Effect of content framing in smoking prevention campaigns on recognition and attitudes: a virtual reality study.

Objectives: Anti-tobacco campaigns often suffer from a lack of systematic evaluation and may not always have the intended impact on the target population. Our research adopted immersive virtual reality (iVR) to systematically evaluate preventive anti-tobacco messages in a controlled setting while mimicking a naturalistic and ecological environment. We investigated the effect of content framing of Anti-tobacco posters on attitudes and cravings toward tobacco, and poster recognition. Methods: Participants were undergraduate students (n = 121), mostly female (76%). They were immersed in a virtual environment incidentally exposing them to either negatively, positively, or neutrally framed preventive posters based on their experimental condition. Their gaze was eye-tracked during the entire procedure. Results: Results indicate that incidental exposure to preventive anti-tobacco posters while directly looking at negatively framed posters was associated with lower positive attitudes toward tobacco. Incidental exposure to posters did not impact their explicit recognition, except when exposed to negatively framed posters. No significant effect was found on craving. Conclusions: We advise health campaign designers to consistently use negatively framed preventive messages and recommend the use of iVR to evaluate campaigns before launching them.