Numeracy and memory for risk probabilities and risk outcomes depicted on cigarette warning labels.

Brittany Shoots-Reinhard, Breann Erford, Daniel Romer, Abigail T Evans, Abigail Shoben, Elizabeth G Klein, Ellen Peters
Author Information
  1. Brittany Shoots-Reinhard: Department of Psychology. ORCID
  2. Breann Erford: Department of Psychology.
  3. Daniel Romer: Annenberg Public Policy Center. ORCID
  4. Abigail T Evans: Department of Psychology.
  5. Abigail Shoben: College of Public Health. ORCID
  6. Elizabeth G Klein: College of Public Health. ORCID
  7. Ellen Peters: Department of Psychology.

Abstract

OBJECTIVE: Greater numeracy is associated with higher likelihood to quit smoking. We examined whether numeracy supports learning of numeric health-risk information and, in turn, greater risk perceptions and quit intentions.
METHOD: Adult smokers ( = 696) viewed text warnings with numeric risk information four times each in one of three warning-label types (text-only, low-emotion pictorial [i.e., with image], high-emotion pictorial). They completed posttest measures immediately or 6 weeks later. Emotional reactions to warnings were reported the second time participants viewed the warnings. Numeracy, memory for risk probabilities and risk outcomes, risk perceptions, and quit intentions were assessed postexposures.
RESULTS: Memory for risk probabilities and risk outcomes depended on warning-label type and posttest timing. Consistent with memory-consolidation theory, memory for high- versus low-emotion labels was lower immediately, but declined less for high-than low-emotion labels. Label memory was similar between conditions at 6 weeks. Numeracy predicted overall superior memory (especially for risk probabilities) controlling for health literacy and education. It also indirectly predicted greater risk perceptions and quit intentions via memory. In exploratory analyses, however, the superior recall of risk probabilities of smoking among those higher in numeracy was associated with lower risk perceptions.
CONCLUSIONS: Numeracy is associated with superior risk memory, which relates to greater risk perceptions and quit intentions. More numerate and educated smokers may be better able to quit due to their superior learning of smoking's risks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

References

  1. J Health Econ. 2010 Jan;29(1):1-28 [PMID: 19963292]
  2. Health Psychol. 2012 Jan;31(1):106-13 [PMID: 21806302]
  3. PLoS One. 2013;8(1):e52206 [PMID: 23341895]
  4. Ann Behav Med. 1998 Spring;20(2):135-40 [PMID: 9989319]
  5. Psychol Sci. 2006 May;17(5):407-13 [PMID: 16683928]
  6. Psychol Sci. 2015 Apr;26(4):433-43 [PMID: 25770099]
  7. Psychol Bull. 2009 Nov;135(6):943-73 [PMID: 19883143]
  8. J Behav Ther Exp Psychiatry. 1994 Mar;25(1):49-59 [PMID: 7962581]
  9. Risk Anal. 1994 Dec;14(6):1101-8 [PMID: 7846319]
  10. Tob Control. 2016 May;25(3):341-54 [PMID: 25948713]
  11. Med Decis Making. 2014 May;34(4):430-42 [PMID: 24246563]
  12. Tob Control. 2020 Sep;29(5):556-563 [PMID: 31462579]
  13. JAMA. 1999 Mar 17;281(11):1019-21 [PMID: 10086437]
  14. J Pers Soc Psychol. 2015 May;108(5):802-22 [PMID: 25285966]
  15. Ann Behav Med. 2018 Feb 17;52(3):204-215 [PMID: 29538662]
  16. Prev Med. 2009 Aug-Sep;49(2-3):219-23 [PMID: 19573553]
  17. Patient Educ Couns. 2005 Jun;57(3):294-9 [PMID: 15893211]
  18. Int J Behav Nutr Phys Act. 2015 Jan 24;12:4 [PMID: 25616598]
  19. Am J Public Health. 2015 Feb;105(2):373-9 [PMID: 25521868]
  20. Med Care Res Rev. 2007 Apr;64(2):169-90 [PMID: 17406019]
  21. Tob Control. 2006 Jun;15 Suppl 3:iii71-5 [PMID: 16754950]
  22. J Natl Cancer Inst. 2008 Jun 18;100(12):845-53 [PMID: 18544745]
  23. Nicotine Tob Res. 2017 Oct 1;19(10):1155-1162 [PMID: 28031378]
  24. Law Hum Behav. 2000 Jun;24(3):271-96 [PMID: 10846372]
  25. Patient Educ Couns. 1999 Sep;38(1):33-42 [PMID: 14528569]
  26. Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S47-56 [PMID: 17931136]
  27. Tob Control. 2011 Sep;20(5):327-37 [PMID: 21606180]
  28. Perspect Psychol Sci. 2007 Mar;2(1):33-52 [PMID: 26151918]
  29. Acta Psychol (Amst). 2017 Mar;174:68-79 [PMID: 28189707]
  30. Addict Behav. 1994 Mar-Apr;19(2):209-17 [PMID: 8036967]
  31. Psychol Health. 2018 Feb;33(2):213-234 [PMID: 28385093]
  32. J Health Commun. 2006;11 Suppl 1:93-102 [PMID: 16641076]
  33. Journal Mass Commun Q. 2017 Jun 01;94(2):416-442 [PMID: 29975497]
  34. Health Psychol. 1991;10(5):360-5 [PMID: 1935872]
  35. PLoS One. 2017 Jul 12;12(7):e0180674 [PMID: 28704410]
  36. Patient Educ Couns. 2007 Apr;66(1):100-7 [PMID: 17137743]
  37. Ann Behav Med. 2019 Mar 20;53(4):358-371 [PMID: 29947729]
  38. Nicotine Tob Res. 2014 Mar;16(3):263-9 [PMID: 23946325]
  39. Psychol Sci. 2010 Oct;21(10):1369-76 [PMID: 20739672]
  40. Emotion. 2011 Feb;11(1):12-9 [PMID: 21058846]
  41. Patient Educ Couns. 2011 Jan;82(1):30-5 [PMID: 20219316]
  42. Nicotine Tob Res. 2019 Jun 21;21(7):974-978 [PMID: 30285145]
  43. J Epidemiol Community Health. 2012 Feb;66(2):189-92 [PMID: 22003080]
  44. PLoS One. 2013;8(1):e54937 [PMID: 23383006]
  45. Med Decis Making. 2017 Aug;37(6):688-702 [PMID: 28398836]
  46. N Engl J Med. 2013 Jan 24;368(4):341-50 [PMID: 23343063]
  47. PLoS One. 2015 Dec 16;10(12):e0142879 [PMID: 26672982]
  48. Risk Anal. 2009 Oct;29(10):1473-88 [PMID: 19671102]
  49. MMWR Morb Mortal Wkly Rep. 2018 Nov 09;67(44):1225-1232 [PMID: 30408019]
  50. Trends Neurosci. 1998 Jul;21(7):294-9 [PMID: 9683321]
  51. J Behav Decis Mak. 2013 Apr;26(2):198-212 [PMID: 32313367]
  52. J Exp Psychol. 1963 Feb;65:190-3 [PMID: 14033436]
  53. Med Decis Making. 2010 Jul-Aug;30(4):464-73 [PMID: 20160070]

Grants

  1. P50 CA180908/NCI NIH HHS
  2. /Food and Drug Administration; Center for Tobacco Products
  3. /National Science Foundation
  4. /National Institutes of Health; National Cancer Institute

MeSH Term

Adult
Female
Humans
Male
Product Labeling
Risk Factors
Smoking
Smoking Prevention
Tobacco Products

Word Cloud

Created with Highcharts 10.0.0riskmemoryquitperceptionsprobabilitiesintentionsNumeracysuperiornumeracyassociatedgreaterwarningslow-emotionoutcomeslabelshighersmokinglearningnumericinformationsmokersviewedwarning-labelpictorialposttestimmediately6weekslowerpredictedOBJECTIVE:Greaterlikelihoodexaminedwhethersupportshealth-riskturnMETHOD:Adult=696textfourtimesonethreetypestext-only[ieimage]high-emotioncompletedmeasureslaterEmotionalreactionsreportedsecondtimeparticipantsassessedpostexposuresRESULTS:MemorydependedtypetimingConsistentmemory-consolidationtheoryhigh-versusdeclinedlesshigh-thanLabelsimilarconditionsoverallespeciallycontrollinghealthliteracyeducationalsoindirectlyviaexploratoryanalyseshoweverrecallamongCONCLUSIONS:relatesnumerateeducatedmaybetterableduesmoking'srisksPsycInfoDatabaseRecordc2020APArightsreserveddepictedcigarettewarning

Similar Articles

Cited By (3)