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Randomized Controlled Trial
. 2022 Nov:134:107383.
doi: 10.1016/j.addbeh.2022.107383. Epub 2022 May 31.

Communicating the risks of tobacco and alcohol co-use

Sarah D Kowitt  1 , Melissa J Cox  2 , Kristen L Jarman  3 , Amanda Y Kong  4 , Arvind Sivashanmugam  5 , Jennifer Cornacchione Ross  6 , Adam O Goldstein  7 , Leah M Ranney  3
Affiliations
Randomized Controlled Trial

Communicating the risks of tobacco and alcohol co-use

Sarah D Kowitt et al. Addict Behav. 2022 Nov.

Abstract

Background: While tobacco and alcohol co-use is highly prevalent across the United States, little experimental research has examined ways to counter such dual use. We developed and tested messages about the risks of co-using tobacco and alcohol among adults who used a combustible tobacco product and drank alcohol within the 30 days.

Methods: In an online experiment, 1,300 participants were randomly assigned to read different messages about tobacco and alcohol co-use (e.g., Alcohol and tobacco cause throat cancer). Three between-subjects experiments manipulated the presence of: 1) a marker word (e.g., Warning), 2) text describing the symptoms of health effects and a quitting self-efficacy cue, and 3) an image depicting the health effect. Participants rated each message using a validated Perceived Message Effectiveness (PME) scale. We used independent samples t-tests to examine differences between experimental conditions. Results include effect sizes (Cohen's d) to compare standardized mean differences.

Results: Our sample was 64% male, 70% white, 23% Black, and 17% Hispanic/Latino with a mean age of 42.4 (SD = 16.4) years. Messages that described the symptoms of the health effect (d = 0.17, p = 0.002) and included an image (d = 0.11, p = 0.04) were rated significantly higher in PME compared with messages that did not describe symptoms and were text-only. We found no significant effects of a marker word or self-efficacy cue on PME.

Conclusions: Messages that describe the symptoms of health effects and include text and images may be particularly effective for communicating the risks of tobacco and alcohol co-use and decreasing adverse health effects from co-use.

Keywords: Alcohol; Co-use; Communication; Messages; Multiple health behavior change; Tobacco.

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Conflict of interest statement

Competing Interests: None

Figures

Figure 1.
Figure 1.
Experimental stimuli
See this image and copyright information in PMC

References

    1. Allen JA, Duke JC, Davis KC, Kim AE, Nonnemaker JM, & Farrelly MC (2015). Using mass media campaigns to reduce youth tobacco use: a review. American Journal of Health Promotion, 30(2), e71–e82. - PubMed
    1. Ames SC, Pokorny SB, Schroeder DR, Tan W, & Werch CE (2014). Integrated smoking cessation and binge drinking intervention for young adults: a pilot efficacy trial. Addictive Behaviors, 39(5), 848–853. - PubMed
    1. Anantharaman D, Marron M, Lagiou P, Samoli E, Ahrens W, Pohlabeln H, … Richiardi L (2011). Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer. Oral Oncology, 47(8), 725–731. - PubMed
    1. Goldstein et al. (2021). Effect of Cigarette Constituent Messages With Engagement Text on Intention to Quit Smoking Among Adults Who Smoke Cigarettes. JAMA Network Open, 4(2). doi:10.1001/jamanetworkopen.2021.0045 - DOI - PMC - PubMed
    1. Baig SA, Gottfredson NC, Noar SM, Boynton MH, Ribisl KM, & Brewer NT (2018). UNC Perceived Message Effectiveness: Validation of a Brief Scale. Annals of Behavioral Medicine, 52, S78–S78. - PMC - PubMed

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