Graduation Year

2022

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychology

Major Professor

Thomas H. Brandon, Ph.D.

Co-Major Professor

Robert C. Schlauch, Ph.D.

Committee Member

Diana Rancourt, Ph.D.

Committee Member

Joseph A. Vandello, Ph.D.

Committee Member

Margaret Booth-Jones, Ph.D.

Keywords

health equity, race, pandemic, tobacco, Black American

Abstract

The COVID-19 pandemic has illuminated persistent racial differences in access and quality of healthcare resources that result in disproportionately poor health outcomes for Black and African Americans, relative to Whites. Given COVID-19’s influence on racial health disparities broadly, examination is warranted on whether the pandemic has more specificallyinfluenced smoking motivation and, subsequently, tobacco-related health disparities. The goal of this study was to test whether COVID-19 related video content differentially primed smoking motivation (cravings, cessation self-efficacy, and motivation to quit) among Black and White smokers. I used an online research platform to host an experiment with a 2x3 between-subjects factorial design (Race vs. Affective Health Threat Prime). Race included Black or White and Health Threat Prime videos included COVID-19 plus explicit health disparities, COVID-19 alone, or Foodborne Illness as a control. Black (n = 501) and White (n = 511) participants were randomly assigned to one of six groups. Results showed no main effects of Health Threat Prime on cravings or cessation self-efficacy and no interaction effects on any smoking motivation variable. However, there were main effects of Race on all smoking motivation variables. Blacks, relative to Whites, had lower cravings and higher cessation self-efficacy and motivation to quit smoking. Income was a significant moderator of the relationship between health threat prime and motivation to quit smoking. For Whites with higher income, there were no differences in motivation across conditions, but there was variability for Blacks with higher income. The most variability was among participants with lower income, with Blacks showing higher motivation than Whites overall. Findings suggest that either the health threat primes were not robust enough to elucidate affect associated with the pandemic or that COVID-19 has not had a robust influence on smoking motivation across Black and White smokers.

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