eCite Digital Repository

Exploring the impact of efficacy messages on cessation-related outcomes using Ecological Momentary Assessment


Lambert, V and Ferguson, SG and Niederdeppe, J and Hammond, D and Hardin, JW and Thrasher, JF, Exploring the impact of efficacy messages on cessation-related outcomes using Ecological Momentary Assessment, Tobacco Induced Diseases, 16, (September) Article 94460. ISSN 1617-9625 (2018) [Refereed Article]


Copyright Statement

Copyright 2018 Lambert V. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.18332/tid/94460


Introduction: Observational studies indicate that cigarette package inserts with efficacy messages about the benefits of quitting (i.e. response efficacy) and recommendations for successful cessation increase smokersí self-efficacy to quit and promote sustained cessation. However, the effects of inserts with such efficacy messages have not been studied using experimental designs. This study used ecological momentary assessment (EMA) to assess smokersí responses to efficacy inserts.

Methods: In a randomized case-crossover study among smokers from the United States (n=23), participants received a one-week supply of cigarettes with efficacy inserts and a one-week supply without any inserts, and were randomized to use the packs with inserts on either the first or second week of the study. For 14 consecutive days, participants used a smartphone to answer brief surveys on cessation-related variables during smoking sessions and at the beginning of each day. Multilevel mixed-effects linear and logistic regression models compared responses during the insert period to those of the non-insert period.

Results: The insert period was associated with greater desire to quit (b=0.21, p=0.012), motivation to quit (b=0.18, p=0.001), self-efficacy to cut down (b=0.26, p<0.001) and to quit (b=0.28, p<0.000), and response efficacy/ perceived benefits of quitting (b=0.13, p=0.012). Insert exposure was not significantly associated with forgoing cigarettes (OR=1.9, p=0.2).

Conclusions: Results from this EMA study suggest that inserts with efficacy messages may promote determinants of smoking cessation. This is consistent with observational research in Canada, which is the only country to use inserts with efficacy messages as well as pictorial warnings about smoking risks on the outside of packs. Future studies should assess the extent to which efficacy inserts can not only be used to communicate health information to smokers but also work in synergy with pictorial warnings.

Item Details

Item Type:Refereed Article
Keywords:health warnings, warning labels, smoking cessation
Research Division:Health Sciences
Research Group:Public health
Research Field:Health promotion
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Ferguson, SG (Professor Stuart Ferguson)
ID Code:129538
Year Published:2018
Web of Science® Times Cited:2
Deposited By:Medicine
Deposited On:2018-12-05
Last Modified:2019-04-08
Downloads:65 View Download Statistics

Repository Staff Only: item control page