The effects of warning smokers on perceived risk, worry and motivation to quit

Go ahead. Nag, nag, nag. It might do some good after all. The more smokers worry about health risks, the more they will contemplate quitting, according to a new study in the latest issue of the journal Annals of Behavioral Medicine.

Warning messages create worry that can nudge smokers down that road, the researchers concluded.

"We didn't set out with the goal of trying to get people to quit," said Renee Magnan, a psychologist at the University of New Mexico. The idea was to prompt smokers to think about it. "The more we can do to get them motivated, the better."

Magnan and colleagues recruited 119 smokers, with an average age of 26. Half were students at North Dakota State University and the others were from the neighboring Fargo community. During a meeting, researchers told participants that the experiment was about communicating smoking-related information. The researchers said they would not ask smokers to quit, but smokers would receive messages on a personal digital assistant (PDA) eight times a day during the first week and six times a day the second week.

Researchers divided the smokers into two groups. For one group, the messages focused on various hassles - stress and money, for example. The other group received antismoking messages, some of which described how it affects nonsmokers when someone else smokes or how smoking can lead to wrinkles and yellow teeth. However, Magnan said the messages with more influence concerned serious health effects. The most worrisome was, "93 percent of lung cancer patients die within five years."

More than half of participants getting serious antismoking messages reported trying to quit during the intervention. Comparatively, about 19 percent of smokers in the other group said they tried to quit.

The research highlights an "innovative way to expose people to these messages," said Danielle McCarthy, a clinical psychologist at Rutgers University. "Worry seems to be part of what's important," she added.

The issue of how to warn smokers about health risks is a concern for researchers. "There is some good evidence to the complete ineffectiveness of our current warning labels," McCarthy said. "Larger warnings are better. That's one piece of the puzzle."

Magnan, who was involved with the study while doing graduate work in North Dakota, said the evidence could move researchers to learn more about how often to expose smokers to such messages. "Also, it's entirely likely that the type of smoker is important. It may work best for smokers who are thinking about quitting," she said. "It may help them move from thinking to doing."

Magnan RE, et al. The effects of warning smokers on perceived risk, worry and motivation to quit. Annals of Behavioral Medicine 31(1), 2009.