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Hastings and MacFadyen have raised important questions about the optimal direction for future tobacco control media campaigns. There is much that we agree with. However, we disagree with their central recommendation that campaigns should reduce the use of messages that portray the serious consequences of tobacco use in an emotionally evocative way. They base this recommendation on four assumptions which we feel are questionable:
fear messages rely on a rational model of decision making, but the decision to smoke is not made rationally
these approaches are likely to become less effective over time because: (a) most people already know that smoking has serious consequences; (b) most smokers already want to quit; and (c) repetition of the same messages diminishes their power
anti-tobacco communications should be part of a broader communication that promotes a whole set of healthy behaviours
commercial marketers have developed new and effective strategies over the past 20 years and these strategies can work equally well for marketing non-smoking.
We disagree with the first three of these points and would like to quibble a bit about the fourth.
HOW AND WHY DO THESE “FEAR” MESSAGES WORK?
Most of the research on the effectiveness of fear appeals does indeed rely on models of rational cognitive processing. These models yield predictions about when fear appeals will be effective and when they won't, based on concepts such as “protection motivation”1 or subjective expected utility.2 They spawn complex experiments that attempt to produce variations in perceived severity of the danger, susceptibility to the danger, and perceived ability to perform the required response. Interestingly, these experiments frequently fail to yield support for the theoretical models.3 Instead, most studies show that the more fear aroused by the communication, the greater the persuasion.4,5 Likewise, we have evidence that the most effective anti-tobacco advertisements among both adults and teenagers …
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