Sample Conceptual Models

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Attachment 4
PATH Study Sample Conceptual Models
June 26, 2014

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 1. CONCEPTUAL MODEL FOR PACKAGING AND HEALTH
WARNING LABELS
Health Warnings

1. Salience & Processing
1a. Awareness of warnings
1b. Knowledge of warnings
1c. Noticing of warnings
1d. Depth of processing

2. Positive Beliefs
/ Product Appeal
2a. Attractiveness

3. Social
Norms

4. Affective
reactions
4a. Fear
4b. Disgust

5. Cognitive
Reactions
5a. Beliefs about
health effects
5b.
Thinking/worry
about health risks

7. Perceived
Risk

8. Avoidance
8a. Covering
warnings
8b. Requesting
Packs

9. Quit
Intentions/Motivation to
remain abstinent

6. Cessation
Beliefs
6a. Selfefficacy
6b. Quit-line
information
6c. Website
information

10. Use of
Cessation
Assistance

11. Smoking Behavior
11a. Changes in
consumption
11b. Quit Attempt
11c. Abstinence
11d. Relapse

1

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 2. CONCEPTUAL MODEL FOR HEALTH EDUCATION CAMPAIGNS
1. MASS ACTION
1a. Paid Media
1b. Public Relation
1c. Media Advocacy

2. Increase awareness among
policy makers:
2a. News media, advocacy
groups, key opinion leaders
(business leaders), decision
makers

6. Community
Action
6a. More engaged
and active local
communities with an
interest in the issue

3. Increase awareness among
general population:
3a. general population, smokers,
youth, decision makers:
recall receptivity, responsiveness
3b. News media

4. Knowledge and Behavior Change
4a. Changed/reinforced attitudes and
beliefs among target population
4b. Increased Knowledge
4c. Policy Discussions
4d. Increased decision maker support
for policies and other actions

7. Societal Policy Enactment:
7a. Increased availability of
tobacco dependence treatment
7b. Higher prices for tobacco
products
7c. Smoke-free laws
7d. Tobacco-Free Outdoor Areas
7e. Marketing Restrictions
7f. Funding Increases

5. Knowledge and Attitude
Change
5a. Changed/reinforced
attitudes and beliefs among
target population
5b. Increased knowledge
5c. Increased support for
policies

8. Behavior Change Mediators
8a. Calls to Quitline
8b. Utilization of online
cessation services
8c. Utilization of other cessation
support (counseling, alternative
therapies, support groups)
8d. Quit Attempts
8e. Home Smoking Policies
8f. Response to “Call to Action”
8g. Sharing of information

9. Outcomes
9a. Successful Quits
9b. Initiation Averted
9c. Increased Compliance with
policies

2

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 3. CONCEPTUAL MODEL FOR PRODUCT REGULATION
(ADDITIVES) AND PERFORMANCE STANDARDS
Product Standard
(e.g., reduce addictiveness, toxicity,
and/or appeal)

3. Unintended
consequences
3a. Changes in product
availability
(price/marketing)
3b. Offsetting changes in
toxicity/abuse liability
3c. Contraband (see more
in-depth model)
3d. Evasion of regulation
(e.g., mentholating
accessories)

2. Policy-specific mediators
2a. Compliance with regulation
2b. Product design and
performance
2c. Industry marketing

5. General mediators
5a. Choices made by user of
banned products
5b. Changes in consumer
perceptions (i.e., beliefs about
harmfulness of remaining
products)

6. Proximal outcomes
6a. Patterns of tobacco use behavior
6a1. Way products used
6a2. Quitting
6a3. Relapse
6a4. Initiation

7. Distal Outcomes
7a. Health outcomes

3

4. Moderators
4a. Demographics
4b. Biological factors
4c. Dependence
4d. Consumer perceptions
4e. Other consumer factors (e.g.,
sensation seeking)

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 4. CONCEPTUAL MODEL FOR MODIFIED RISK TOBACCO
PRODUCTS AND NEW TOBACCO PRODUCTS
New products
Substantial Equivalence determinations
Modified Risk Tobacco Product claim

3. Incidental effects
3a. Changes in product
availability

2. Policy-specific mediators
2a. Product design and
performance
2b. Industry innovation
2c. Product marketing

4. Moderators
4a. Demographics
4b. Biological factors
4c. Dependence
4d. Price
5. General mediators
5a. Consumer perception of
regulated product
5b. Changes in beliefs about
harmfulness of other products
5c. Attitude to products

6. Proximal outcomes
6a. Patterns of tobacco use
behavior
6a1. Way products used
6a2. Quitting
6a3. Relapse
6a4. Initiation

7. Distal Outcomes
7a. Health outcomes

4

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 5. CONCEPTUAL MODEL FOR INDUSTRY ADVERTISING AND
PROMOTION
1. Policy Variables
1a. Advertising bans
1b. Advertising restrictions
1c. Promotions bans
1d. Promotions restrictions
1e. Sponsorship restrictions
1f. Sponsorship bans

2. Tobacco
Industry
Compliance

4. Moderating
Variables
4a. Socio-economic
measures
4b. Gender
4c. Age
4d. Income
4e. Education
4f. Parental smoking
4g. Peer smoking
4h. Sibling smoking
4i. Other tobacco
control policies

3. Tobacco Industry Innovation
Changes In:
3a. Product design
3b. Product promotion
3c. Sponsorship
3d. Tobacco Point of sale marketing
3e. Price Strategies

5. Proximal Variables
5a. Tobacco company marketing expenditure
5b. Types of marketing/compliance
5c. Awareness of each marketing channel
5d. Engagement in types of marketing (e.g.
Participation in promotional offers)

6. Distal variables
6a. Brand awareness and familiarity
6b. Attitudes/beliefs about brands
6c. Beliefs and attitudes towards tobacco industry
6d. Beliefs and attitudes towards tobacco control
6e. Self-efficacy
6f. Intention to quit
6g. Intention to smoke
6h. Perception of health risks
6i. Perception of prevalence of smoking/perceived smoking
norms

7. Tobacco Use Behaviors
7a. Smoking prevalence/uptake of smoking
7b. Quit attempts
7c. Quit success
7d. Brand choice

5

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

FIGURE 6. CONCEPTUAL MODEL FOR CONTRABAND

Policy
3. Environmental Moderators
3a. Industry Capability
3b. Production Costs
3c. Potential for illicit
production/smuggling
3d. Enforcement of contraband
laws
3e. Price differential between
illicit and licit products
3f. Social norms/marketing

Performance standard

Proximal variables
2a. Availability of illicit product
2b. Cost of obtaining contraband
2c. Attitudes toward regulation

5. Individual Moderators
5a. Income/SES
5b. Age
5c. Gender
5d. Consumption of affected
product
5e. Dependence
5f. Retail market structure
5g. Location
5h. Willingness to evade law
5g. Consumer perceptions about
the quality of illicit products

Distal Variables
4. Purchase behavior
4a. Brand switching
4b. Purchase quantity
4d. Purchase location
4e. Tax avoidance

Outcomes
6. Behavior change
6a. Cessation
6b. Initiation
6c. Consumption

6