A brief measure of reactance to health warnings

J Behav Med. 2017 Jun;40(3):520-529. doi: 10.1007/s10865-016-9821-z. Epub 2017 Jan 24.


Reactance to persuasive messages involves perceived threat to freedom, anger, and counterarguing that may undermine the impact of health warnings. To understand reactance's effects, reliable and valid assessment is critical. We sought to develop and validate a brief Reactance to Health Warnings Scale (RHWS). Two independent samples of US adults completed the brief RHWS in studies that presented warnings on cigarette packs that smokers carried with them for 4 weeks (Study 1; n = 2149) or as digital images of cigarette packs that participants viewed briefly (Study 2; n = 1413). The three-item Brief RHWS had good internal consistency and test-retest reliability. The scale correlated with higher trait reactance and exposure to pictorial warnings, supporting its convergent validity. With respect to predictive validity, the Brief RHWS predicted perceived message effectiveness, quit intentions, avoidance of the warnings, and number of cigarettes smoked per day. The Brief RHWS can serve as an efficient adjunct to the development of persuasive messages.

Keywords: Defensive processing; Health communication; Health warnings; Pictorial warnings; Reactance; Tobacco control.

MeSH terms

  • Adolescent
  • Adult
  • Avoidance Learning*
  • Female
  • Humans
  • Intention
  • Male
  • Middle Aged
  • Product Labeling*
  • Reproducibility of Results
  • Smoking Cessation / methods*
  • Young Adult