Examining reactions to smoking and COVID-19 risk messages: An experimental study with people who smoke

•Growing evidence suggests smoking cigarettes worsens COVID-19 outcomes, but few studies have examined the effects of this information on people who smoke.•Our experiment randomized 1,004 adults who smoke into one of four message conditions: COVID-19 risk, smoking risk, combined risk of smoking for COVID-19 severity, or a non-risk control.•Results showed that messages about worse outcomes of COVID-19 for people who smoke increased the perceived severity of smoking-related disease (vs. non-risk control messages) and intentions to quit smoking (vs. COVID-19 risk messages) or intentions to reduce smoking (vs. smoking risk messages and control messages).•Exposure to the combined risk messages (vs. control) was associated with higher odds of mask-wearing intentions in the next 2 weeks.•This the first study (to our knowledge) to demonstrate that messages about the increased risk of smoking for COVID-19 severity impacted both smoking and COVID-protective intentions.•Our findings suggest that messages about the combined risk of smoking and COVID-19 may be a promising strategy to reduce smoking intentions and increase intentions to protect against COVID-19. Smoking cigarettes worsens COVID-19 outcomes, and news media and health agencies have been communicating about that. However, few studies have examined how these messages affect attitudes, beliefs, and behavioral intentions of people who smoke. These are critical variables that can inform public health campaigns to motivate quitting smoking during the COVID-19 crisis. In August 2020, we conducted an online experiment in the U.S. with 1,004 adults who smoke. Participants were randomized to one of four message conditions: COVID-19 risk, smoking risk, combined risk of smoking for COVID-19 severity, or a non-risk control. Outcomes were message reactions (emotions and reactance), attitudes and beliefs (severity, susceptibility, self-efficacy, response efficacy for smoking and COVID-19, and conspiracy beliefs), and behavioral intentions (smoking intentions, COVID-protective intentions, and information-seeking). Multivariate analysis of covariance (MANCOVA) showed that combined risk messages elicited higher perceived severity of smoking-related disease than control messages. Similarly, the combined risk condition resulted in greater intentions to quit smoking in the next month (vs. COVID-19 risk condition) and intentions to reduce smoking in the next 6 months (vs. smoking risk and control; ps < .05). Multivariate logis