Examination of a hope- and fear-based message targeting older adults who smoke: A randomized trial.
Adrienne L Johnson, Lucy Popova, Jesse T Kaye and 1 others
PMID 39442415WHAT IT FOUND
A fear-based message linking smoking to dementia increased motivation to quit in older adults, while a hope-based message did not.
Neither message changed the intention to quit. The effect was on short-term motivation only, not on actual cessation behavior or long-term intent.
Key findings
01Compared to a control message, the fear-based message significantly increased motivation to quit, but the hope-based message did not.
02There were no significant differences between the fear, hope, and control messages in terms of change in intention to quit.
03The fear message elicited higher levels of worry and lower levels of happiness compared to the hope message, though sadness and fear differences were not significant after correction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured only immediate changes in motivation and intention after a single exposure, not actual smoking cessation behavior or long-term quit rates. Participants self-reported their smoking status and medical history, which may be subject to recall or social desirability bias. The fear and hope messages differed in wording and visual elements (color background), which may have contributed to the observed differences in emotional response and motivation. Psychiatric distress levels differed between groups at baseline, though analyses controlled for this. The study was retrospectively registered, which raises concerns about potential outcome switching or analysis plan changes.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute on Aging.
The easy way to misread this
Do not interpret the increased motivation as evidence that the message will lead to quitting. The study found no change in intention to quit, and did not measure actual cessation behavior. A single exposure to a fear message may spark interest but does not guarantee a patient will attempt to stop smoking.