Tips from Former Smokers: A Content Analysis of Persuasive Message Features and Recommendations for Message Design

Theoretical Background and research questions/hypothesis: Years of research on message design and effects provides insight regarding the most persuasive message appeals. The purpose of this study was to evaluate the content of the messages being presented in the CDC’s Tips from Former Smokers (TIPS) campaign. TIPS was the first ever paid national tobacco education campaign. The campaign was launched in March of 2012 and focused on increasing knowledge about the health outcomes caused by smoking. Messages also encouraged current smokers to quit and to avoid smoking around others to protect their families from exposure to secondhand smoke. A content analysis of persuasive message design features was conducted to critically examine campaign content. The types of persuasive appeals present in campaign messages were identified and classified. Persuasive message design theories provide guidance regarding the most effective ways to change attitudes and behaviors. Message design features include: Emotional appeals, evidence type, message sidedness, efficacy, norms, attitude functions, message frame, and characteristics of the source. 

Methods: Campaign materials were coded for the presence of message variables. Four independent coders were trained to use a codebook developed to assess persuasive message design features. A total of 122 campaign messages, including video, print, and social media posts were systematically examined. To establish inter-coder reliability 15% of campaign materials were coded by all four coders.  The average pairwise Cohen’s kappa was 0.90 and the average pairwise percent agreement was 94.78. 

Results: In the campaign, 79.5% of messages included emotional appeals. Negative emotions were most common including: guilt (N = 47, 38.5%), disgust (N = 30, 24.6%), and fear (N = 60, 49.9%). When fear was present 97% of messages mentioned severity and 50% mentioned susceptibility.  Just 15 messages (12%) contained hope appeals and 7 (5%) contained warmth appeals. Quantitative evidence was present in 5.7% (N = 7) of messages. Qualitative evidence was present in 77% (N = 94) of messages. In the sample, 107 messages (87.7%) stated facts and 69 (56.6) provided visual evidence. In terms of attitude functions, most messages served a knowledge function (62.3%).  An ego-defensive function was present in 50.8%, a utilitarian function was present in 54.1%, a social identify function was present in 38.5%, and a value expressive function was present in 15.60%. Most messages were loss framed and presented the disadvantages of smoking (N = 69, 56.6%) with only 13.9% (N = 17) presenting a gain frame. 

Conclusions: Results from this content analysis indicate that the campaign contained more fear and guilt appeals, than other emotions. Evidence was typically presented in the form of a narrative from sources with firsthand experience. Suggestions for persuasive message design in large scale public heath communication campaigns is discussed. 

Implications for research and/or practice: Little research has systematically evaluated the breadth of message characteristics present in large scale behavior change initiatives. This analysis provides a complete understanding of the types of persuasive appeals being utilized in the TIPS campaign. There is an opportunity for message designers to utilize persuasion and message design theory to increase message effectiveness.