Smoking self-concept moderates the effects of self-affirmation on smoking-related beliefs and behavioral intentions

Abstract

Objective

Smoking stigmatization has been shown to hinder cigarette smoking cessation, especially among individuals with a strong smoker identity. Self-affirmation, a psychological threat-management coping strategy, can promote smoking cessation, and may mitigate the adverse consequences of stigmatization.

Design

Data from an online sample of 1,020 U.S. adult smokers were analyzed using multiple linear regression.

Main Outcome Measures

Participants completed a self-affirmation (or no-affirmation control) writing task before viewing a smoking stigma (or non-stigma control) anti-smoking public service announcement video. Participants then reported smoking-related cognitions and behavioral intentions.

Results

Among participants with strong—but not weak—ties to a smoker identity (smoking self-concept), self-affirming led to higher quit intentions compared to the control condition. Among participants with weak—but not strong—smoking self-concepts, those who self-affirmed had lower intentions to switch completely to e-cigarettes relative to the control condition. Exposure to stigmatization reduced intentions to seek cessation counseling, particularly among those with weak smoking self-concepts.

Conclusion

Findings demonstrate the critical role that smoking identity centrality plays in moderating reactions to both affirming and stigmatizing stimuli. Additional research is needed to better understand how self-affirmation and stigma-reduction interventions can be tailored and implemented in natural contexts.

Acknowledgments

We would like to thank Dr. Marie Helweg-Larsen for her comments on study design and materials.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The materials and data that support the findings of this study are openly available in Open Science Framework at https://doi.org/10.17605/OSF.IO/FKU42

Notes

1 Data were excluded from participants who reported technical issues (n = 2), had duplicate responses (n = 16; initial responses were kept), did not meet the smoking status criterion (n = 16), provided poor quality responses to the values affirmation writing task (n = 45), or did not pass the attention check for the stigma induction (n = 19; they reported not being able to see the video clearly). Exclusion criteria included smoking 0 cigarettes per day on average (n = 6), smoking regularly before the age of 9 (n = 2), never starting to smoke regularly (n = 4), and either did not know (n = 2) or refused (n = 2) to report the age they first started smoking. Poor quality responses to the values affirmation writing task were very short (generally less than 19 words; n = 21), unrelated (n = 15), or lacked explanations for why the value was personally meaningful in their life (n = 9).

Additional information

Funding

This work was supported by the National Cancer Institute at the National Institutes of Health. Data collection was facilitated through a contract with Westat (Contract Number HHSN261201800002B). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.