The role of information avoidance in managing uncertainty from conflicting recommendations about electronic cigarettes

ABSTRACT

Insufficient scientific evidence about electronic cigarettes (e-cigarettes) has led to conflicting recommendations (CRs) by credible scientific organizations, creating a public health debate that could prove especially difficult to reconcile as current and former smokers make decisions about whether to use e-cigarettes. To investigate how CRs about e-cigarettes may affect intentions to engage in healthy behaviors, 717 former and current smokers were randomly exposed to one of five conditions (varying in the level of conflict in recommendations) in this between-subject experiment. Our results indicated a significant interaction between the message level of conflict and individuals’ information avoidance, employed to maintain hope and deniability. These results suggest the effects of CRs stemming from scientific uncertainty vary with subgroups of people, pointing to several pressing theoretical and practical implications.

KEYWORDS:

• Uncertainty
• conflicting recommendations
• confusion
• carryover effects
• information avoidance
• electronic cigarettes

Acknowledgements

Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50-CA179546-01. 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 (FDA). We thank Dr. Paul Schrodt and three anonymous reviewers for their constructive feedback in the peer review process.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Our sample, although predominantly being White, showed consistency with the demographics of tobacco and e-cigarette users in nationally representative samples. According to the latest Health Information National Trends Survey (HINTS; National Cancer Institute, 2019) dataset, 80.8% and 80.6% tobacco users and e-cigarette users respectively reported as White.

2 The information level across conditions might be different, which future research is encouraged to take into account. Specifically, the stimuli in the two-sided condition may be perceived as more informative than those in the one-sided or no recommendation control conditions.

3 Based on the conceptualization of the carryover effects and previous literature (e.g., Nagler, 2014), the healthy lifestyle intention should not be treated as a latent variable measured by three specific behaviors, because the intention for healthy lifestyle is not a global measure, and the three specific behaviors examined in the current study are not inherent scale for healthy lifestyle. For instance, it is not uncommon that one individual adheres to healthy dieting but does not conduct enough physical activity (or goes to gym frequently but consumes a high volume of alcohol). Therefore, the three behaviors (i.e., fruit and vegetable intake, exercise, and limited alcohol intake) should be analyzed individually to provide a clear picture of the moderated mediating mechanism.

4 Although the two information avoidance constructs (i.e., avoid to maintain uncertainty and avoid insufficient information) were correlated at the magnitude of r = .58, they were analyzed in separate statistical models, and therefore did not cause multicollinearity.

5 According to the a priori power analysis using G*power (Faul et al., 2009), when the power (1 − β) was set at .95 (α = .05), 470 subjects are needed in order to detect a small effect size (.20). Therefore, we believe our design is well-powered.

6 When median splitting the sample based on participants’ score of IAT to maintain uncertainty, 44 participants with the median score were categorized in the low information avoidance group. Acknowledging that assigning the participants in the median IAT level (n = 44) to the low information avoidance group may introduce arbitrariness, we conducted further analyses of splitting the participants into three groups (i.e., low [M – SD], median [M], high [M + SD]) based on their IAT and obtained similar results. The detailed results of additional analyses are available upon request.

Additional information

Funding

Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50-CA179546-01; U.S. Food and Drug Administration.

Notes on contributors

Qinghua Yang

Qinghua Yang (Ph.D., University of Miami, 2015) is an assistant professor in the Department of Communication Studies at the Texas Christian University. Her research focuses on health information seeking and processing, health interventions and campaigns, and new media.

Natalie Herbert

Natalie Herbert (Ph.D., University of Pennsylvania, 2020) is a PhD in Communication from the Annenberg School for Communication, where her dissertation studied perceptions of scientific uncertainty about e-cigarettes. She was a 2020 Christine Mirzayan Science and Technology Policy Graduate Fellow at the National Academies of Sciences, Engineering, and Medicine.

Sijia Yang

Sijia Yang (Ph.D., University of Pennsylvania, 2019) is an assistant professor at the School of Journalism and Mass Communication at the University of Wisconsin-Madison. His research focuses on message effects and persuasion, computational social science, and digital media.

Julia Alber

Julia Alber (Ph.D., University of Florida, 2015) is an assistant professor in the Department of Kinesiology and Public Health at California Polytechnic State University. Her research explores using communication technologies for promoting and understanding cancer prevention behaviors.

Yotam Ophir

Yotam Ophir (Ph.D., University of Pennsylvania, 2018) is an assistant professor of Communication at the University at Buffalo. His research focuses on media effects and persuasion, computational social science, and the interaction of misinformation and society.

Joseph N. Cappella

Joseph N. Cappella (Ph.D., Michigan State University, 1974) is the Gerald R. Miller Professor of Communication at the Annenberg School for Communication at the University of Pennsylvania. He is a Fellow of the International Communication Association and its past president, a distinguished scholar of the National Communication Association, and recipient of the B. Aubrey Fisher Mentorship Award.