Persuasion Through Affirmation or Threat? The Moderating Role of Self-Esteem in Self-Affirmation and Self-Threat Effects in Health Risk Messages

Can deliberate self-affirmation and self-threat inductions be effectively employed in health persuasion targeting bystanders or individuals not directly responsible for health risks? Drawing on the self-affirmation theory, this study examines the effectiveness of message-integrated self-affirmation and self-threats in secondhand smoke (SHS) health risk messages among Chinese nonsmokers. An online experiment was conducted, using a 3 (self-integrity strategies: self-affirming vs. self-threatening vs. control group) × 2 (reference points: self-referencing vs. other-referencing) between-subjects factorial design, with self-esteem treated as a continuous moderator. Results showed that both strategies, compared to a control group, elicited greater negative self-appraisal, which in turn increased psychological reactance. Notably, self-affirmation led to stronger anti-SHS behavioral intentions than the control group. While reference points did not moderate the effects, self-esteem emerged as a key moderator: high self-esteem enhanced the persuasive impacts of both strategies, whereas low self-esteem heightened defensive coping and its undesirable influences on behavioral intention. Theoretically, the findings extend self-affirmation theory in health persuasion by identifying self-esteem as a key moderator in self-integrity appeals. Practically, although both self-integrity strategies can enhance message persuasion, self-affirmation appears particularly impactful, and tailoring interventions to recipients' self-esteem may further optimize persuasive outcomes.