Improving the effectiveness of tobacco education for low-educated adolescents: giving information or telling a story?

Abstract

Background: Low-educated adolescents more often smoke tobacco and are less influenced by school health education. This study investigates the effectiveness of narrative versus informative written health materials. Methods: Three-wave experimental study on a sample of 256 low-educated adolescents, measuring knowledge about disadvantages of smoking, beliefs, attitude, and intention. Waves were one month apart; exposure to materials was prior to the second wave. Repeated measures anova was employed. Findings: Immediately after exposure, knowledge increased in informative condition and beliefs became more negative towards smoking in both conditions. However, attitude became borderline more positive towards smoking in narrative condition. Four weeks after exposure, attitude was significantly more positive towards smoking in narrative condition, whereas there was a non-significant change in the other direction in the informative condition. No significant effects on intention were found. An explanation for the undesired effect on attitude is that it was also found that adolescents in the narrative condition thought less about the negative consequences of smoking. Discussion: A narrative format reduces active processing of message content. For low-educated adolescents, an informative format is advised.