Thursday, May 3, 2018

Smoking Kills: Persuading University of Warwick students to stop smoking on campus

For our behaviour change project, we created a video with the primary goal of persuading individuals, particularly university students to quit smoking. The motivation behind this was that it might lead to a reduction in smoking on campus.  The goal of this project was not aimed at implementing a smoking ban policy on campus, but rather to persuade individuals who do smoke on campus to quit. As a group, we felt that the incentive of decreasing smoking was a particularly important cause. A report in 2016, published by the Health & Social care information centre whom collaborate with the NHS, reported that younger adults were more likely to smoke than older adults. This report stated that 25% of 16-34 year olds considered themselves to be smokers and 20% of adults in the UK were likely to smoke on a daily basis (See Figure 1). Furthermore, it was reported that adults with higher levels of qualifications were less likely to smoke. This being said, it was still reported that individuals in the UK completing higher education before receiving a degree,  as much as 15% of this target group were still likely to be smokers.


Figure 1 – Taken from Statistics on Smoking, published in 2016. Health and Social Care Information Centre.




Smoking in public places may have detrimental long-term health effects on non-smoking University students. The NHS states that long-term exposure to second-hand smoke can increase the likelihood of contracting lung cancer by 20-30% and coronary heart disease by 25-30%. To emphasise the harmfulness of second-hand smoke, a 50 year report in the U.S., conducted by the U.S. Department of Health and Human Services predicts that an alarming figure of 2,500,000 non-smokers have died from health problems caused by exposure to secondhand smoke in the U.S. since 1964. It could, therefore, be presented as a strong argument that persuading individuals to reduce the frequency or to refrain from smoking in high capacity areas on campus is justifiable. It has been suggested that the majority of lifelong smokers begin smoking before the age of 24 (Missouri, 2016), thus making university students a high target audience for tobacco companies to convince students to take up the habit of smoking. A study by Levinson et al. (2008) commented that smoking is considered a social activity at University for those who partake in it. This is particularly worrying, as a social activity that has connotations of harmless behaviour may have detrimental long-lasting health issues. For example, the NHS in 2014 released figures that estimated around 1.7 admissions to hospital over 2014-2015 were due to ailments that are likely to have been caused by smoking. This is an alarming 4.7 thousand admissions each day! Moreover, the NHS also estimated that in the year 2014, around 78,000 deaths in the UK were attributed to smoking.  

Our project consisted of a video that was uploaded to YouTube (seen below) and was also shown on the big screen in the Piazza of Warwick campus for a week up to the 29th April. The incentive behind uploading our video to YouTube was to allow wide-scale accessibility to view our video.  Demographics for YouTube (seen in Figure 2) show that the highest age range of users who access YouTube were individuals in the age range 18-34. These figures emphasise the importance of utilising a media platform to upload our video that will reach University students. This is particularly important when coupled with the Health & Social care information centre’s report, which stated that almost 25% of 16-34 year olds were considered to indulge in smoking behaviour. The motive behind using the big screen in the popular location of the University piazza was an attempt to target Warwick university students directly. Firstly, the piazza is often one of the busiest areas on campus; thus allowing our video to be viewed by a larger amount of students, rather than it being uploaded solely to YouTube, Facebook or other social media platforms. Secondly, the goal of the project was to try and promote a change on University campus. The use of the big screen allowed our message in the video to be conveyed directly to University of Warwick students. Therefore, it could be argued that this approach may lead to having a bigger impact on reducing the number of individuals that smoke on campus. Thirdly, the piazza is considered a highly social location on campus, whereby many students meet to engage in conversation or engage in group activities. In light of research by Levinson et al. (2008), that suggests smoking amongst University students is considered a social activity, the use of a social location on campus to convey the video’s message seemed highly appropriate. 





Some factors were implemented to ensure that the issue being addressed was conveyed to the target audience in mind. Firstly, the video was filmed on campus, in locations that would have been highly identifiable by the majority of students at the University of Warwick. Secondly, the video consisted of dialogue in English, Spanish and Urdu. The foreign languages were accompanied with English subtitles. The motive behind the incorporation of multiple spoken languages within our video was based on many premises.  Firstly, Warwick University has been named as one of the world’s top 20 most international universities (Times Higher education). The foreign languages spoken in the video may have been directly targetable to some University students, thus incorporating the international aspect that Warwick University has been rated so highly for.  However, the use of foreign languages was not to specifically target Spanish or Urdu speakers. In fact, the use of multiple languages served as a message to collectively unite as a highly international University to reduce smoking on campus. This message was conveyed in the video. 


Figure 2. 




There were a variety of persuasion techniques that were implemented in our video to assist in the goal of the project, which was attempting to persuade Warwick students to reduce smoking on campus.







Loss Aversion

Loss aversion is a central conclusion from the study of risky choices. It refers to an underlying tendency we all have, whereby people prefer to avoid losses than to acquire similar gains (Tversky & Kahneman, 1991). People hate losing. For example, this persuasive technique was used in a simple experiment. In the experiment, half of the class were given coffee mugs, and other half did not receive a mug (Thaler & Sunstein, 2008). Mug owners were later invited to sell these mugs and nonowner to buy them. They did this by answering the question “at each of the following prices, indicate whether you would be willing to give up your mug/buy your mug.” Findings showed that mug owners were demanding around twice as much to give up their mugs than others were willing to pay for (Thaler & Sunstein, 2008). This show that people do not assign value to objects, but rather when they have to give something up, it hurts them more than acquiring the same thing (Thaler & Sunstein, 2008).

We tried to persuade others to change their behaviour and decrease their smoking habits by using loss aversion in the video. We hoped that by explicitly telling students about all the money they would be able to save throughout their lifetime (around £90,000), would encourage them to at least decrease the level of smoking. This way we were not only supporting students to lead a healthier lifestyle but also to realise that all the money they are spending on tobacco could be better spent elsewhere. Students have many expenses, and even by decreasing their smoking habits, they would be able to cut down and save more money.


Attribution effects / Manded altercast

Attribution effect is a tactic for persuading people by attributing certain desirable or undesirable characteristics to people who perform a specific behaviour. This persuasion technique was used in several experiments by Bryan, Adams, and Monin (2013) to prevent undesirable behaviour. The study tested whether highlighting the identity consequences of cheating would cause people to be honest. Participants could claim money which they were not entitled to, at the experimenter’s expense (Bryan, Adams, & Monin, 2013). Instructions of the task participants had to complete were subtly manipulated by referring to cheating with language that would either highlight the implications of cheating for the participant’s identity (e.g. “Please don’t be a cheater”) or would focus more on the action (“Please don’t cheat”). Participants who were assigned to the “cheating” condition demanded more money than those in the “cheater” condition, who showed no evidence of cheating expense (Bryan, Adams, & Monin, 2013). The findings show how powerful subtle changes in linguistic can be in preventing unethical behaviour by appealing to people’s desire to maintain the self-image as honest (Bryan, Adams, & Monin, 2013).

Similarly, in the video, we highlighted the identity consequences of smoking to try and cause people to stop or decrease their smoking habits. By using subtle changes in linguistics, such as, “don’t be a smoker”, we hoped to prevent smoking by appealing to people’s desire to maintain a self-image of being healthy.


Framing Effects

Framing effect is a cognitive bias whereby people react differently to the same choice depending on the context. Information about a health behaviour like smoking can be presented in a gain frame for example “you will live longer if you quit smoking” or a loss frame “you will die sooner if you don’t stop smoking” (Toll et al., 2007). An obtained gain for decreasing smoking behaviour can be framed as “you prolong your heart and lung life” or an avoided loss for decreasing smoking behaviour can be framed as “you don’t shorten your heart and lung life” (Tasso, Monaci, Trentin, & Rosabianca, 2005). According to Prospect theory, making gains salient leads to loss averse behaviour whereas making losses salient leads to risk-seeking behaviour (Tverksy & Kahneman, 1981). 

There is mix research as to which frame is more effective. A study on high school students suggested that loss framed warnings on cigarette packages decreased smoking-related behaviour and increased intentions to reduce smoking levels (Goodall & Appiah, 2008). Keeping in line with that, our video included loss framed facts about how others will find you unattractive due to your smoking habits. However according to Prospect theory, making losses salient leads to risk-seeking behaviour (Tverksy & Kahneman, 1981). Indeed in another study on college students, gain framed messages significantly decreased smoking behaviour, which was sustained for 6 weeks (Schneider et al., 2001). Keeping in line with that, our video included gain framed facts like how decreasing smoking will save your life, other’s life and your money as well. Thus, in the video for our project, we thought that one way to decrease the smoking behaviour might be by strengthening the link between smoking and its associated desirable and undesirable identities.


Social proof

Bandura’s (1986) Bobo doll experiments introduced social cognitive theory. These studies suggested that the observation of others behaviour can result in a similar change of behaviour within the observer. This action is known as a heuristic in the form of social proof. For example, a study by Weaver, Miller, Garcia, and Schwarz (2007) demonstrated that hearing the same message from one person three times was as persuasive as hearing the same message from three different people. In our video, the message “smoking kills” was repeatedly mentioned throughout, in order to try and emphasise the detrimental associations of smoking, in an attempt to persuade individuals to quit. Even after all the research explaining the adverse health problems associated with smoking, it may seem strange as to why such a high percentage of individuals still smoke on a daily occurrence. In fact, it is likely that many smokers were influenced to start smoking as they may have modelled it from parents and friends. This is particularly relevant when the availability heuristic (Tversky & Kahneman, 1973) proposes that the ease of retrieval of an event is an indicator of its relative frequency in the environment and thus its importance. 

In regards to our study, Cialdini (2007) states a particularly relevant point, mentioning that school based anti-smoking programs had lasting effects only when it used same-age peer leaders as teachers. Therefore, the individuals whom featured in the video were group project members, individuals that are active members of the University’s community and are of similar ages to the majority of University students. Social proof and other persuasion techniques outlined above, were incorporated into our video to express the detrimental factors associated with smoking, coupled with the beneficial aspects of quitting smoking in an attempt to persuade individuals to reduce smoking on campus. 


To conclude, our project aimed to reduce smoking behaviour on Warwick University campus. We decided to take this step by uploading a video on the Big Screen in the piazza, as well as on YouTube. We used different persuasive techniques in our video, rooted in the principles of loss aversion, framing effects and social proof. It may have been beneficial to question University students as to whether they saw the video presented on the Big Screen and if indeed these persuasion techniques resulted in any viewer being less inclined to smoke on campus. This would allow us to determine whether our project reached its target audience, as well as deciding whether more work (e.g. posters around campus, giving talks on the risks associated to smoking...) should be implemented in addition to our project, to persuade students to smoke less on campus.



  
Areeba, Sofia and Thomas


References

Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of Social and Clinical Psychology, 4, 359-373.

Bryan, C. J., Adams, G. S., & Monin, B. (2013). When cheating would make you a cheater: Implicating the self prevents unethical behavior. Journal of Experimental Psychology: General, 142, 1001-1005.

Cialdini, R. B. (2007). Influence: The psychology of persuasion. New York: Collins.

Goodall, C., & Appiah, O. (2008). Adolescents' perceptions of Canadian cigarette package warning labels: Investigating the effects of message framing. Health Communication, 23, 117-127.

Health and Social Care Information Centre. (2016). Statistics on Smoking, England. Hscic, 2-39.

Levinson, A. H., Campo, S., Gascoigne, J., Jolly, O., Zakharyan, A., & Vu Tran, Z. (2007). Smoking, but not smokers: Identity among college students who smoke cigarettes. Nicotine & Tobacco Research, 9, 845-852.

Medicine. Missouri (2016). Research reveals when and why students smoke in effort to help them quit.

Schneider, T. R., Salovey, P., Pallonen, U., Mundorf, N., Smith, N. F., & Steward, W. T. (2001). Visual and auditory message framing effects on tobacco smoking. Journal of Applied Social Psychology, 31, 667-682.

Tasso, A., Monaci, M. G., Trentin, R., & Rosabianca, A. (2005). Frame effects in persuasive messages against smoking. In Annual Conference of the Cognitive Science Society, Stresa, Italy.

Thaler, R., & Sunstein, C. (2008). Nudge: Improving decisions about health, wealth and happiness. London: Penguin Books.

The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.

Toll, B. A., O'malley, S. S., Katulak, N. A., Wu, R., Dubin, J. A., Latimer, A., ... & Salovey, P. (2007). Comparing gain-and loss-framed messages for smoking cessation with sustained-release bupropion: A randomized controlled trial. Psychology of Addictive Behaviors, 21, 534-544.

Tversky, A. & Kahneman, D. (1973). Availability: A heuristic for judging frequency and probability. Cognitive psychology, 5, 207-232.

Tversky, A., & Kahneman, D. (1981). The framing of decisions and the psychology of choice. Science, 211, 453-458.

Tversky, A., & Kahneman, D. (1991). Loss aversion in Riskless choice: A reference-dependent model. Quarterly Journal of Economics, 106, 1039-1061.

Weaver, K., Miller, T. D., Garcia, M. S., & Schwarz, N. (2007). Inferring the popularity of an opinion from its familiarity: A repetitive voice can sound like a chorus. Journal of Personality and Social Psychology, 92, 821-833.




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