Abstract:
Despite over fifty years of research into the health consequences of smoking, tobacco use remains one of the leading preventable causes of death both in New Zealand and globally. Smoking has been linked to the development of multiple cancers, cardiovascular disease, and respiratory illnesses, and it is estimated that one in two smokers die from smoking-related health problems (US Department of Health and Human Services, 2014). Tobacco control strategies aimed at limiting smoking initiation and increasing smoking cessation have been only partially successful and their mechanisms remain unclear, as around 600,000 New Zealanders continue to smoke daily (Ministry of Health, 2014). A promising avenue for tobacco control research is leveraging emotions. Emotions are evolved adaptations that facilitate responding to particular classes of eliciting stimuli. Disgust and health anxiety are two emotions that occur in response to health-threatening stimuli (i.e., disease and death) – elicitors which are present in the outcomes of long-term smoking behaviour (Consedine & Moskowitz, 2007; Davey, 2011). Prior cross-sectional content on graphic health warning labels has linked these emotions with greater efficacy, but the causal role of each emotion in generating tobacco related avoidance remains unclear. The current study overcomes the limitations of past work by experimentally separating and manipulating these two emotions and testing their effects on subjective and objective avoidance among more and less dependent smokers. In the study, 72 daily smokers completed a web-based questionnaire assessing demographics, smoking history, health status, and personality factors. Participants were then gender block randomised to control, disgust, or health anxiety conditions in the laboratory, completing a series of smoking-related tasks while both subjective and objective indices of smoking-related avoidance were assessed. Disgust and health anxiety were successfully and independently induced. A 3 (experimental condition) x 2 (high/low smoking dependency) ANOVA revealed several key findings. First, both emotions impacted different indices of smoking avoidance. Inducing health anxiety caused lower ratings of willingness to pay for a cigarette. Conversely, disgust caused lower craving ratings, lower ratings of willingness to pay for a cigarette (among more highly dependent smokers), and increased the likelihood of accepting smoking cessation information. Overall, the findings of this study provide experimental evidence that disgust and health anxiety causally impact smoking behaviour and that, despite their functional and theoretical similarities, the two emotions have distinct effects and suggest that the links between emotions and avoidance may vary among more versus less dependent smokers. Findings thus extend theory and prior work on emotions-smoking links, and the success of the inductions in generating avoidance has clear implications for future tobacco control policy.