Comparing gain- and loss-framed messages for smoking cessation with sustained-release bupropion: a randomized controlled trial

Abstract

Prospect theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome, gain-framed messages will be more persuasive than loss-framed messages when attempting to encourage smoking cessation. To test this hypothesis, the authors randomly assigned participants (N=258) in a clinical trial to either a gain- or loss-framed condition, in which they received factually equivalent video and printed messages encouraging smoking cessation that emphasized either the benefits of quitting (gains) or the costs of continuing to smoke (losses), respectively. All participants received open label sustained-release bupropion (300 mg/day) for 7 weeks. In the intent-to-treat analysis, the difference between the experimental groups by either point prevalence or continuous abstinence was not statistically significant. Among 170 treatment completers, however, a significantly higher proportion of participants were continuously abstinent in the gain-framed condition as compared with the loss-framed condition. These data suggest that gain-framed messages may be more persuasive than loss-framed messages in promoting early success in smoking cessation for participants who are engaged in treatment.

Figures

Figure 1

Study flowchart. Gain-framed messages focused on attaining a desirable outcome or not attaining (avoiding) an undesirable outcome. Loss-framed messages emphasized attaining an undesirable outcome or not attaining (avoiding) a desirable outcome.

Figure 2

Survival (abstinence) analysis to end of treatment showing a main effect for message framing. Gain = messages focused on attaining a desirable outcome or not attaining (avoiding) an undesirable outcome. Loss = messages emphasized attaining an undesirable outcome or not attaining (avoiding) a desirable outcome.

Figure 3

Survival (abstinence) analysis to end of treatment showing an interaction of Message Framing × Gender. Gain = messages focused on attaining a desirable outcome or not attaining (avoiding) an undesirable outcome. Loss = messages emphasized attaining an undesirable outcome or not attaining (avoiding) a desirable outcome.