Health Communications for Adults Smoking Nondaily

Adults smoking nondaily (ASN) make up approximately one-third of adults who currently use cigarettes in the U.S. and experience substantial risk of cancer, respiratory, and cardiovascular mortality. Yet, ASN often do not perceive themselves as vulnerable to health consequences of smoking and are less likely than those smoking daily to attend to or be persuaded by smoking health risk campaigns targeted to the general population adults who smoke. It is critically important to develop smoking health risk messages targeted to ASN that are perceived as personally relevant and meaningfully influence key outcomes associated with smoking cessation. As the first step in a programmatic line of research designed to improve health communications for and smoking cessation outcomes among ASN, we propose to develop and carefully evaluate theoretically-based smoking health communications targeted to ASN intended to increase knowledge, worry, risk perceptions, motivation, and intentions to quit. The Communication-Persuasion Matrix (CPM) offers an overarching conceptual framework for developing and evaluating targeted messages. We will pursue two aims. In Aim 1a, guided by the CPM and empirical evidence that affect and social cues are especially strong predictors of smoking behavior among ASN, we will develop smoking cessation messages with content that varies on affective valence (positive vs. negative) and smoking consequences (social vs. health). Factors specifically relevant to ASN will be targeted, including the perception that they are not “smokers” and social cues for smoking. In Aim 1b, Learner verification and revision procedures with ASN (N=20) will be used to evaluate the initial messages for comprehension, attractiveness, acceptability, and personal relevance. Messages will be modified in an iterative process according to participant feedback throughout learner verification and revision. In Aim 2, in a 2x2 factorial design, the optimized messages from Aim 1 will be presented to ASN via an online panel (N=320) to test the effects of message affective valence (positive vs. negative) and consequences (social vs. health). Participants will be randomized to view one of four categories of messages: Positive/Health, Positive/Social, Negative/ Health, Negative/Social. Key outcomes will be assessed pre- and post-message exposure. We hypothesize that positive (vs. negative) and social (vs. health) messages will produce greater increases in knowledge, worry, risk perceptions, motivation, and intentions to quit smoking among ASN. Identifying underlying components of effective messaging for this vulnerable group is especially impactful as findings can inform the development of future targeted messaging or smoking cessation campaigns. In the future, we plan to conduct a fully powered RCT to evaluate the efficacy of the targeted messages at enhancing motivation to quit and examining quit attempts and tobacco treatment enrollment among ASN, a substantial, at risk, and underserved population of U.S. adults who smoke. Project Number: 1R03CA286623-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Bethany Shorey Fennell | Institution: UNIVERSITY OF KENTUCKY, LEXINGTON, KY | Award Amount: $164,484 | Activity Code: R03 | Study Section: Special Emphasis Panel[ZCA1 SRB-2 (M2)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11218757