Torleif Halkjelsvik

Fear appeals in advanced tobacco control environments: the impact of a National Mass Media Campaign in Norway

Norway has one of the most comprehensive infrastructures for tobacco control in the world and has launched several media campaigns recent years. Can yet another anti-smoking campaign, using fear appeal messages, have an immediate impact on smoking behavior, motivation to quit and health beliefs? A sample of smokers (N = 2543) completed a survey before and after a 7-week national media campaign. Individual exposure to campaign (unaided recall) was used as predictor of change. We observed no statistically significant effect on smoking status but tendencies were in the expected direction for daily smokers (P = 0.09). There were no effects on number of cigarettes per day, likelihood to quit or reduce smoking. Small but statistically significant effects were found on motivation to quit (P < 0.01, ηp(2) = 0.004) and perceived seriousness of health hazards (P < 0.05, ηp(2) = 0.002). In addition, there was an increase in interpersonal discussions about health and smoking for those exposed to the campaign (P < 0.01, ηp(2) = 0.008). We conclude that there are very small effects of a relatively short and intense mass media campaign on a population of smokers already exposed to one of the most comprehensive tobacco control programs in the world.

Andel av befolkningen i Norge med et risikofylt alkoholkonsum målt gjennom Alcohol Use Disorders Identification Test (AUDIT)

Aims To estimate the proportion of the Norwegian population that according to the World Health Organization (WHO) guidelines should be followed up by primary health care, based on three levels of risk drinking. We also investigated the relationship between risky drinking and demographic variables (gender, age and education). MaterialS & METHODS – In 2012 and 2013 Statistics Norway conducted 4048 telephone interviews on a random sample of the population aged 16–79 (55.3% response rate). The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument for primary health care, was used to identify potential problem drinking. We used descriptive statistics and linear regression analysis. Results Approximately 17% of the sample scored within the WHO-recommended limits for simple advice and/or further monitoring. Of these, 2% scored above the limit for the two most serious risk categories. Risky drinking was most prevalent among men, especially those aged 16–50. Among women, there was most risky drinking in the 16–30 age group. The regression analysis showed that age, gender and education predicted AUDIT sum scores. Conclusion A large proportion scored within the least serious risk group, where simple advice to cut down on alcohol is the recommended measure. This group mostly consisted of younger respondents (16–30 years), and a large majority were men (age categories 20 and older). These are individuals who do not necessarily have an alcohol problem, but are at increased risk for negative consequences such as injury during intoxication, and/or developing misuse or dependence over time.

The distribution and role of causal beliefs, inferences of responsibility, and moral emotions on willingness to help addicts among Norwegian adults

The purpose of this study was to explore the distribution and role of causal beliefs, inferences of responsibility, and moral emotions on deservingness of help to addicts among Norwegian adults using the social motivational model of Weiner. The data derives from a web panel survey of Norwegian adults aged 20 to 69 years (N = 1062, response rate 67%) in 2011. They responded to a questionnaire tapping into the above measures for nine different addictions in terms of a hypothetical person: “Think of a person addicted to–.” The respondents mainly located the cause of the addictions inside the person and attributed the responsibility for the problem to the individual. In general, addicted persons did not receive a high mean level of sympathy, whereas a high mean level of willingness to provide help and assistance was reported. However, there were substantial variations among the nine addictions as to mean rating levels, with snus and sedatives as the two extreme counterparts. Separate SEM analyses for the nine addictions showed support for Weiners mediation model with inferences of responsibility and sympathy (moral emotion) as effective mediators for deservingness of help. This pattern was stable across the nine addictions. Implications for interventions and possible limitations are discussed.

Changes in Norwegian public opinion on alcohol policy, 2005–2012

Aims During the last two decades there has been a substantial liberalisation of Norwegian alcohol policy in terms of increased availability of alcohol. We have studied what happens with public support for alcohol control policies in a country where the policy is liberalised. First, we summarise the findings from previous Norwegian studies on changes in attitudes toward alcohol control policies. Second, we present new empirical analyses on changes in attitudes toward a broad spectre of policies in 2005–2012, and whether the pattern of change varied according to gender, age, education and alcohol use. Design The empirical analyses were based on self-reported attitudes toward Norwegian alcohol policies from nine web surveys conducted among 20–69-year-old Norwegians (N = 12 304). Results The analyses showed increased support for a wide range of restrictive alcohol policy measures from 2005 to 2012 – both for measures that had been liberalised and those that had been stable. We found no substantial moderation by gender, age, educational level and drinking frequency, which indicates that the pattern of change was similar for various sub-groups based on such variables. Conclusions Previous research has observed a shift toward increasing support for a restrictive alcohol policy around the millennium. Current data shows that this trend has continued until 2012. We discuss the relationship between alcohol policy and public opinion, and propose that the trend may be connected to changes in value orientations, increased experience with alcohol-related harm and changes in beliefs about the harm-limiting effect of restrictive measures.

Disgust in fear appeal anti-smoking advertisements: The effects on attitudes and abstinence motivation

Abstract Aims: The use of fear appeals with disgusting graphical content is part of current practice in health campaigns. Previous studies have suggested both a detrimental and a beneficial effect of disgust in fear appeals on different types of outcome measures. We were interested in whether disgust in anti-smoking messages decreases or increases persuasion as measured by motivation to abstain from smoking and attitudes towards smoking. Methods: In two online experiments (total N = 1045), smokers (26%) and non-smokers were randomly assigned to watch fear appeal anti-smoking ads that elicited high versus moderate levels of disgust but similar levels of fear. Smokers reported motivation to quit, while non-smokers reported motivation to not start smoking. All participants reported explicit attitudes toward smoking and performed an Implicit Association Test that measures implicit attitudes toward smoking and cigarettes. Findings: There were no differences between these conditions, except on a measure of implicit attitudes. However, this effect was not replicated in the second study, and analyses across studies revealed no substantial difference between the conditions. Conclusions: In the current context, there were no or potentially very small benefits of using disgust elements when level of fear was held constant (i.e. compared to other means of inducing negative emotions).

Does it matter how you ask? The forbid–allow asymmetry in the measurement of attitudes towards drug policies

BACKGROUND It is important to know whether the public opinion on drug policies can be measured in a reliable and valid way. One of the threats to the validity of surveys on attitudes toward drug policies are wording effects, of which the most well-known is the forbid-allow asymmetry, i.e., people are often more willing to not allow something than to forbid it. The aim of the present study was to estimate the size of the allow-forbid asymmetry when measuring attitudes toward drug policy issues in the Norwegian adult population. METHODS The data derive from a sample of 2182 adult Norwegian, aged 18-70, drawn from a large online panel comprising more than 50,000 Norwegian citizens (55% response rate). According to a 2 (allow vs. forbid)×2 (question vs. statement) between-subjects design, participants indicated support for the following three restrictive drug policies: (i) to allow/forbid wine in grocery stores, (ii) to allow/forbid smoking in parks and other public places and (iii) to allow forbid cannabis for recreational purposes. RESULTS There was not a significant difference between the framing conditions (forbid-allow) across the three policies, with an estimated difference of 2 percentage points (95% confidence intervals 0-5). CONCLUSION The results suggest that survey research in the present context of drug policy is indeed more of a fact-finding enterprise than a process of constructing data.

Persistence Motives in Irrational Decisions to Complete a Boring Task

We explored a novel task paradigm where participants from the online work marketplace Amazon Mechanical Turk were given the choice to quit or continue an unfinished boring task for identical economic rewards. In Studies 1a and 1b, about half the participants chose to continue (corresponding to an average of 55 and 35 cents in foregone earnings). Participants’ self-reported reasons for continuing involved various types of persistence motives, reflecting a desire to persist or complete per se. Studies 2, 3a, 3b, and 3c ruled out the possibility that people continued because they enjoyed the task or believed there were additional rewards for continuing. Study 4 showed that the choice to quit/continue was associated with the manner in which the choice was presented (persistence test vs. decision-making test) and individual differences in dispositional persistence motives. The present data indicate that motivational forces independent of the focal reward may affect intertemporal decisions.

Mental States of Addiction Conceptions in the Adult Norwegian Population

An increasing number of studies have examined lay meanings of addiction. The purpose of this study was to explore whether a generalized conception of an addiction mind-set was evident in the beliefs of a sample of 1,062 Norwegian adults responding to an online survey. The respondents were given a rating task in the following form: “Addiction to [substance/behavior] is/represents [descriptive term].” For each of the nine different addictive behaviors (cocaine, cannabis, alcohol, gambling, smoking, amphetamine, sedatives, snus, and heroin), the respondents rated their endorsement of 11 descriptive terms (mental states): reduced self-determination, obsession, strong urge, strong appetite, strong craving, reduced moral competence, reduced rational decision making, compulsion, habit, conflicting desire, and reduced willpower. Principal components analyses identified two distinct factors for six addictive behaviors: cocaine, cannabis, alcohol, gambling, amphetamine, and heroin. The endorsement levels of the descriptive items of the two factors were consistently high. Sedatives, smoking, and snus did not fit into the two factors. Norwegian adults thus seem to ascribe to a model of an addiction mind-set comprising two distinct versions, the irresistible, involuntary (Craving-compulsion version), and the voluntary resistible dimensions of addiction (Reduced agency version).