The effects of smoking cues in anti -smoking public service announcements on smoking urge, message processing and intention to quit smoking

Tobacco use is currently the leading risk factor for preventable death in the United States and an important cause of premature death worldwide (Fagerström, 2002). One important factor that contributes to relapse in smokers is how smokers or recently quit smokers respond to smoking-related cues. Both the cue-reactivity literature and "smoking movie" studies suggest that smoking cues can elicit smoking urge and negatively affect message processing and intention to quit smoking. A content analysis of 589 antismoking public service announcements (PSAs) found that 40% of the ads contained smoking cues. The current study represents the first effort to test the impact of smoking cues in the context of antismoking PSAs. With a concern of the possible deleterious effects of smoking cues, it was hypothesized that smoking cues in antismoking PSAs would elicit smoking urge accompanied with psychophysiological reactions guided by the positive-reinforcing model of urge. Smoking cues were also hypothesized to distract smokers' attention away from processing of the ad arguments and negatively affect their intention to quit smoking through their attitude, self-efficacy and involvement. Several individual differences were examined as potential moderators for these processes. Using a 2 (no-cue versus smoking-cue, within-subject factor) by 2 (strong versus weak argument, between-subject factor) experimental design and random assignment among 96 adult smokers, the current study showed that smoking cues in antismoking PSAs elicited smoking urge, which was paired with a reduction in heart rate and skin conductance. Ad learning, self-efficacy, intention to quit, and the impact of argument strength on ad effectiveness evaluation were improved in the smoking-cue condition compared to the no-cue condition. However, because smoking cue was confounded with the number of ads watched, ad presentation order, and time, it was not conclusive that the observed effects were attributable to smoking cues. Implications for the relationship between smoking cues and attention, psychophysiological reactions during cue exposure, message design, and effective ad targeting were discussed, together with the limitations and future directions.