Smoking, implicit attitudes, and context-sensitivity: An Overview

The focus on implicit attitudes toward smoking is relatively novel and this chapter provides the first systematic review of research in this domain. The review summarizes empirical studies focusing on implicit attitudes toward smoking. Implicit attitudes are suggested to guide automatic behavior, thereby playing a pivotal role for automatic processes inherent in addictive behaviors. The chapter further explores the extent to which implicit attitudes are sensitive to context. More specifically it reviews studies that have focused on the differential effects of external cues such as warning labels as well as internal cues such as deprivation. Overall 32 studies were analyzed, including studies focusing on implicit attitudes toward smoking compared to positive, negative or neutral categories; implicit attitudes in relation to situational context such as TV advertisement, warning labels and (non)smoking settings; and implicit attitudes in relation to nicotine dependence and nicotine deprivation. Results of these studies show that although smokers generally have more positive implicit attitudes than non-smokers, the valence of the implicit attitude depends on the contrasting category and hence varies as a result of the applied method or stimuli. Studies considering situational contexts revealed that implicit attitudes toward smoking are partly dependent on external cues, especially outcome expectancies. Similarly, internal cues are shown to affect implicit attitudes whereby not so much the level of nicotine dependency but more the level of nicotine deprivation seems vital. Only one study investigated the combined effect of external and internal cues on implicit attitudes toward smoking, not only highlighting the complexity of the relationships, but also the importance of considering implicit attitudes when developing and evaluating intervention. Implications for intervention and future research are indicated in the discussion.