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. 2020;8(1):96-109.
doi: 10.1080/21642850.2020.1730844. Epub 2020 Feb 20.

Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults

Darren Mays  1 , Andrea C Johnson  1   2 , Lilianna Phan  1 , Kenneth P Tercyak  1 , Kathryn Rehberg  1 , Isaac Lipkus  3
Affiliations

Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults

Darren Mays et al. Health Psychol Behav Med. 2020.

Abstract

Objective: We examined effects of hookah tobacco risk messages on risk appraisals, attitudes towards hookah, ambivalence about hookah use, and willingness to smoke in young adults aged 18-30 years (n = 234).

Design: In an online experiment, participants completed preexposure measures and were randomized to hookah tobacco risk messages or to a no message control condition.

Main outcome measures: Risk appraisals, attitudes, ambivalence, and willingness to smoke hookah.

Results: Those who viewed risk messages reported greater risk appraisals (M 4.50, SD 1.17 vs. M 3.87, SD 1.16, p < .001), less positive attitudes (M -0.56, SD 1.24, vs. M 0.39, SD 1.35, p < .001), greater ambivalence (M 3.86, SD 1.26, vs. M 3.08, SD 1.32, p < .001), and less willingness to smoke than controls (M 4.48, SD 1.27, vs. M 4.85, SD 1.37, p = .034). Structural equation modeling demonstrated messages reduced willingness to smoke by evoking less positive attitudes (b = -0.15, 95% CI -0.32, -0.05) and by the effect of heightened risk appraisals on less positive attitudes (b = -0.14, 95% CI -0.30, -0.07).

Conclusions: Honing messages and understanding their mechanisms of action are necessary to produce more effective interventions to address hookah and other tobacco use in young adults.

Keywords: Young adults; ambivalence; attitude; risk communication; tobacco.

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Conflict of interest statement

Disclosure statement No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Final structural equation model. Note: Direct paths from the model illustrated here. Measurement model and factor loadings are not shown. Model fit statistics were RMSEA = 0.06 [90% CI = 0.03, 0.07], CFI = 0.97, SRMR = 0.06. *p<.05, **p<.01, ***p<.001.
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