Beliefs about the relative harm of "light" and "low tar" cigarettes: findings from the International Tobacco Control (ITC) China Survey.

BACKGROUND: Many smokers in Western countries perceive "light" or "low tar" cigarettes as less harmful and less addictive than "regular" or "full flavoured" cigarettes. However, there is little research on whether similar perceptions exist among smokers in low and middle incomes, including China. OBJECTIVE: To characterise beliefs about "light" and "low tar" cigarettes among adult urban smokers in China. METHODS: We analysed data from Wave 1 of the ITC China Survey, a face-to-face household survey of 4732 adult Chinese smokers randomly selected from six cities in China in 2006. Households were sampled using a stratified multistage design. FINDINGS: Half (50.0%) of smokers in our sample reported having ever tried a cigarette described as "light," "mild" or "low tar". The majority of smokers in our sample (71%) believed that "light" and/or "low tar" cigarettes are less harmful compared to "full flavoured" cigarettes. By far the strongest predictor of the belief that "light" and/or "low tar" cigarettes are less harmful was the belief that "light" and/or "low tar" cigarettes feel smoother on the respiratory system (p<0.001, OR=53.87, 95% CI 41.28 to 70.31). CONCLUSION: Misperceptions about "light" and/or "low tar" cigarettes were strongly related to the belief that these cigarettes are smoother on the respiratory system. Future tobacco control policies should go beyond eliminating labelling and marketing that promotes "light" and "low tar" cigarettes by regulation of product characteristics (for example, additives, filter vents) that reinforce perceptions that "light" and "low tar" cigarettes are smoother on the respiratory system and therefore less harmful.

What happened to smokers' beliefs about light cigarettes when "light/mild" brand descriptors were banned in the UK? Findings from the International Tobacco Control (ITC) Four Country Survey.

AIM: This paper examines how beliefs of smokers in the UK were affected by the removal of "light" and "mild" brand descriptors, which came into effect on 30 September 2003 for Member States of the European Union (EU). PARTICIPANTS: The data come from the first four waves (2002-2005) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, USA, UK and Australia (15 450 individual cases). DESIGN: The UK ban on misleading descriptors occurred around the second wave of data collection in the ITC survey, permitting us to compare beliefs about light cigarettes among adult smokers in the UK before and after the ban, with beliefs in the three other ITC countries unaffected by the ban. RESULTS: There was a substantial decline in reported beliefs about the benefits of light cigarettes in the UK following the policy change and an associated public information campaign, but by 2005 (ie, wave 4), these beliefs rebounded slightly and the change in beliefs was no greater than in the USA, where there was no policy change. CONCLUSIONS: The findings reveal that high levels of misperceptions about light cigarettes existed among smokers in all four countries before and after the EU ban took effect. We cannot conclude that the policy of removing some aspects of misleading labels has been effective in changing beliefs about light cigarettes. Efforts to correct decades of consumer misperceptions about light cigarettes must extend beyond simply removing "light" and "mild" brand descriptors.

Enhancing the effectiveness of tobacco package warning labels: a social psychological perspective.

OBJECTIVE: To outline social psychological principles that could influence the psychosocial and behavioural effects of tobacco warning labels, and to inform the development of more effective tobacco warning labels. DATA SOURCES: PsycInfo and Medline literature searches and expert guided selection of principles and theories in social psychology and of tobacco warning labels, including articles, books, and reports. CONCLUSIONS: Tobacco warning labels represent a potentially effective method of influencing attitudes and behaviours. This review describes social psychological principles that could be used to guide the creation of more effective warning labels. The potential value of incorporating warning labels into a broader public health education campaign is discussed, and directions for future research are suggested.

Compensatory conviction in the face of personal uncertainty: going to extremes and being oneself.

Study 1 participants' self-integrity (C. M. Steele. 1988) was threatened by deliberative mind-set (S. E. Taylor & P. M. Gollwitzer, 1995) induced uncertainty. They masked the uncertainty with more extreme conviction about social issues. An integrity-repair exercise after the threat, however, eliminated uncertainty and the conviction response. In Study 2, the same threat caused clarified values and more self-consistent personal goals. Two other uncertainty-related threats, mortality salience and temporal discontinuity, caused similar responses: more extreme intergroup bias in Study 3, and more self-consistent personal goals and identifications in Study 4. Going to extremes and being oneself are seen as 2 modes of compensatory conviction used to defend against personal uncertainty. Relevance to cognitive dissonance and authoritarianism theories is discussed, and a new perspective on terror managenment theory (J. Greenberg, S. Solomom, & T. Pyszczynski, 1997) is proposed.

Alcohol, sexual arousal, and intentions to use condoms in young men: applying alcohol myopia theory to risky sexual behavior.

Data from 7 studies were aggregated to examine how reported sexual arousal and alcohol intoxication interact to affect attitudes and intentions toward engaging in unprotected sexual intercourse in college-age men (N = 358). When participants were in a sober or placebo condition, their self-reports of sexual arousal had no effect on their responses. When participants were intoxicated, however, those who felt sexually aroused reported more favorable attitudes, thoughts, and intentions toward having unprotected sex than did those who did not feel aroused. These findings support alcohol myopia theory (C. M. Steele & R. A. Josephs, 1990), which states that alcohol intoxication restricts attentional capacity so that people are highly influenced by the most salient cues in their environment. It is suggested that sexual arousal is a powerful internal cue that interacts with alcohol intoxication to enhance attitudes and intentions toward risky sexual behaviors.

Alcohol myopia and condom use: can alcohol intoxication be associated with more prudent behavior?

We tested 2 competing theories about the effects of alcohol on intentions to engage in risky behavior. Disinhibition predicts that intoxicated people will exhibit risky behavior regardless of environmental cues, whereas alcohol myopia (C. M. Steele & R. A. Josephs, 1990) predicts that intoxicated people will be more or less likely to exhibit risky behavior, depending on the cues provided. In 4 studies, we found an interaction between intoxication and cue type. When impelling cues were present, intoxicated people reported greater intentions to have unprotected sex than did sober people. When subtle inhibiting cues were present, intoxicated and sober people reported equally cautious intentions (Studies 1-3). When strong inhibiting cues were present, intoxicated people reported more prudent intentions than did sober people (Study 4). We suggest that alcohol myopia provides a more comprehensive account of the effects of alcohol than does disinhibition.

Community Intervention Trial for Smoking Cessation (COMMIT): changes in community attitudes toward cigarette smoking.

The success of the Community Intervention Trial for Smoking Cessation (COMMIT) in changing smoking attitudes is examined by testing two primary hypotheses: (1) the priority of smoking as a public health problem increased more in the intervention communities than in the comparison communities, and (2) norms and values that support non-smoking increased more in the intervention than in the comparison communities. One community within each of 11 matched pairs was randomly assigned to receive a 4-year (1989-92) community-based smoking control intervention. Community attitudes towards smoking were measured primarily by cross-sectional surveys in 1989 (n = 9875) and 1993 (n = 14117) but a cohort (n = 5450) also provided attitude information. The main trial effect was on heavy smokers in the intervention communities who showed significantly more change in their beliefs about smoking as a public health problem. Despite the absence of an intervention-comparison difference, the magnitude of change in community-wide norms and values was related to the level of smoking control activities. In the cohort, light-to-moderate smokers in the intervention communities came to have stronger beliefs about smoking as a serious public health problem. COMMIT's impact on the beliefs of heavy smokers about the seriousness of smoking as a public health problem has important public health implications.

Measuring attitudes towards smoking in the Community Intervention Trial for Smoking Cessation (COMMIT).

We present the development of indices using baseline data from the Evaluation Survey for the Community Intervention Trial for Smoking Cessation (COMMIT). The indices are designed to measure two primary attitude constructs that relate to smoking behavior: beliefs about smoking as a public health problem (SPHP); and norms and values concerning smoking (NVS). Two general approaches to index construction, the rational method and the factor analytic method, were used. Item analysis suggested good internal consistency for both indices (alpha > 0.75). Seven subconstructs emerged from the factor analysis accounting for 55.0% of the total variance. The SPHP and NVS items uniquely identify with four factors and three factors, respectively, confirming the validity of the two indices. Confirmatory factor analyses of a different data set provided further validation. Validity was also assessed by an examination of the relationships between index scores and smoking status. Smokers reported significantly higher scores than non-smokers on the two measures indicating, as anticipated, that smokers have more favorable attitudes towards smoking than non-smokers. These findings suggest that the two a priori constructs of SPHP and NVS are empirically distinguishable components of attitudes towards smoking, and that the indices developed here are reliable and valid measures of those constructs.

The conflicted individual: personality-based and domain-specific antecedents of ambivalent social attitudes.

Historically, attitude theory and research has assumed that attitudes are largely unconflicted and unidimensional summary statements of feelings and beliefs. More recent work has reexamined this assumption (Thompson, Zanna, & Griffin, in press). The present article details two studies that continue to investigate this notion, examining antecedent variables assumed important in the genesis of attitudinal ambivalence. The first study focuses upon personality-based factors such as individuals' Need for Cognition (NFC) and Personal Fear of Invalidity (PFI) (a heightened concern with error). The pattern of results was consistent with our predictions: High NFC was associated with less ambivalence and high PFI was associated with greater ambivalence. The second study investigated a domain-specific antecedent. It was predicted that higher involvement would reduce the level of ambivalence experienced. Further, involvement was expected to moderate the effect of the personality-based antecedents. Again, results confirmed our hypotheses. High NFC was associated with less ambivalence, especially under conditions of high involvement with the issues. Conversely, high PFI individuals who were highly involved with these issues experienced more ambivalence. These results are discussed in terms of their implications for attitude theory.

Decision making in altered states: effects of alcohol on attitudes toward drinking and driving.

A laboratory experiment and 2 field studies tested the hypothesis that alcohol affects attitudes and intentions toward drinking and driving. Sober and intoxicated participants completed a questionnaire assessing their attitudes and intentions to drink and drive in a number of situations. Results indicated that when asked general or noncontingent questions, sober and intoxicated participants were equally negative about this behavior. However, when a contingency was embedded in the question (e.g., "would you drink and drive only a short distance?"), intoxicated participants were significantly less negative about drinking and driving. These results are consistent with alcohol myopia (C. M. Steele & R. A. Josephs, 1990)--the notion that alcohol intoxication decreases cognitive capacity so that people are more likely to attend to only the most salient cues.

Are social-psychological smoking prevention programs effective? The Waterloo study.

Recent evaluations of smoking prevention programs have suggested considerable promise for curricula emphasizing resistance of social influences. The present study extends these evaluations by addressing key methodological limitations in previous work. Twenty-two matched schools were randomized to experimental and control conditions. Grade 6 students received a 6-week core curriculum, plus additional sessions through Grades 7 and 8. Questionnaires, and saliva samples to validate self-reported smoking behavior, were collected at five times over the 2-year study period. Cross-sectional and longitudinal analyses examined program impact for five levels of initial smoking experience, ranging from "never smoker" through regular, weekly smoker. Significant program effects were documented, most clearly for those having some experience with smoking before the program began and for those with smoking peer and family models. This study provides the methodologically most rigorous test to date of social influence programs for smoking prevention and documents for the first time significant effects for those at high risk for smoking.

Arousal as a necessary condition for attitude change following induced compliance.

This study examined whether arousal is or is not a necessary condition for attitude change in the induced compliance paradigm. In a 2 times 3 design, experimental subjects were induced to write counterattitudinal essays under either high- or low-choice conditions. All subjects were led to believe that a pill, which they had just taken in the context of a separate experiment, was a placebo. In reality, subjects were given a pill that contained either phenobarbital (tranquilizer condition), amphetamine (amphetamine condition), or milk powder (placebo condition). In this last condition, the results yielded the usual dissonance effect: High choice produced more attitude change in the direction of the essay than low choice. When subjects were given a tranquilizer, this effect was virtually eliminated; when subjects were given amphetamine, attitude change increased under high choice and was exhibited for the first time under low choice. These results are consistent with the notion that attitude change is in the service of reducing arousal and with the idea that arousal from other sources can be misattributed to attitude-discrepant behavior.

Physiological mediation of attitudinal responses.

A study was undertaken to try to ascertain the best model of the relationship between stimuli, physiological responses, and attitudes. Subjects were asked to indicate their attitudes toward various nations after having received various bogus information about how they responded physiologically to the stimuli. The results indicate the following: (a) In general, attitudes appear to be physiologically mediated; (b) physiological mediation of attitudes is strongest when prior knowledge about the stimuli is low but is independent of prior attitudes about the stimuli; (c) bogus physiological feedback does not seem to be verbally mediated; and (d) the most fruitful distinction between types of bogus feedback is between any feedback versus no feedback, not between change versus no change or between increase versus decrease in response.