SciELO - Scientific Electronic Library Online

vol.14 número1Using subjective judgement to determine the validity of a tutorial performance evaluation instrumentSpeaking to experts and patients: Recommendations for improving antiretroviral therapy (ART) adherence índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados



Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google


Health SA Gesondheid (Online)

versión On-line ISSN 2071-9736
versión impresa ISSN 1025-9848

Health SA Gesondheid (Online) vol.14 no.1 Cape Town  2009




A qualitative investigation of south african cigarette smokers' perceptions of fear appeal messages in anti-smoking advertising



Ingrid Lynch; Lauren M. de Bruin; Nafisa Cassimjee; Claire Wagner

Department of Psychology, University of Pretoria, South Africa





Cigarette smoking continues to pose a global health risk, including in developing countries. Fear appeal messages have been widely employed in health communication to reduce cigarette smoking, but studies provide conflicting results on their efficacy. The present qualitative study explores smokers' perceptions of fear appeal messages used in anti-smoking advertising. Focus group discussions were conducted with male and female smokers from Gauteng. A thematic analysis found that participants negatively viewed advertisements that use unrealistic images and failed to relate to the message portrayed. Information about the risks associated with smoking was perceived as patronising and as positioning smokers as ignorant and unintelligent. In addition, fear appeal messages that only focus on long-term consequences of smoking were perceived as ineffective. Participants failed to identify with content that solely relied on factual information at the expense of an emotive appeal. The findings suggest that anti-smoking communication could benefit from content that evokes shock without sacrificing realism, that it should include information about shortterm and immediately visible consequences of smoking and that it should avoid negative depictions of smokers that alienate them from the message being portrayed.

Keywords: fear appeal; perceptions of health risk; health communication; smoking; qualitative analysis


Sigaretrook dra steeds 'n wêreldwye gesondheidsrisiko, met inbegrip van in ontwikkelende lande. Vrees-oproepende boodskappe word algemeen in gesondheidskommunikasie gebruik om rookgedrag te verminder, maar studies toon teenstrydige resultate rakende die doeltreffendheid daarvan. Die huidige kwalitatiewe studie ondersoek rokers se persepsies van vrees-oproepende boodskappe soos in antirook-advertensies gebruik. Fokusgroepbesprekings is met manlike en vroulike rokers in Gauteng gehou. 'n Tematiese ontleding het gevind dat deelnemers advertensies wat onrealistiese beelde gebruik, negatief beskou en dat hulle nie met die boodskap identifiseer nie. Inligting oor die risiko's geassosieer met rook is as neerbuigend gesien en dat dit rokers as onkundig en onintelligent voorstel. Verder is gevind dat vrees-oproepende boodskappe wat slegs op langtermyngevolge van rook fokus ondoeltreffend beskou word. Deelnemers het nie met inhoud geïdentifiseer wat slegs op feitlike inligting steun ten koste van 'n emotiewe beroep nie. Die bevindinge stel voor dat antirook-kommunikasie uit inhoud kan baat wat skok uitlok, sonder om realisme prys te gee. Inhoud moet oor inligting van korttermyn- en onmiddellik sigbare gevolge van rook beskik en negatiewe uitbeeldings wat rokers van die boodskap distansieer, moet vermy word.



“Full text available only in PDF format”




Aronson, J., 1993, 'A pragmatic view of thematic analysis', The Qualitative Report 2(1), viewed 3 November 2008, from         [ Links ]

Bauman, K.E., Laprelle, J., Brown, J.D., Kock, G.G. & Padgett, C.A., 1991, 'The influence of three mass media campaigns on variables related to adolescent cigarette smoking: Results of a field experiment', American Journal of Public Health 81, 597-604.         [ Links ]

Beaudoin, C.E., 2002, 'Exploring anti-smoking ads: Appeals, themes, and consequences', Journal of Health Communication 7, 123-137.         [ Links ]

Bryman, A., 2004, Social research methods, 2nd edn., Oxford University Press, Oxford.         [ Links ]

Campbell, C., 1997, 'Migrancy, masculine identities and AIDS: The psychosocial context of HIV transmission on the South African Gold Mines', Social Science and Medicine 45(2), 273-281.         [ Links ]

Charmaz, K., 2008, 'Grounded theory as an emergent method', in S.N. Hesse-Biber & P. Leavy (eds.), Handbook of emergent methods, pp. 155-172, Guilford Press, New York.         [ Links ]

Denscombe, M., 2001, 'Uncertain identities and health-risking behaviour: The case of young people and smoking in late modernity', British Journal of Sociology 52(1), 157-177        [ Links ]

Department of Health, 2003, South Africa demographic and health survey 2003: Preliminary report, Department of Health, Pretoria.         [ Links ]

Dion, M., 2005, Is fear really persuasive: The case of anti-smoking advertising for young adults, viewed 17 February 2008, from         [ Links ]

Gilbert, E., 2005, 'Contextualising the medical risks of cigarette smoking: Australian young women's perceptions of antismoking campaigns', Health, Risk & Society 7(3), 227-245.         [ Links ]

Groenewald, P., Vos, T., Norman, R., Laubscher, R., Van Walbeek, C., Saloojee, Y., Sitas, F., Bradshaw, D. & SACRACG (the South African Comparative Risk Assessment Collaborating Group), 2007, 'Estimating the burden of disease attributable to smoking in South Africa in 2000', South African Medical Journal 97(8), 674-681.         [ Links ]

Hafstad, A., Aaro, L.E. & Langmark, F., 1996, 'Evaluation of an anti-smoking mass media campaign targeting adolescents: The role of affective responses and interpersonal communication', Health Education Research 11, 29-38.         [ Links ]

Hale, J.L. & Dillard, J.P., 1995, 'Fear appeals in health promotion campaigns', in E. Maibach & R.L. Parrott (eds.), Designing health messages, pp. 65-80, Sage, Thousand Oaks.         [ Links ]

Johnston, L.D., O'Malley, P.M. & Bachman, J.G., 2001, Monitoring the future national survey results on drug use 1975-2000. Volume II: College students and adults ages 19-40, National Institute on Drug Abuse, Bethesda.         [ Links ]

Kaptein, A. & Weinman, J., 2004, Health psychology, Blackwell Publishing, Oxford.         [ Links ]

Killen, J.D., 1998, 'Cigarette smoking prevention', in E. Blechman & K. Brownell (eds.), Behavioural medicine for women: A comprehensive handbook, pp. 228-232, Guilford Press, New York.         [ Links ]

Mackay, J., Erikson, M. & Shafey, O., 2006, The tobacco atlas, 2nd edn., The American Cancer Society, Atlanta.         [ Links ]

Maguire, K. & Love, K., 2006, 'Health and fear: A study of the use of fear in promoting healthy behaviours among 18-25 year old students in relation to smoking', Journal of Environmental Health Research 5(2), 95-104.         [ Links ]

Montazeri, A. & McEwen, J., 1997, 'Effective communication: Perception of two anti-smoking advertisements', Patient Education & Counselling 30, 29-35.         [ Links ]

Murray, D.M., Prokhorov, A.V. & Harty, K.C., 1994, 'Effects of a state-wide antismoking campaign on mass media messages and smoking beliefs', Preventive Medicine 23(1), 54-60.         [ Links ]

Ringold, D.J., 2002, 'Boomerang effects in response to public health interventions: Some unintended consequences in the alcoholic beverage market', Journal of Consumer Policy 25(1), 27-63.         [ Links ]

Sitas, F., Urban, M., Bradshaw, D., Kielkowski, D., Bah, S. & Peto, R., 2004, 'Tobacco attributable deaths in South Africa', Tobacco Control 13, 396-399.         [ Links ]

Smith, K.H. & Stutts, M.A., 2006, 'The influence of individual factors on the effectiveness of message content in antismoking advertisements aimed at adolescents', The Journal of Consumer Affairs 40, 261-293.         [ Links ]

Swart, D. & Panday, S., 2003, The surveillance and monitoring of tobacco control in South Africa, WHO Tobacco Control Papers, viewed 4 February 2008, from .         [ Links ]

Taylor, S.J. & Bogdan, R., 1989, Introduction to qualitative research methods: The search for meanings, Wiley & Sons, New York.         [ Links ]

Tobacco Products Amendment Act No. 12., 1999, Government Gazette, No. 19962, 406, viewed 4 February 2008, from         [ Links ]

Wakefield, M., Flay, B., Nichter, M. & Giovino, G., 2003, 'Effects of anti-smoking advertising on youth smoking: A review', Journal of Health Communication 8, 229-247        [ Links ]

Wilson, D., Parsons, J. & Wakefield, M., 1999, 'The health-related quality of life of never smokers, ex-smokers, and light, moderate, and heavy smokers', Preventive Medicine 29, 139-144.         [ Links ]

Witte, K., 1992, 'Putting the fear back into fear appeals: The extended parallel process model', Communication Monographs 59, 329-349.         [ Links ]

Witte, K., 1998, 'Fear as motivator, fear as inhibitor: Using EPPM to explain fear appeal successes and failures', in P.A. Anderson & L.K. Guerrero (eds.), The handbook of communication and emotion, pp. 423-450, Academic Press, New York.         [ Links ]

Witte, K. & Allen, M., 2000, 'A meta-analysis of fear-appeal: Implications for effective public health campaigns', Health & Education Behaviour 27, 591-615.         [ Links ]

Wolburg, J.M., 2006, 'College students' responses to anti-smoking messages: Denial, defiance, and other boomerang effects', The Journal of Consumer Affairs 40(2), 294-323.         [ Links ]



Ingrid Lynch
Department of Psychology
University of Pretoria
Lynwood Road
Hatfield, 0002
South Africa

Received: 02 Sep. 2008
Accepted: 27 Nov. 2008
Published: 02 June 2009

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons