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Ironic Consequences of Health Information

Educating students about the risks and associated harms of AOD use and abuse is a bedrock element of our prevention effort. We implicitly and explicitly assume that if we rationally put forth the options, students will make an “educated” decision, which will naturally be less risk prone.  Knowledge of risks will counteract the salient social and physiological positives of use.  Further, it is assumed that risk knowledge is at least benign, but usually helpful.  Recent research puts this assumption in doubt.

Studies of warning labels are continuing to cast doubt on how health-risk related information is processed and translates into behavioral choices.  Just released is a study out of Israel that shows warning labels for a variety of products (medications, cigarettes and artificial sweeteners) increase purchases when the decision is delayed (Steinhart, Carmon, & Trope, 2013).  The authors rightly label this phenomenon the “ironic effect of warnings.” 

The theory used to predict and explain the finding is that when an ad is presented showing positive aspects of a product, warnings actually increases message credibility because it becomes viewed as a more balanced message.  Advertisements tend to have a central message of vague social or other benefits (such as fitting in with a fun social group), and then quite specific risks (such as emphysema). With the passage of time, the specific risks are lost within the memory of the viewer, but the general positives remain because our memory tends to value abstractions in long-term memory.  But here’s the really troubling part: the increased credibility generated by the warning adds weight to the abstract benefits increasing the pro-use effect of the ad.  So the presence of a warning label decreases immediate use, but actually increases delayed use.

So does that mean we should only have warning labels associated with point-of-sale instances?  Well our research of alcohol warning labels on menus suggests that that can be problematic too.  Given that drinking is a behavior partly motivated by entering a period of “release” or “time out” (MacAndrew & Edgerton, 1969) it may not be surprising that some high-risk demographics actually show increased likelihood to over-consume in the presence of warnings and standard drink information (Devos-Comby, Holscher, Anderson, & Lange, 2012).

So this means… Our impulse to educate students about the risks of AODs is only natural; we are on a college campus, after all.  The value of education is high, and it is assumed that the more information given to students, the healthier their decisions will be.  But we clearly need to be careful how this information is presented.  If our goal is first and foremost prevention, then how and when information is presented may have dramatically different effects.  It is even possible that we are inadvertently increasing the behaviors we seek to prevent.  Understanding the subtleties of how the messages are received, both in the short- and long-term, may be a critical step that is ignored to our peril.

References

Devos-Comby, L., Holscher, J., Anderson, C., & Lange, J. E. (2012). Is Standard Drink Size Information Enough To Curb Drinkers’ Enthusiasm? Findings From A Field Intervention Among Bar Goers. Presented at the 35th Annual Meeting of the Research Society on Alcoholism, San Francisco, CA. Retrieved from http://aodinitiatives.org/iprevention/reports/files/RSA_2012_Poster.pdf

MacAndrew, C., & Edgerton, R. B. (1969). Drunken comportment: A social explanation. Chicago: Aldine.

Steinhart, Y., Carmon, Z., & Trope, Y. (2013). Warnings of Adverse Side Effects Can Backfire Over Time. Psychological Science. doi:10.1177/0956797613478948