Exposure to Cigarette Advertising and Adolescents' Intentions to Smoke: The Moderating Role of the Developing Self-Concept

Increased exposure to cigarette advertising and marketing is associated with increased levels of adolescent smoking (see narrative reviews by DiFranza et al., 2006; Wakefield, Flay, Nichter, & Giovino, 2003, see meta-analysis by Wellman, Sugarman, DiFranza, & Winkoff, 2006). The Master Settlement Agreement (MSA), reached in 1998, essentially banned youth-focused tobacco advertising and significantly restricted how the tobacco industry can advertise and market cigarettes. As a seeming consequence of the MSA, the relative proportion of advertising and marketing dollars has moved away from youth-focused outlets (e.g., magazine and billboard advertisements to point of sale promotions; Federal Trade Comission, [FTC], 2007). However, tobacco industry advertising budgets have nearly doubled since 1998 (FTC, 2007) and a substantial majority of adolescents continue to be exposed to cigarette advertising and marketing (King & Siegel, 2001; Lancaster & Lancaster, 2003; Lee, Taylor, & McGetrick, 2004; Pollack & Jacobson, 2003). For example, the ∼$32 million decrease in tobacco industry advertising in newspapers and magazines from 2002 to 2004 (FTC, 2007) corresponded only to an 11% drop in the percentage of adolescents who report being exposed [see the 2002 and 2004 National Youth Tobacco Survey (http://www.cdc.gov/tobacco/data_statistics/surveys/NYTS/index.htm)]. Cigarette advertising may be particularly influential for adolescents who have never smoked or who have minimal levels of experience with smoking. The development of dependent smoking among youth has been characterized as stage-based (Leventhal & Cleary, 1980; Mayhew, Flay, & Mott, 2000). Adolescents are theorized to move from (a) never smoking or having no desire or intention to smoke; to (b) preparing to smoke; to (c) engaging in initial smoking trials (i.e., the first puffs of a cigarette on one or in a few very circumscribed occasions); to (d) experimenting with smoking (i.e., more frequent, but still irregular smoking in particular contexts); to (e) engaging in regular smoking (i.e., smoking on a regular basis in specific contexts); and then finally to (f) engaging in dependent smoking (i.e., smoking that occurs regularly and is driven by processes that define the nicotine dependence syndrome, e.g., craving, withdrawal, see Shadel, Shiffman, Niaura, Nichter, & Abrams, 2000). In general, transitions to smoking among the earlier stages (e.g., never smoking to preparing to smoke to engaging in initial trials) are theorized to be governed more by factors such as tobacco-related media, improving the self-image, peer norms, and mood, whereas later transitions (e.g., experimental to regular to dependent use) are theorized to be governed more by physiological cues and reactions to smoking, and to processes relating to nicotine dependence (e.g., craving, withdrawal) (Flay & Petraitis, 1994; Leventhal & Cleary, 1980; USDHHS, 1994). Consistent with this theoretical position, data from a recently published meta-analysis indicate that exposure to cigarette advertisements increases the odds of moving from never smoking to initiation by 79–91%; exposure increases the odds of progressing from experimental smoking to more regular smoking around 12%. The effects of exposure on initiation were significantly larger than the effects of exposure on progression to regular smoking (Wellman et al., 2006). Clearly, then, exposure to cigarette advertising still appears to represent a potentially significant influence on adolescent smoking, particularly in never smoking adolescents. However, the field still struggles to understand who is most vulnerable to the effects of cigarette advertising. A better understanding of moderators of cigarette advertising efficacy could lead to improved smoking prevention and media literacy programs that target particularly vulnerable individuals with more aggressive interventions (Kazdin & Nock, 2003). The research reported in this article builds on recent work (Shadel, Niaura, & Abrams, 2001, 2004b) that has examined how individual differences in the developmental maturity of the self-concept may be associated with adolescents’ responses to cigarette advertising. This work has capitalized on findings suggesting that the images in cigarette advertisements are critical to understanding their persuasive efficacy among adolescents (Covell, 1992; Covell, Dion, & Dion, 1994; Romer & Jamieson, 2001; Shadel, Niaura, & Abrams, 2002; Slovic, 2001). It also builds on less formal speculation that the adolescents’ developing self-concept is a psychological mechanism through which cigarette advertising may exert an effect on adolescent smoking (Chapman & Fitzgerald, 1982; Krugman, Quinn, Sung, & Morrison, 2005; Pierce, DiStafan, Jackson, & White, 2002; Pollay et al., 1996; USDHHS, 1994). Individuals’ self-concept undergoes significant change during adolescence (Arnett, 1999; Erikson, 1968; Harter, 1999a, b; Marcia, 1999). Social-cognitive perspectives on self-concept development operationalize these changes in self-concept as conflicts among the various descriptive self-attributes that an individual adolescent uses to define him or her self (i.e., “How can I be both independent and dependent?”). In general, these conflicts are relatively fewer in number during early adolescence (e.g., ages 11–13), increase during middle adolescence (ages 14–17) and decline in late adolescence (ages 18–22) and beyond (Harter, 1999a, b; Harter & Monsour, 1992). Conflicts among self-attributes arise due to adolescents’ increasing awareness that new and different self-attributes can be used to describe them, and a lack of the cognitive facilities necessary to resolve the contradictions that may arise between opposing self-attributes. The cognitive capacity to resolve self-conflicts develops during middle and late adolescence. Adolescents who possess a high number of self-conflicts and are not capable of resolving those conflicts (i.e., young adolescents due to their relative lack of cognitive maturity) look to external contexts to help them decide, which attributes are most important and which one(s) they should adopt as part of their self-concept (Harter, 1999a). Shadel and colleagues (2001) proposed that the powerful images displayed by cigarette advertisements represent one such external context that adolescents who have higher levels of unresolvable self-conflict may look to for help in defining themselves. In a sample of never smokers, a previous study (Shadel et al., 2004b) found that young adolescents with a greater number of self-conflicts reported that cigarette advertising imagery was more relevant to them compared to young adolescents with lower numbers of self-conflicts and middle adolescents (regardless of self-conflict). Self-relevance of the advertisements was a key outcome in this study, given that communications that are more relevant to the self are generally more persuasive than those for which that is not the case (Petty & Wegener, 1999). Significant questions about the role of self-conflict in moderating adolescents’ reactions to cigarette advertising remain, however. Most critically, it is unclear as to whether self-conflict has any bearing on adolescents’ smoking cognitions and smoking behavior after they have been exposed to cigarette advertising. The purpose of the current study was to expand upon the findings of Shadel et al. (2004b) by evaluating how the number of self-conflicts interacts with age and self-relevance of cigarette advertising to predict adolescent never smokers’ intentions to smoke following exposure to cigarette advertising. Intentions are a key predictor of progression to regular smoking in adolescence (Choi, Gilpin, Farkas, & Pierce, 2001; Wakefield et al., 2004) and as such, are a logical outcome for laboratory-based work with adolescent never smokers. Based upon theory (Shadel et al., 2001) and prior work (Shadel et al., 2004b), it was hypothesized that young adolescents who have higher numbers of self-conflicts and who evaluate cigarette advertisements as more self-relevant would have the strongest intentions to smoke following exposure to cigarette advertising compared to young adolescents with lower numbers of self-conflicts. Self-conflict was not expected to play as strong a role with middle adolescents.