A Test of the Anger Activism Model: truth® Campaign Advertising-Induced Anger, Self-Efficacy, and Message-Related Cognitions

Introduction: Although most studies regarding emotion and health messaging have focused on the effects of fear, anger may also have beneficial effects. The extended Anger Activism Model (AAM) contends that efficacy beliefs and anger intensity are critical to determining message-relevant cognitions. This study tested the extended AAM using responses to two advertisements from the truth® youth anti-smoking campaign. Methods: Data used in this study is from the online, cross-sectional Truth Initiative Media Monitoring Tracking Survey, which surveys 15-21 year olds. This analysis includes responses from July 2014 through March 2015 (n= 4,792). Self-reported information on anti-tobacco ad-induced anger and efficacy were used to separate individuals into six anger/efficacy groups. Analysis of variance and regression analyses were conducted to understand group differences in anti-tobacco message-relevant cognitions, namely ad-related persuasiveness, receptivity, and conversation. Results: Results indicated that, as predicted by the model, anti-tobacco message-relevant cognitions were highest among the high anger/high efficacy group and lowest among the low anger/low efficacy group. For the high anger/high efficacy group compared to the low anger/low efficacy group for the two ads, odds of being persuaded by the anti-tobacco ads were 49.78 (95% confidence interval (CI) 20.62 to 120.16] and 18.52 (95% CI 10.35 to 31.55) times higher, odds of being receptive to the anti-tobacco ads were 28.12 (95% CI 14.39 to 54.94) and 23.89 (95% CI 13.53 to 42.21) times higher, and odds of conversing about the anti-tobacco ads were 25.15 (95% CI 13.89 to 45.56) and 12.91(95% CI 8.01 to 20.82) times higher. The relationship between anger/efficacy group and anti-tobacco message-relevant cognitions varied based on advertisement and type of cognition, which suggests that the type of messaging found in advertisements can alter how strongly anger and efficacy impact message-relevant cognitions. However, there was no evidence for the extended AAM’s prediction that the relationship between anger intensity and message-related cognitions varies based on level of efficacy. Conclusions: This test of the extended AAM found that, as predicted by the model, anti-tobacco messages that incite high anger and high efficacy in combination can have powerful effects. So while fear aroused by anti-tobacco messages featuring health consequences has been shown to be effective, this study suggests that a wider range of emotions – including anger - should be investigated to assess how such emotions might help elicit the desired responses among the target audience, ultimately preventing uptake of tobacco use and reducing rates of smoking