Accentuating the Positive More Effective In Inspiring Smokers to Quit

The adage “It’s not what you say but how you say it”—was confirmed by a Yale study, which shows that playing up the benefits of quitting smoking is more effective in getting people to quit than emphasizing the problems associated with continuing to smoke.

The difference is substantial enough that consideration should be given to rewriting the warning labels on packs of cigarettes to emphasize the benefits of quitting smoking rather than the risk of continuing, said first author Benjamin Toll, assistant professor of psychiatry at Yale School of Medicine.

This is the first study to assess the effects of “message framing” for smoking cessation in the context of a smoking cessation clinical trial.

The study, published this month in Psychology of Addictive Behaviors, examined the use of prospect theory in getting people to quit smoking. Prospect theory maintains that gain-framed messages (“You will live longer if you quit smoking”) should be more effective than loss-framed messages (“You will die sooner if you do not quit smoking”) when attempting to encourage smokers to quit.

The research team randomly assigned 258 smokers in a clinical trial in which they received video and printed messages that emphasized either the benefits of quitting smoking or the costs of continuing to smoke. All of the participants also received the antidepressant bupropion for seven weeks.

There were only small differences in the number of participants in the two groups who went on to complete the treatment program. However, among the 170 smokers who completed treatment, those who received the more positive, or gain-framed, message were significantly more likely to maintain abstinence than those who received the more negative, or loss-framed, messages.

 “Interestingly, women who received the message about the benefits of quitting smoking were less likely to relapse than the men who heard and read the same message,” Toll said. “There is emerging evidence showing that some women may be particularly sensitive to gain-framed messages.”

Co-authors include Stephanie O’Malley, Ran Wu, Amy Latimer, Nicole Katulak, Boris Meandzija, Tony George, Peter Jatlow, and Peter Salovey, of Yale; Judith Cooney of the University of Connecticut School of Medicine, and Joel Dubin of the University of Waterloo.

Psychology of Addictive Behaviors: December 2007

The work above was funded, fully or in part, by the Yale Clinical and Translational Science Award (CTSA) grant from the National Center for Research Resources at the National Institutes of Health.