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Multiple gender expressions in anti-smoking messages reduced perceived effectiveness among sexual and gender minority young adults

Multiple gender expressions in anti-smoking messages reduced perceived effectiveness among sexual an…
Photo by Navy Medicine / Unsplash
Key Takeaway
Consider that multiple gender expressions in anti-smoking messages may reduce perceived effectiveness among sexual and gender minority young adults.

A randomized online experiment evaluated four anti-smoking message conditions: feminine, masculine, gender expansive, or multiple gender expressions. The study population consisted of 1,113 sexual and gender minority young adults. The primary outcome was perceived message effectiveness (PME), and a secondary outcome was perceived character similarity. Follow-up duration was not reported.

Messages with multiple gender expressions were associated with lower PME than all other conditions. In contrast, messages with multiple gender expressions increased perceived character similarity compared to messages showing masculine expressions. Specific p-values or confidence intervals were not reported for these associations.

No adverse events, serious adverse events, discontinuations, or tolerability data were reported. The study design and setting were online. Funding or conflicts of interest were not reported.

The main limitation is that other factors may also contribute to PME. The practice relevance involves designing health campaigns that resonate with the diverse gender identity groups within the SGM community. Perceived character similarity mediated the relationship between message exposure and PME.

Study Details

Study typeRct
EvidenceLevel 2
PublishedMay 2026
View Original Abstract ↓
This research examines how gender expressions in health messages influence perceived message effectiveness (PME) for sexual and gender minority (SGM) young adults through perceived character similarity. In an online experiment, 1,113 SGM young adults were randomly assigned to view six anti-smoking messages portraying one of four gender expressions: feminine, masculine, gender expansive, or multiple gender. Findings indicated that messages with multiple gender expressions increased perceived character similarity among SGM young adults compared to messages showing masculine expressions; perceived character similarity mediated the relationship between message exposure and PME. However, messages with multiple gender expressions were associated with lower PME than all other conditions. Furthermore, moderation analysis revealed nuanced differences in responses based on participants' gender identities. Theoretically, this study underscores the mediating role of perceived character similarity in tailored communication, while suggesting that other factors may also contribute to PME. The findings have practical implications for designing health campaigns that resonate with the diverse gender identity groups within the SGM community.
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