Abstract
Background: To improve the efficacy of digital smoking cessation interventions for young adults, intervention
messages need to be acceptable and appropriate for this population. The current study compared ratings of smoking
cessation and urge reduction messages based on Cognitive Behavioral Therapy (distraction themed) and Acceptance
and Commitment Therapy (acceptance themed) in young adults who smoke.
Methods: A total of 124 intervention messages were rated by an online Qualtrics panel of N = 301 diverse young
adults who currently smoked tobacco cigarettes (Age M = 26.6 years; 54.8% male; 51.5% racial/ethnic minority; 16.9%
sexual or gender minority (SGM); 62.5% daily smoking). Each participant rated 10 randomly selected messages (3,010
total message ratings; 24.3 ratings per message) on 5-point scales (higher scores representing more favorable ratings)
evaluating quality of content, quality of design, perceived support for coping with smoking urges, and perceived
support for quitting smoking. Mixed models examined associations between message category (distraction vs.
acceptance), participant level predictors (sociodemographic variables, readiness and motivation to quit, daily
smoking, psychological flexibility), and message ratings.
Results: Overall ratings ranged from M = 3.61 (SD = 1.25) on support for coping with urges to M = 3.90 (SD = 1.03) on
content, with no differences between distraction and acceptance messages. Male participants gave more favorable
ratings on the dimensions of support for coping (p < 0.01) and support for quitting (p < 0.01). Participants identifying
as SGM gave lower ratings for message design (p < 0.05). Participants with a graduate degree gave higher ratings
on support for coping with urges and support for quitting (both p < 0.05). Higher motivation to quit was associated
with more favorable scores across all dimensions (all p < 0.01). Those smoking daily rated messages as less helpful for
coping with urges (p < 0.01) and quitting smoking (p < 0.05) compared to those smoking non-daily. Few interactions
were found between message category distraction vs. acceptance and participant characteristics.
Conclusions: Distraction and acceptance messages received similar ratings among young adults who smoke
cigarettes. Message revisions may be needed to increase appeal to women, SGM, those with lower education, and those less motivated to quit. Messages will be refined and used in an ongoing micro-randomized trial to investigate
their real-time impact on smoking urges and behaviors.
messages need to be acceptable and appropriate for this population. The current study compared ratings of smoking
cessation and urge reduction messages based on Cognitive Behavioral Therapy (distraction themed) and Acceptance
and Commitment Therapy (acceptance themed) in young adults who smoke.
Methods: A total of 124 intervention messages were rated by an online Qualtrics panel of N = 301 diverse young
adults who currently smoked tobacco cigarettes (Age M = 26.6 years; 54.8% male; 51.5% racial/ethnic minority; 16.9%
sexual or gender minority (SGM); 62.5% daily smoking). Each participant rated 10 randomly selected messages (3,010
total message ratings; 24.3 ratings per message) on 5-point scales (higher scores representing more favorable ratings)
evaluating quality of content, quality of design, perceived support for coping with smoking urges, and perceived
support for quitting smoking. Mixed models examined associations between message category (distraction vs.
acceptance), participant level predictors (sociodemographic variables, readiness and motivation to quit, daily
smoking, psychological flexibility), and message ratings.
Results: Overall ratings ranged from M = 3.61 (SD = 1.25) on support for coping with urges to M = 3.90 (SD = 1.03) on
content, with no differences between distraction and acceptance messages. Male participants gave more favorable
ratings on the dimensions of support for coping (p < 0.01) and support for quitting (p < 0.01). Participants identifying
as SGM gave lower ratings for message design (p < 0.05). Participants with a graduate degree gave higher ratings
on support for coping with urges and support for quitting (both p < 0.05). Higher motivation to quit was associated
with more favorable scores across all dimensions (all p < 0.01). Those smoking daily rated messages as less helpful for
coping with urges (p < 0.01) and quitting smoking (p < 0.05) compared to those smoking non-daily. Few interactions
were found between message category distraction vs. acceptance and participant characteristics.
Conclusions: Distraction and acceptance messages received similar ratings among young adults who smoke
cigarettes. Message revisions may be needed to increase appeal to women, SGM, those with lower education, and those less motivated to quit. Messages will be refined and used in an ongoing micro-randomized trial to investigate
their real-time impact on smoking urges and behaviors.
| Original language | English |
|---|---|
| Article number | 1852 |
| Journal | BMC Public Health |
| Volume | 25 |
| DOIs | |
| Publication status | Published - 20 May 2025 |
Keywords
- Communication
- Evaluation
- Messages
- Mobile health
- Smoking cessation