Message Framing to Reduce Smoking Behaviours

Year Submitted: 2025
Published Date: 06 November 2025

Tags: Population Health, Physical Health, Preventive Care, Community Health, Public Awareness, Care Continuum, Care Process ＆ Redesign, Adherence Rate, Value Based Care, Safe Care

About this Content

Aims

Due to the undesirable and negative effects of smoking, health campaigns and efforts
have been launched at the national level to reduce smoking. The aim of this study was
twofold, (1) to understand smoking behaviours among adolescent smokers; and (2) to
examine the effects of message framing in reducing smoking behaviours in an
educational institution. To understand adolescent smoking behaviours, adolescent
smokers were interviewed on their attitudes towards smoking, related behaviours,
motivations, and opinions on current smoking cessation efforts. Moreover, the
effectiveness of message framing on smoking behaviours was examined through
posters eliciting community identity, moral obligation, and rules. These posters were
placed at various smoking hotspots and smoking behaviours were recorded through
naturalistic observations. The results revealed that the role of peers was a key factor
influencing adolescents smoking attitudes and behaviours, and attitudes towards
current smoking initiatives were generally negative. Additionally, reminding smokers
of the rules (no smoking allowed) reduced the number of smokers at different
locations, while reminding smokers of their moral obligation reduced the number of
cigarettes smoked.

Methods

The effectiveness of message framing on smoking behaviours was examined through
posters eliciting community identity, moral obligation (i.e., to not affect others through
the inhalation of second-hand smoke from ones smoking), and rules. These posters
were placed at various smoking hotspots, and their impact on smoking behaviours
(if any) was assessed through naturalistic observations. A field experiment examining the effectiveness of posters and messages eliciting
current rules, moral obligation, and community identity in reducing smoking behaviours
was conducted. Measures of the number of cigarettes smoked and number of smokers
(per 15 min interval during peak hours) were collected. For the intervention, a
randomised controlled trial (RCT) was used and the three locations, identified as
smoking hotspots around campus, were counterbalanced. Data was collected during
specific periods in the day (10 11am, 1 2pm, 3 4pm) for 3 days.

Results

Reducing smoking behaviours: Findings suggest that different poster messages were
effective at addressing different smoking behaviours. The poster reminder of the rule
(no smoking allowed) was the most effective in reducing the number of people
smoking across the various locations (Figure 4). On the other hand, across all the
locations, there was no practical significance in the number of cigarettes smoked.
Each smoker would smoke an average of about 1 cigarette, regardless of the poster
message (Figure 5).

Lessons Learnt

The lesson learnt here was that sometimes, a clear and direct message sends the
strongest nudge. This mirrors findings that we have found in some other studies,
where sometimes a clear and simple nudge would be found to be more effective than
multi-pronged nudges incorporating multiple Behavioural Insights (BI) mechanisms.

Keywords

smoking cessation, health seeking behaviours

Innovators' Details

Connect with this contributor!

Tan Wah Pheow - TAN_Wah_Pheow@tp.edu.sg

Project Attachment

177_TP_TPCABS_Message_Framing_to_Reduce_Smoking_Behaviours.pdf (opens in new tab)