately smoke and, given their greater income constraints, we hypothesized that making financial costs of smoking more salient would encourage more smokers to try quitting. Further, we predicted that financial messages would be stronger in finan ...[more]

PMID: 24139975

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Project description:INTRODUCTION:In China, the regular use of tobacco by much of the population has brought great losses in both health and economy. This study used the framing-effect theory to explore people's preferences regarding message-framing for education about financial and health-related gains associated with smoking cessation in different areas of Shanghai, China. In particular, it attempts first to identify any influencing factors and offers some suggestions to improve the efficiency of education efforts regarding tobacco control. METHODS:A message-framing field study was conducted in three districts in Shanghai that represent low-income, middle-income and high-income areas between June and August 2015, respectively. This study examines leaflets with a different message-framing (Health-Financial Framework) to ascertain the preferences of participants at the different locations. A total of 4650 participants were recruited and asked to complete a questionnaire. The z-test, chi-squared test and logistic regression analysis were used for statistical analysis. RESULTS:In low-income areas, participants were more inclined towards financial rather than health message-framing, especially in financial and health oriented locations. In the middle-income areas, participants preferred health message-framing, especially at hospital locations. In the high-income areas, health message-framing was preferred in health and neutral locations in comparison with financial locations. The type of area, location and household monthly income have an impact on participants' preference for message-framing. CONCLUSIONS:Three suggestions are proposed for tobacco control health education in China: 1) Combine health education information design with the framing-effect theory to improve the effectiveness of information content, 2) Considering the impact of different types of area and location, different tobacco control health education strategies should be adopted to improve the efficiency of publicity, and 3) Targeted and personalized tobacco control health education strategies should be implemented among different audiences.

Project description:IntroductionMost people who smoke cigarettes are not willing (ie, not ready) to make a quit attempt (QA) at any given time. Unfortunately, interventions intended to increase QAs and the success of QAs are only modestly effective. Identifying processes leading to QAs and quitting success could guide intervention development.Aims and methodsThis is a secondary analysis of a randomized factorial trial of 6 weeks of motivation-phase interventions among primary care patients (N = 517) who were initially unwilling to quit but were willing to reduce their smoking. Using logistic regression, we controlled for treatment condition and tested whether baseline or change in smoking-related constructs after 6 weeks of treatment predicted (1) making an at least 24 h QA between weeks 6 and 26 and (2) quitting success at week 26 (7-day point-prevalence abstinence among those who made a QA). Predictors included cigarettes/day, time to first cigarette, motivation to quit, quitting self-efficacy, anticipated urges to smoke if quit, positive affect, negative affect, and time spent around others who smoke.ResultsIn multivariable models that included all smoking-related constructs, changes in the following variables predicted initiating a QA above and beyond other variables: greater baseline time to first cigarette (odds ratio [OR] = 1.60), increases in time to first cigarette (OR = 1.27), and increases in quitting self-efficacy (OR = 1.14). Increased motivation to quit predicted conversion of a QA into quitting success at 26 weeks (OR = 1.36).ConclusionPredictors of making a QA differed from predictors of quitting success. Predictors of QAs and success could each serve as important treatment targets of motivation-phase interventions.ImplicationsMotivation-phase interventions for people initially unwilling to quit smoking cigarettes may be improved by striving to increase their (1) time to first cigarette and quitting self-efficacy to promote QAs and (2) motivation to quit to promote quit success. Future experimental tests of such interventions are needed to identify causal determinants of QAs and quitting success.

Dataset Information

Financial versus health motivation to quit smoking: a randomized field study.

Publications

Financial versus health motivation to quit smoking: a randomized field study.

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