In this study, the Extended Parallel Process Model (EPPM) served as a theoretical background for explaining the persuasive effects of fear appeals on smokers. Based on the self-consistency theory, self-esteem was included as a moderator in this model for understanding in more detail under which circumstances, a fear appeal leads to accepting responses or to reactance. An online experiment was conducted, participating smokers read an article that contained either a neutral picture or a fear appeal. Including self-esteem in the EPPM revealed that in contrast to smokers with high self-esteem, smokers with low self-esteem increased perceived susceptibility and intention to quit, as well as reactance to a fear appeal. Moreover, reactance could not be considered a negative reaction to the fear appeal message, because for individuals with low self-esteem it was positively associated with the intention to quit. Results suggest that additionally considering smokers’ self-esteem can contribute to a more accurate prediction of the persuasive effects of fear appeals.
The impact of self-esteem and reactance in health-related behavior is discussed, as are the implications for health-related messages and future research.