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Reactance to Health Warnings Scale: Development and Validation

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Health warnings may be less effective if they elicit reactance, a motivation to resist a threat to freedom, yet we lack a standard measure of reactance.

Purpose

We sought to validate a new health warning reactance scale in the context of pictorial cigarette pack warnings.

Methods

A national sample of adults (n = 1413) responded to reactance survey questions while viewing randomly assigned pictorial or text warnings on images of cigarette packs. A separate longitudinal sample of adult smokers received the warnings on their own cigarette packs (n = 46).

Results

Factor analyses identified a reliable and valid 27-item Reactance to Health Warnings Scale. In our experimental study, smokers rated pictorial warnings as being able to motivate quitting more than text warnings. However, five reactance scale factors weakened the warnings’ impact (anger, exaggeration, government, manipulation, and personal attack; all p < .05).

Conclusions

The Reactance to Health Warnings Scale had good psychometric properties. Reactance weakened the impact of pictorial warnings on smokers’ evaluation of the warning’s ability to motivate quitting.

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Acknowledgments

We thank M. Justin Byron, Gavin Fitzsimons, Amy McQueen, and Jessica Pepper for their feedback on the scale items.

Author information

Authors and Affiliations

  1. University of North Carolina, Chapel Hill, NC, USA

    Marissa G. Hall MSPH, Paschal Sheeran PhD, Seth M. Noar PhD, Kurt M. Ribisl PhD, Laura E. Bach MPH & Noel T. Brewer PhD

  2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 325 Rosenau Hall CB7440, Chapel Hill, NC, 27599, USA

    Marissa G. Hall MSPH, Kurt M. Ribisl PhD, Laura E. Bach MPH & Noel T. Brewer PhD

  3. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Marissa G. Hall MSPH, Paschal Sheeran PhD, Seth M. Noar PhD, Kurt M. Ribisl PhD, Laura E. Bach MPH & Noel T. Brewer PhD

  4. Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA

    Paschal Sheeran PhD

  5. School of Media and Journalism, University of North Carolina, Chapel Hill, NC, USA

    Seth M. Noar PhD

Authors
  1. Marissa G. Hall MSPH
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  2. Paschal Sheeran PhD
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  6. Noel T. Brewer PhD
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Corresponding author

Correspondence to Noel T. Brewer PhD.

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Funding

Research reported in this publication was supported by The National Cancer Institute and FDA Center for Tobacco Products (CTP) under Award Number P30CA016086-38S2. 5P50CA180907 from the National Cancer Institute and FDA Center for Tobacco Products (CTP) supported MGH’s time spent writing the paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

Conflict of Interest

The authors declare that they have no conflict of interest.

Adherence to Ethical Standards

The University of North Carolina at Chapel Hill Institutional Review Board approved our study protocol. We obtained informed consent with each participant prior to enrolling them in the study.

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Hall, M.G., Sheeran, P., Noar, S.M. et al. Reactance to Health Warnings Scale: Development and Validation. ann. behav. med. 50, 736–750 (2016). https://doi.org/10.1007/s12160-016-9799-3

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  • DOI: https://doi.org/10.1007/s12160-016-9799-3

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