Journal of Behavioral Medicine

, Volume 40, Issue 3, pp 520–529 | Cite as

A brief measure of reactance to health warnings

  • Marissa G. HallEmail author
  • Paschal Sheeran
  • Seth M. Noar
  • Kurt M. Ribisl
  • Marcella H. Boynton
  • Noel T. Brewer


Reactance to persuasive messages involves perceived threat to freedom, anger, and counterarguing that may undermine the impact of health warnings. To understand reactance’s effects, reliable and valid assessment is critical. We sought to develop and validate a brief Reactance to Health Warnings Scale (RHWS). Two independent samples of US adults completed the brief RHWS in studies that presented warnings on cigarette packs that smokers carried with them for 4 weeks (Study 1; n = 2149) or as digital images of cigarette packs that participants viewed briefly (Study 2; n = 1413). The three-item Brief RHWS had good internal consistency and test–retest reliability. The scale correlated with higher trait reactance and exposure to pictorial warnings, supporting its convergent validity. With respect to predictive validity, the Brief RHWS predicted perceived message effectiveness, quit intentions, avoidance of the warnings, and number of cigarettes smoked per day. The Brief RHWS can serve as an efficient adjunct to the development of persuasive messages.


Reactance Defensive processing Health warnings Tobacco control Pictorial warnings Health communication 



Research reported in this publication was supported by The National Cancer Institute and FDA Center for Tobacco Products (CTP) under Award Number P30CA016086-38S2. F31CA196037 from the National Cancer Institute of the National Institutes of Health supported MGH’s time 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.

Compliance with ethical standards

Conflict of interest

Marissa G. Hall, Paschal Sheeran, Seth M. Noar, Kurt M. Ribisl, Marcella H. Boynton and Noel T. Brewer declare that they have no conflict of interest.

Human and animal rights and Informed consent

Study procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Researchers obtained informed consent from study participants.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Marissa G. Hall
    • 1
    • 4
    Email author
  • Paschal Sheeran
    • 2
    • 4
  • Seth M. Noar
    • 3
    • 4
  • Kurt M. Ribisl
    • 1
    • 4
  • Marcella H. Boynton
    • 1
    • 4
  • Noel T. Brewer
    • 1
    • 4
  1. 1.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  2. 2.Department of Psychology and NeuroscienceUniversity of North CarolinaChapel HillUSA
  3. 3.School of Media and JournalismUniversity of North CarolinaChapel HillUSA
  4. 4.Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillUSA

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