title: "Consumer Responses to Infectious Disease Cues: An Integrative Framework and Research Agenda" authors: "Felipe M. Affonso" journal: "European Journal of Marketing" year: 2025 volume: 59 issue: 4 pages: "973-998" doi: "10.1108/EJM-01-2024-0070" citation: "Affonso, Felipe M. (2025), \"Consumer Responses to Infectious Disease Cues: An Integrative Framework and Research Agenda,\" European Journal of Marketing, 59 (4), 973-98." bibtex: | @article{affonso2025consumer, title={Consumer Responses to Infectious Disease Cues: An Integrative Framework and Research Agenda}, author={Affonso, Felipe M.}, journal={European Journal of Marketing}, volume={59}, number={4}, pages={973998}, year={2025}, publisher={Emerald Publishing}, doi={10.1108/EJM-01-2024-0070} } > **Disclaimer:** This is a machine-readable conversion of the published paper for use with AI tools. It may contain conversion errors in formatting, tables, or equations. Always verify against the [published version](https://doi.org/10.1108/EJM-01-2024-0070). **Consumer Responses to Infectious Disease Cues: An Integrative Framework and Research Agenda** **Keywords**: behavioral immune system; consumer psychology; infectious diseases; threat FELIPE M. AFFONSO Felipe M. Affonso (felipe.affonso@okstate.edu) is an Assistant Professor of Marketing, Spears School of Business, Oklahoma State University, Stillwater, OK 74078. Correspondence concerning this article should be addressed to Felipe M. Affonso, (352) 727-2536. The author thanks Chris Janiszewski, Aner Sela, Richard Lutz, and Amir Erez for comments on an earlier version of the manuscript. In addition, the author dedicates this paper to the loving memory of Wagner Vinicius Pretola. **Consumer Responses to Infectious Disease Cues: An Integrative Framework and Research Agenda** **Abstract** **Purpose:** This paper develops an integrative framework explaining how infectious disease cues influence consumer behavior by connecting evolutionary psychology and behavioral immune system literature with consumer research. **Design/methodology/approach:** The paper synthesizes pathogen-avoidance psychology and consumer behavior research to identify three psychological changes (affect, cognition, motivation) influencing consumer responses, developing theoretical propositions across five domains while identifying boundary conditions. **Findings:** Disease cues trigger changes in affect (disgust, anxiety), cognition (narrowed attention), and motivation (self-protection). These influence consumer responses across self-regulation, social behavior/identity, information processing, evaluation, and prosocial/sustainable behaviors. The framework identifies boundary conditions moderating these effects. **Research limitations/implications:** The framework advances understanding of disease threats\' influence on consumer behavior and suggests future research directions, including contextual effects and individual differences. **Practical implications:** The framework helps marketers predict consumer responses to disease cues, offering insights for marketing strategies during health crises and normal times. **Originality/value:** This paper provides the first comprehensive framework explaining disease cues\' systematic influence on consumer behavior through psychological changes, extending behavioral immune system theory into consumer domains. **Keywords**: behavioral immune system; consumer psychology; infectious diseases; threat Consumers frequently encounter infectious disease cues in daily life, from shoppers sneezing in supermarkets to news headlines about disease outbreaks. These cues significantly impact consumer behavior, as exemplified by recent research showing disease threats increase preference for familiar brands (Galoni et al., 2020), visual patterns in advertising (Lee et al., 2023), and non-anthropomorphic products (Ding & Xu, 2023). However, despite growing evidence of these effects, the literature lacks a comprehensive framework to understand how disease cues systematically influence consumer behavior. The pathogen-avoidance psychology literature suggests that encountering disease cues activates the \"behavioral immune system\" - an evolved set of psychological mechanisms that detect and respond to infection risks (Schaller & Neuberg, 2012; Ackerman et al., 2018). Drawing on this literature, we propose that disease cues trigger fundamental shifts in affect (e.g., heightened disgust and anxiety), cognition (e.g., narrowed cognitive scope), and motivation (e.g., self-protection goals). These shifts systematically influence consumer responses across multiple domains: self-regulation and control, social behavior and identity processes, information processing, evaluative processes, and prosocial and sustainable behaviors. This research makes several contributions. First, it provides an integrative framework explaining how disease cues influence consumer behavior through specific psychological mechanisms affect, cognition, and motivation. By delineating these basic processes, we provide a theoretical foundation that not only explains existing work but helps predict novel responses for future research. Second, it extends behavioral immune system theory by identifying novel consequences in consumer domains. Third, it advances understanding of threat responses in consumer behavior by highlighting the unique aspects of disease threats. Finally, it offers practical insights for marketers navigating both health crises and everyday disease concerns. # THE PSYCHOLOGY OF DISEASE AVOIDANCE **Disease Avoidance as a Motivational Mechanism** The evolutionary arms race between disease-causing pathogensbacteria, fungi, protozoa, worms, viruses, helminthsand their host's immune system has been ongoing since the first living organisms (Jalasvuori & Bamford, 2008; Wolfe et al., 2007). Disease-causing pathogens imposed powerful selection pressures on humans (Gangestad & Buss, 1993), shaping natural selection and genetic variation in populations over millennia (Karlsson et al., 2014). The impact of infectious diseases has always been significant; for instance, the Bubonic Plague decimated 30 to 60% of the European population (Dobson & Carper, 1996), the Spanish flu killed between 40 and 100 million people worldwide (Olson et al., 2005), and infectious diseases continue to kill millions annually. These pathogen threats necessitated the development of adaptations to fight infection (Fumagalli et al., 2011; Thornhill & Fincher, 2014). The primary defense against infection is the biological immune system, which operates through physiological processes that secrete molecules (e.g., cytokines) to promote inflammation, detect and neutralize pathogens, and heal injuries (Akira et al., 2006; Janeway, 2001). However, mobilizing a biological immune response imposes serious fitness costs: it is metabolically expensive, temporarily incapacitating, and reactive, defending only after pathogens have invaded the body (Lochmiller & Deerenberg, 2000; McDade, 2005). Furthermore, pathogens evolve rapidly to evade immune responses. These shortcomings highlight the adaptive value of a motivational system that facilitates behavioral avoidance of pathogens, which is evolutionarily advantageous by preventing infection altogether (Cremer et al., 2007; Hart, 1990; Meunier, 2015). Behavioral avoidance of pathogens is common in the animal kingdom. For instance, some ants line their nests with antibiotic resins (Chapuisat et al., 2007), mammals and birds remove parasites by grooming or preening (Hart, 1990), and elephants use branches to repel mosquitoes (Hart & Hart, 1994). Research suggests humans have also developed a behavioral immune system that helps avoid infection through behaviors triggered by pathogen cues such as sneezing, coughing, foul odors, or skin lesions (Schaller & Park, 2011). This system aims to avoid infection by prompting behaviors like avoiding sick individuals and certain foods. **Disease Avoidance Motivation: Consequences for Disease-Related Responses** Motivational systems drive goal-directed behavior through attentional, affective, and cognitive states. In the behavioral immune system literature, the affective state of disgust is central to disease avoidance motivation. Disgust is experienced as revulsion and a desire to withdraw from the eliciting stimulus, typically associated with objects posing a disease threat (Rozin et al., 2000; Stark et al., 2007). Empirical evidence supports the notion that objects historically posing the greatest disease threat, such as bodily wastes and sick individuals, are most likely to evoke disgust (Curtis et al., 2011). Motivational systems also influence attention and cognition. Infection-connoting stimuli increase attentional engagement and recall more than fear-evoking stimuli, even when controlling for visual attention (Carretié et al., 2011). Physiological studies reveal that infection threat stimuli elicit unique neural and autonomic responses, distinct from other threats like predatory threats (Kreibig, 2010; Stark et al., 2007). For instance, infection cues cause changes in cardiovascular and respiratory variables, such as increased heart rate variability and skin conductance, which differ significantly from responses to other threats (Stark et al., 2007). **Disease Avoidance Motivation: Consequences for Disease-Unrelated Responses** Can pathogen-avoidance motivations influence responses to stimuli who pose no objectively meaningful risk of infection at all? Extant research on social psychology shows this is the case. For example, Ackerman et al. (2009) found that cues related to infectious diseases increased overgeneralization bias, where people exhibit heightened sensitivity to deviations in facial symmetry and other morphological features, even in contexts unrelated to infection risk. This suggests that disease-avoidance motivations can be triggered by superficial perceptual cues, leading to broader implications for judgment and decision-making. This system\'s broad influence extends to non-obvious responses, impacting attentional processes, judgment, social cognition, and moral judgments. Please see Table 1 for a summary of research on people's responses to infectious disease cues in social psychology. ++ | **Table 1.** People's Responses to Infectious Disease Cues Summary of Research Findings in Social Psychology^1^ | +:=====================================================================================================================================:+:===================================================================================================================================================================================================================================================================================================================================================================:+:==============================================================================================================================================================================================:+ | **Domain** | **Findings** | **Citations** | ++++ | Attentional Processes | Overgeneralization bias toward features resembling infection symptoms and cues associated with disease; narrowed attention to these cues; greater sensitivity towards morphological deviance of geometric shapes; sensitivity towards processing dissimilarities rather than similarities; socially dense environments perceived as more crowded and confining | Ackerman et al. (2009); Makhanova et al. (2015); Nussinson et al. (2018); Ryan (2012) | ++++ | Judgement and Decision-Making | Devaluation of objects and environments associated with unfamiliar people; desire for health and attractiveness improvements; decreased global risk tolerance; increased motivation for status acquisition | Ackerman et al. (2018); Brown and Sacco (2020) Mortensen et al. (2010); Prokosch et al. (2019) | ++++ | Social Cognition and Social Interaction | Increased dissimilarity between ingroups and outgroups; aversion and stigmatization expressed toward outgroup members (e.g., elderly, obese, disabled); increased prejudice towards people with morphological anomalies; greater preference for healthy, symmetrical, attractive mates; reduced preference for extraverts; increased concern about one's self-image | Ackerman et al. (2018); Brown and Sacco (2016); Faulkner et al. (2004); Gangestad and Buss (1993); Huang et al. (2011); Murray et al. (2013); Navarrete and Fessler (2006); Park et al. (2007) | ++++ | Social Influence and Moral Judgements | Higher conformity to cultural norms; more social conservatism; stringent punishment for violating moral norms | Horberg et al. (2009); Murray and Schaller (2012); Murray et al. (2013); Terrizzi et al. (2013) | ++++ | We note that the findings on people's responses to infectious disease cues are more extensive than what the table outlines. See Murray and Schaller (2016) and Ackerman et al. (2018) for social psychology-focused reviews, and Murray et al. (2019) for a review focused on the physiological foundations of the pathogen-avoidance system focused on three different levels: sensory, cellular, and genetic. | | | | Source: Author's own work | ++ Two principles explain these wide-ranging effects: the Smoke Detector Principle and the Functional Flexibility Principle (Murray & Schaller, 2016; Schaller & Park, 2011). The Smoke Detector Principle suggests the system detects and responds to inferred infection risks from perceptual cues, even if they pose no real threat (Michalak & Ackerman, 2020; Ryan, 2012). This leads to a high sensitivity to various cues (e.g., sneezing, skin lesions), even in contexts where infection is unlikely or biologically impossible. The Functional Flexibility Principle posits that the pathogen-avoidance system activates strongly when the perceived vulnerability to infection is high, balancing the costs and benefits of the response. When individuals perceive themselves as invulnerable, the system\'s responses are minimal. Conversely, perceived high vulnerability results in stronger cognitive, affective, and behavioral responses (Schaller & Neuberg, 2012; Schaller et al., 2007). Thus, the strength of these responses can be influenced by factors such as health-related self-efficacy. In summary, research on social psychology demonstrates that disease-avoidance motivations can be triggered even when there is no objective risk of infection, and these motivations can influence disease-irrelevant contexts. This literature has documented effects across multiple domains: attentional processes, judgment and decision-making, social cognition and interaction, and social influence and moral judgments. These diverse effects appear to operate through several core psychological mechanisms - triggering protective motivations, activating social distancing tendencies, and prompting compensatory control responses. As we will review next, these same fundamental mechanisms help explain how disease cues influence consumer behavior across various domains. # CONSUMER RESPONSES TO DISEASE CUES: SYNTHESIS OF EXISTING RESEARCH The emerging body of research examining consumer responses to disease cues has expanded considerably, with multiple studies investigating how these cues impact behavior across various domains. However, these findings remain fragmented. Below, we synthesize key studies and identify theoretical patterns that inform our proposed framework, categorizing consumer responses into three primary mechanisms: safety and health concerns, social contact avoidance, and control-seeking behavior. *Safety-Health Protection*. A primary way disease cues affect consumer behavior is by activating safety and health concerns that drive protective responses. For instance, Gao (2024) demonstrates that disease salience prompts consumers to discard edible leftovers due to contamination concerns, even when such concerns are unwarranted. Similarly, Huang et al. (2017) found that disease cues reduce interest in secondhand products due to contamination concerns, while Yi et al. (2024b) showed that consumers avoid densely displayed products that might harbor pathogens. Consumers also prefer familiar (vs. unfamiliar) products as familiarity signals safety (Galoni et al., 2020). *Social Contact Avoidance*. Disease cues also reduce preferences for products and environments associated with social contact. For example, Huang and Sengupta (2020) found that disease cues decrease preference for typical products associated with many people, driving consumers toward more exclusive or atypical options. Ding and Xu (2023) found that disease cues reduce preferences for anthropomorphic products due to their social associations. Similarly, Yi et al. (2024b) showed that product density, which implies greater human contact, leads to avoidance under disease threat. *Control and Structure Seeking*. The third mechanism through which disease cues influence consumer behavior is by triggering compensatory responses aimed at restoring order and control. Lee et al. (2023) found that disease cues increase consumers\' preference for visually patterned products as they seek to impose order on their environment. Kim (2020) found that disease cues increase variety seeking because it enhances freedom and personal control. Yi et al. (2024a) demonstrated that disease threats increase preference for colorful products as a means of emotional regulation and control restoration. Sun et al. (2024) showed that disease cues exacerbate the sunk cost bias due to increased feelings of uncertainty and low control over the environment. Additionally, Galoni et al. (2020) found that disease cues lead consumers to prefer familiar brands, as familiarity signals safety and predictability. **The Need for a Comprehensive Framework for Consumer Responses to Disease Cues** Despite these valuable insights and the importance of this phenomenon, there remains a significant gap in integrating these effects into a cohesive framework to predict consumer behavior across various contexts. With the goal of filling this gap, the next section is organized as follows. First, we define the construct of disease avoidance motivation and describe three assumptions that sustain the literature on pathogen-avoidance behavior. Then, we propose that disease cues trigger fundamental changes in affect, cognition, and motivation - three basic psychological processes through which disease cues influence consumer behavior. Finally, we identify different categories of consumer responses that emerge from these psychological changes, and develop formal propositions for future research. # CONSUMER RESPONSES TO DISEASE CUES: PROPOSITION OF A FRAMEWORK **Disease Avoidance Motivational State: Definition and Assumptions** We define the disease avoidance motivational state as a goal-directed mental state triggered by infectious disease cues perceived as threatening. This state is characterized by a heightened focus on avoiding contact with potential pathogens. While there are different ways people can cope with disease threats (e.g., cognitive reappraisal, distraction, denial), avoidance is a coping strategy consistent with the evolutionary psychology and behavioral immune system literatures. Avoidance behaviors are adaptive responses developed to minimize exposure to potential pathogens, thereby reducing the risk of infection. This strategy aligns with the well-established concept of the behavioral immune system, which includes a set of psychological and behavioral mechanisms aimed at preventing disease. By focusing on avoidance, individuals can proactively manage their environment and interactions to steer clear of perceived threats, thus enhancing their chances of survival and maintaining health (Oaten et al., 2009; Schaller & Park, 2011). The disease avoidance motivational state is activated by cues that signal the potential presence of pathogens. These cues can range from direct observations (e.g., someone sneezing) to more abstract indicators (e.g., news reports about a disease outbreak). Once activated, this state triggers fundamental changes in three basic psychological processes: affect, cognition, and motivation. These changes, then, influence both disease-related and disease-irrelevant consumer behaviors. Our review of the pathogen-avoidance literature, both in the social psychology and consumer research disciplines, suggests three assumptions regarding people\'s responses to pathogen threat. First, infectious disease cues may not necessarily pose an objective risk of infection. Second, the activation of pathogen-avoidance responses is contingent on individuals feeling vulnerable to, or threatened by, the disease that can be potentially caused by the infection-connoting stimuli. Third, these responses, once activated, can exert influences on disease-irrelevant contexts through changes in affect, cognition, and motivation. Our proposed framework is depicted in Figure 1. In the next sections, we will describe the components of this framework. First, we will review different types of infectious disease cues (i.e., triggers or antecedents). Next, we will describe the three fundamental psychological changes (affect, cognition, and motivation) triggered by disease cues (i.e., mediators). These three fundamental changes work together to explain why disease cues influence even seemingly unrelated consumer behaviors, from temporal discounting to sustainable consumption. Finally, we will develop propositions based on how these changes influence distinct domains of consumer behavior (i.e., consequences). When developing these propositions, we also consider potential moderators that can influence the emergence and/or direction of the proposed effects. **Figure 1.** Integrative Framework for Consumer Reactions to Infectious Disease Cues *The framework depicts the full pathway from disease cues to consumer behavior. On the left, triggers (antecedents) include infectious disease cues encountered in five settings: retail, public and social, media and information, home, and workplace. These cues activate a disease avoidance motivational state, which is defined as a goal-directed mental state triggered by infectious disease cues perceived as threatening. This state then triggers fundamental psychological changes (mediators) in three domains: (1) affect (fear, anxiety, disgust, feelings of uncertainty and low control), (2) cognition (narrowed cognitive scope, increased attention to detail, enhanced sensitivity to deviations, more discriminating categorization), and (3) motivation (control and structure seeking, compensatory consumption). These psychological changes, in turn, influence distinct domains of consumer behavior (consequences), including both disease-related responses (e.g., hygiene product preferences, avoidance of contamination cues) and disease-irrelevant responses (e.g., temporal discounting, sustainable consumption, preference for familiar brands, variety seeking, preference for visually patterned or colorful products). The framework also identifies moderators that can influence the emergence and direction of these effects, including individual vulnerability to disease threat.* *Note: Figure image not included in machine-readable version. See published paper for the visual.* Source: Author's own work **Disease Avoidance Motivational State: Triggers (Antecedents)** We propose that consumers may encounter infectious disease cues in several key settings: retail, public and social settings, media and information settings, home, and workplace. These settings have numerous cues that may be interpreted as connoting infection by the pathogen-avoidance system. This aligns with the idea that the pathogen-avoidance system is highly sensitive to a wide range of cues, even those that may not necessarily pose an objective infection risk. *Retail Settings.* In retail environments, several cues can trigger infectious disease avoidance motivation. These include the sight of others coughing or sneezing, the mere presence of others (especially in the context of COVID-19 or during flu season), and cues that increase the salience of product contact by others, such as shelf disorganization, visible fingerprints, and a lack of physical cleanliness (Argo et al., 2006; Morales & Fitzsimons, 2007). Crowded spaces within stores can also heighten the perception of disease risk. For example, research suggests that consumers in crowded stores are more likely to perceive a higher risk of infection (Perlman & Yechiali, 2020; Wang & Ackerman, 2019), which can lead to avoidance behaviors. *Public and Social Settings.* Public and social environments present numerous disease cues, such as seeing sick individuals on public transportation, touching handrails and seats, and encountering crowded spaces. In restaurants and cafes, handling menus, utensils, and food that could have been touched by others, as well as noticing unclean tables or staff not following hygiene practices, can trigger disease avoidance (Kim et al., 2022). Events and gatherings with large crowds and shared facilities, especially without visible sanitation measures, are also significant triggers. *Media and Information Settings.* Exposure to news reports about outbreaks, pandemics, and health advisories can significantly influence disease avoidance motivation. Social media posts about illnesses, shared videos of people displaying symptoms, and discussions on health risks can amplify these concerns (Morii et al., 2023). Health-related advertisements that highlight disease risks or promote hygiene products can serve as powerful triggers. *Home Settings.* At home, consumers may encounter several cues that trigger disease avoidance motivation. These include watching news related to diseases, opening a smelly trash can, dealing with pests or insects, seeing food remains in the kitchen sink, and managing unclean areas like clogged toilets. The presence of a sick household member and sensing bad smells from products can also activate disease avoidance (Straif-Bourgeois et al., 2023). *Workplace Settings.* In the workplace, cues such as dirty desks, shared office equipment, and unclean restrooms can trigger disease avoidance. Additionally, colleagues displaying symptoms of sickness and shared food or drink areas contribute to heightened disease awareness and avoidance behaviors. Workplace cleanliness and the presence of sick colleagues can influence employees\' perceptions of health risks and their subsequent behaviors (Faulkner et al., 2004). We note that while some cues are more distant from consumption situations than others (e.g., unclogging a toilet at home is more isolated from a customer journey than seeing a sick person in a grocery store), motivations and emotional experiences may trigger affective, cognitive, and behavioral responses that will have incidental effects. That is, these responses can affect disease-unrelated situations at later points in time, at different places (Han et al., 2007; Lerner & Keltner, 2000; Lowenstein & Lerner, 2003). This is consistent with the idea that infectious disease cues have the potential to influence a wide range of consumer behaviors and preferences. **Disease Avoidance Motivational State: Fundamental Psychological Changes (Mediators)** While existing pathogen-avoidance literature often describes underlying mechanisms at a general level, referring to \"a complex suite of cognitive, affective, and behavioral mechanisms\" (Ackerman et al., 2018; Murray & Schaller, 2016), we propose that these mechanisms can be organized into three fundamental psychological changes that disease cues reliably trigger: changes in affect, cognition, and motivation. Each of these changes serves specific adaptive functions but can also influence behavior beyond disease-relevant contexts. Below, we detail how disease cues impact each of these basic psychological processes. *Affective States*. Research consistently demonstrates that infectious disease cues trigger a plethora of negative affective states, particularly fear, disgust, anxiety, and feelings of uncertainty and low control. These emotional responses serve as an early warning system that motivates avoidance of potential pathogens before infection occurs (Schaller & Park, 2011; Neuberg et al., 2011). Fear and anxiety emerge as primary responses to disease cues, characterized by heightened arousal and vigilance toward potential threats. Multiple studies have shown that exposure to pathogen cues increases both state and trait anxiety (Mortensen et al., 2010; Miller & Maner, 2012). Neurobiological research demonstrates that this anxiety response is evolutionarily adaptive, as it promotes quick withdrawal from potentially dangerous situations through activation of threat-detection neural circuits (Woody & Szechtman, 2011; LeDoux, 2000). In consumer contexts, Galoni et al. (2020) demonstrated that disease-related fear increased preferences for familiar products, suggesting that these negative emotional states drive consumers toward options perceived as safer and more predictable. Disgust plays a particularly central role in disease avoidance, functioning as a core component of the \"behavioral immune system\" that helps organisms avoid contact with potential sources of infection (Curtis et al., 2011; Oaten et al., 2009). A substantial body of research has established that disease cues reliably elevate disgust sensitivity through multiple pathways (Tybur & Gangestad, 2011; Curtis et al., 2011), which then influences judgments and decisions even in domains unrelated to disease threat. For example, controlled experiments have shown that heightened disgust reduces consumer interest in used products (Huang et al., 2017), influences moral judgments (Horberg et al., 2009), and affects social preferences (Park et al., 2007; Navarrete & Fessler, 2006). Feelings of uncertainty and low control also consistently emerge as key affective responses to disease cues across various research paradigms. Pathogens represent an invisible and often unpredictable threat, leading to increased feelings of vulnerability and diminished perceived control through multiple mechanisms (Prokosch et al., 2019; Fritsche et al., 2008). Experimental studies have demonstrated that disease salience reliably increases both general uncertainty (van den Bos et al., 2009) and specific concerns about personal vulnerability (Duncan et al., 2009). In consumer behavior, converging evidence shows these feelings of uncertainty and low control influence various decisions, from increased preference for structure-providing products (Landau et al., 2015) to enhanced risk aversion in financial decisions (Mortensen et al., 2010; Prokosch et al., 2019). In summary, the activation of these negative affective states serves an important evolutionary function by motivating organisms to avoid potential sources of infection. As we have previously discussed, these affective states have a robust and reliable influence even in contexts objectively unrelated to disease threat. *Cognitive Processes*. Infectious disease cues significantly influence how individuals process information. Specifically, existing research consistently demonstrates that disease cues lead to a narrowing of cognitive scope - a fundamental shift in information processing characterized by increased attention to detail, enhanced sensitivity to deviations, and more discriminating categorization processes. This cognitive narrowing serves an adaptive function by helping individuals detect subtle cues that might signal infection risk (Ackerman et al., 2009). Studies using various methodological approaches consistently show that exposure to disease cues increases attentional focus on potential threats while reducing attention to peripheral information. For instance, Carretié et al. (2011) found that infection-related cues significantly increased attentional engagement compared to other threatening stimuli, even when controlling for visual attention. Physiological studies reveal that disease cues elicit unique neural and autonomic responses distinct from other threats, characterized by increased cardiovascular and respiratory activity consistent with heightened vigilance (Stark et al., 2007). This narrowed attention appears specifically tuned to detect features that could signal contamination or infection risk. The narrowing of cognitive scope also manifests as increased sensitivity to deviations and differences rather than similarities. Nussinson et al. (2018) demonstrated that pathogen cues enhance individuals\' ability to detect subtle dissimilarities between objects, suggesting a shift toward more detailed, discriminating cognitive processing. Similarly, Makhanova et al. (2015) found that disease cues heighten attention to features that could indicate infection, improving the detection of potential threats. This heightened sensitivity to deviation extends beyond disease-relevant stimuli - Ackerman et al. (2009) showed that disease cues increased sensitivity to deviations in facial symmetry and other morphological features, even in contexts unrelated to infection risk. This cognitive narrowing also influences how information is categorized and processed. Research shows that disease cues lead to more precise and discriminating categorization processes (Ackerman et al., 2018), increased sensitivity to anomalies (Nussinson et al., 2018), and enhanced processing of detailed visual information (Lee et al., 2023). These effects are consistent with the evolutionary advantage of detecting subtle cues that might signal infection risk. In summary, the narrowing of cognitive scope represents a fundamental shift in information processing triggered by disease cues. Classic theories of attention and cognitive processing help also explain these effects - for instance, the cognitive tuning model (Friedman & Förster, 2010) suggests that threatening states like disease concern narrow attentional focus to facilitate threat detection. Similarly, the affect-as-information framework (Clore et al., 2001) suggests that the negative affect associated with disease threat promotes more detailed, systematic processing. *Motivational Processes*. Infectious disease cues fundamentally alter individuals\' motivational priorities, activating a powerful self-protection motivation that takes precedence over other goals. This motivational shift represents a core adaptive response that prioritizes personal safety and well-being over competing objectives (Neuberg et al., 2011; Schaller & Park, 2011). The activation of self-protection motivation in response to disease cues is well-documented in the behavioral immune system literature. When faced with infectious disease threats, individuals become primarily motivated to protect themselves from potential harm, leading to behavioral changes aimed at minimizing exposure to pathogens (Ackerman et al., 2018; Murray & Schaller, 2016). This motivational shift is evolutionarily adaptive - throughout human history, successfully avoiding infection has been crucial for survival, making self-protection an essential motivational response to disease cues (Schaller et al., 2007). The primacy of self-protection motivation manifests in various ways. For instance, Mortensen et al. (2010) demonstrated that disease cues increase self-focused protective behaviors and reduce engagement in activities that might expose oneself to risk. Miller and Maner (2012) showed that pathogen threats activate a self-protective motivational system that prioritizes personal safety over social goals. This motivational shift helps explain why individuals often engage in seemingly extreme avoidance behaviors when disease concerns are salient - the motivation to protect oneself takes precedence over other considerations (Duncan et al., 2009). Multiple theoretical frameworks are consistent with the influence of self-protection motivation on behavior. Evolutionary psychology suggests that self-protection represents a fundamental motive that can override other goals when activated (Griskevicius & Kenrick, 2013; Kenrick et al., 2010). Similarly, the prevention-focus literature suggests that threats like disease activate a prevention-oriented motivational state focused on avoiding negative outcomes (Higgins, 1997). The goal-systems perspective explains how activated self-protection goals can inhibit competing goals, leading to behavioral changes across multiple domains (Kruglanski et al., 2002). Importantly, once activated, self-protection motivation can influence behavior even in contexts objectively unrelated to disease threat. This occurs through various processes including goal generalization (Huang & Bargh, 2014), and the activation of associated goal systems (Fishbach et al. 2004). These processes help explain why disease-activated self-protection motivation can impact such a wide range of consumer behaviors, from product preferences to decision-making strategies to social consumption contexts. **Disease Avoidance Motivational State: Consumer Responses (Consequences)** Building on our understanding of how disease cues trigger fundamental changes in affect, cognition, and motivation, we now examine how these psychological changes manifest in distinct domains of consumer behavior. We organize consumer responses into five broad categories that represent core areas of consumer psychology and marketing: self-regulation and control, social behavior and identity, information processing, evaluative processes, and prosocial and sustainable behaviors. These categories were selected for several reasons. First, they represent fundamental domains of consumer behavior that have significant theoretical and practical importance. For instance, self-regulation processes are central to understanding how consumers manage resources and make trade-offs (Baumeister, 2002), while social behavior and identity shape brand relationships and marketplace interactions (Reed et al., 2012). Second, these categories are conceptually distinct yet comprehensive in capturing key consumer responses. While specific behaviors may involve multiple processes at play, each category represents a theoretically separable domain with unique consequences. Finally, these categories allow us to systematically map how the fundamental psychological changes triggered by disease cues (affect, cognition, motivation) influence specific consumer behaviors through clearly articulated mechanisms. Within each category, we develop specific propositions about how disease cues influence consumer behavior, grounding each prediction in the psychological changes identified earlier. We also highlight various manifestations of these effects to demonstrate their broad relevance for consumer behavior and marketing practice. **CONSUMER RESPONSES TO DISEASE CUES: RESEARCH PROPOSITIONS** In this section, we develop propositions about how disease cues influence consumer behavior across the five core domains identified above. For each domain, we first delineate the theoretical mechanisms through which disease cues affect consumer responses, drawing on the fundamental changes in affect, cognition, and motivation established earlier. We then formalize specific propositions that capture these effects. Importantly, we take care to ground each predicted effect in prior research while clearly articulating the proposed psychological pathway from disease cues to consumer behavior. Given the complexity of consumer responses to disease threats, we also consider boundary conditions that might moderate these effects, which are described at the end of each domain. Identifying such moderators is crucial not only for understanding when and why certain effects might emerge more strongly, but also for reconciling potentially competing mechanisms and findings. By systematically exploring these theoretical pathways and boundary conditions, we aim to provide a comprehensive framework that can guide future research while acknowledging the nuanced nature of consumer responses to disease cues. **Consumer Response Category: Self-Regulation and Control** Disease threats fundamentally alter how consumers approach self-regulatory challenges. When faced with disease cues, consumers\' cognitive scope narrows to focus on immediate circumstances rather than distant outcomes (Carretié et al., 2011; Gable & Harmon-Jones, 2010). This cognitive narrowing combines with heightened anxiety about immediate threats (Mortensen et al., 2010; Miller & Maner, 2012) to drive increased attention to proximal versus distant concerns. Moreover, the activation of self-protection motivation (Neuberg et al., 2011; Schaller & Park, 2011) prioritizes immediate safety over long-term goals. Present focus can manifest in various consumer contexts: increased preference for immediate rewards over delayed ones (Kim & Zauberman, 2013), reduced saving behavior (Griskevicius et al., 2013), and greater willingness to pay for products offering immediate benefits (Zauberman & Urminsky, 2016). **P1:** *Disease cues increase present-focused consumer behavior.* Disease cues also impair consumers\' ability to exert self-control. The combination of heightened anxiety (Mortensen et al., 2010; Garg & Lerner, 2013) and cognitive depletion from threat monitoring (Baumeister et al., 2018) reduces self-regulatory resources. Additionally, when self-protection motivation is active (Schaller & Park, 2011; Kenrick et al., 2010), it can override other self-control goals as immediate safety takes priority. This reduced self-control appears across consumer domains: increased impulsive purchasing (Vohs & Faber, 2007), greater food indulgence (Garg & Lerner., 2013), and reduced ability to stick to budgets (Bearden & Haws, 2012). **P2:** *Disease cues reduce consumer self-control.* Disease cues also trigger feelings of low control and uncertainty (Prokosch et al., 2019; Fritsche et al., 2008; Kay et al., 2008), which motivates compensatory consumption as a means of control restoration. When individuals feel a lack of control, they engage in consumption that symbolically addresses the threatened need (Cutright, 2012; Lee et al., 2023; Mandel et al., 2017). Additionally, self-protection motivation (Neuberg et al., 2011; Griskevicius & Kenrick, 2013) directs these compensatory responses specifically toward products and experiences that can restore feelings of safety and security (Galoni et al., 2020; Huang et al., 2017). This compensatory consumption manifests in various ways: consumers may prefer products with clear boundaries that provide structure (Cutright, 2012), seek out patterns in visual displays to restore order (Lee et al., 2023), and show increased preference for familiar brands that signal safety (Galoni et al., 2020). **P3:** *Disease cues increase compensatory consumption behavior.* *Boundary Conditions Self-Regulation and Control.* The effects proposed above are likely moderated by consumers\' perceived control over disease threats. When individuals believe they can effectively manage or prevent infection through their own actions, the psychological impact of disease cues may be attenuated, consistent with research on perceived control and threat response (Kay et al., 2008). This moderation occurs because perceived controllability reduces both anxiety (Bandura, 1988; Langer, 1975) and the need for compensatory behaviors (Kay et al., 2010; Cutright, 2012). Conversely, when disease threats are perceived as uncontrollable, the narrowing of temporal focus (Griskevicius et al., 2011), impairment of self-control (Baumeister et al., 2018), and drive for compensatory consumption (Mandel et al., 2017) become amplified due to heightened vulnerability perceptions (Fritsche et al., 2008; Kay et al., 2008). These effects align with research showing that perceived control moderates responses to various threats (Cutright & Wu, 2023) and influences self-regulatory behavior (Bandura, 1991). Individual differences in health self-efficacy (Schwarzer & Jerusalem, 1995) and contextual factors affecting perceived disease controllability thus represent critical boundary conditions for these effects. **Consumer Response Category: Social Behavior and Identity-Related Processes** Disease cues reshape how consumers navigate social relationships and express identity through consumption. Research demonstrates that disease threats trigger powerful social avoidance tendencies as part of the behavioral immune system (Ackerman et al., 2018; Schaller & Park, 2011; Neuberg et al., 2011). This avoidance emerges through both heightened vigilance toward social threats (Mortensen et al., 2010; Miller & Maner, 2012) and increased anxiety about social contact (Duncan et al., 2009). Additionally, the activation of self-protection motivation leads individuals to prioritize personal safety over social connection (Park et. al, 2007). These social avoidance tendencies manifest in various consumer contexts: reduced preference for crowded retail environments (Yi et al., 2024), decreased interest in shared consumption experiences (Huang & Wang, 2014), and lower willingness to engage in product sharing or collaborative consumption (Belk, 2014). **P4**: *Disease cues increase social avoidance in consumption contexts.* Disease threats fundamentally alter how consumers express and value different aspects of identity through consumption. When faced with disease cues, individuals experience heightened self-focus (Duval & Wicklund, 1972; Woody & Szechtman, 2011) and increased concern for personal well-being (Neuberg et al., 2011; Griskevicius & Kenrick, 2013). This shift toward self-protection, combined with social avoidance tendencies, leads consumers to prioritize expressions of personal identity over social group membership in their consumption choices. This identity shift manifests in various ways: increased preference for products that signal individual achievement or personal qualities (White & Argo, 2009; Berger & Heath, 2007), greater interest in exclusive rather than popular products that communicate uniqueness (Huang & Sengupta, 2020; Chan et al., 2012), and enhanced valuation of products that help differentiate the self from others (Berger & Heath, 2008). **P5:** *Disease cues increase the relative importance of personal versus social identity in consumer choices.* Disease cues systematically alter how consumers process and utilize social information in their decision-making. The activation of self-protection motivation leads individuals to discount social input in favor of personal judgment (Neuberg et al., 2011; Griskevicius & Kenrick, 2013), while heightened vigilance toward social threats (Park et al., 2007; Miller & Maner, 2012) makes consumers more likely to question rather than accept others\' influences. This reduced susceptibility to social influence manifests in multiple aspects of consumer decision-making: decreased reliance on social proof when evaluating products (Berger & Heath, 2008), lower conformity to others\' product choices even when those choices represent market trends or expert opinions (White & Argo, 2009), and reduced effectiveness of peer recommendations in purchase decisions (Zhao & Xie, 2011). **P6**: *Disease cues decrease susceptibility to social influence in consumer decisions.* *Boundary Conditions Social Behavior and Identity-Related Processes.* The effects proposed above are likely moderated by whether social others are perceived as ingroup or outgroup members. This distinction is crucial because ingroup members are typically perceived as sharing similar pathogen avoidance practices and immunity profiles (Faulkner et al., 2004; Schaller & Neuberg, 2012), while outgroup members may be viewed as potential sources of novel pathogens (Park et al., 2007; Murray & Schaller, 2012). Research on coalitional psychology suggests that shared immunity markers serve as important cues for group categorization (Kurzban & Leary, 2001; Van Vugt & Park, 2009). Consequently, while disease cues generally increase social avoidance and personal identity focus with outgroup members (Navarrete & Fessler, 2006; Neuberg et al., 2011), these effects may reverse for ingroup members. With ingroups, disease threats can increase social affiliation as people seek safety in familiar others (Murray et al., 2013; Schaller & Park, 2011), enhance collective identity expression through shared immunity perceptions (Thornhill & Fincher, 2014; Miller & Maner, 2012), and strengthen within-group influence as people rely more heavily on trusted others for guidance (Murray & Schaller, 2012). These patterns align with broader research showing that threats can simultaneously increase ingroup cohesion while amplifying outgroup avoidance (Navarrete et al., 2004; Van Vugt & Park, 2009). The nature of social relationships - particularly ingroup versus outgroup distinctions - thus represents a critical boundary condition for understanding how disease cues shape social consumer behavior. **Consumer Response Category: Information Processing** Disease threats fundamentally alter how consumers process information. When faced with disease cues, individuals\' cognitive scope narrows (Carretié et al., 2011; Gable & Harmon-Jones, 2010) as they become more attentive to immediate environmental details that might signal infection risk. This cognitive narrowing combines with heightened vigilance driven by self-protection motivation (Neuberg et al., 2011; Schaller & Park, 2011) to promote more detailed, systematic processing of information. Additionally, the anxiety and fear triggered by disease threats (Mortensen et al., 2010; Miller & Maner, 2012) further drives focus toward specific, implemental concerns rather than abstract considerations, consistent with research showing that negative affective states promote detail-oriented processing (Schwarz & Clore, 1983). These processing shifts manifest in various consumer contexts: increased attention to product details rather than overall benefits (Huang & Sengupta, 2020), greater focus on concrete product attributes (Lee et al., 2023), and enhanced processing of specific features rather than general categories (White et al., 2011). **P7:** *Disease cues lead to more concrete (vs. abstract) construal levels.* Disease cues profoundly influence how consumers experience the passage of time. The combination of heightened anxiety (Mortensen et al., 2010) and narrowed attentional focus (Carretié et al., 2011; Tyler & Tucker, 1982) makes individuals more acutely aware of temporal experience. Research shows that anxiety tends to extend subjective time perception (Bar-Haim et al., 2010; Tipples, 2011), while increased attention to environmental details makes time feel as if it\'s passing more slowly (Sackett et al., 2010; Fleisig et al., 2009). Furthermore, the vigilance required by self-protection motivation (Neuberg et al., 2011; Woody & Szechtman, 2011) keeps consumers in a state of heightened temporal awareness. These temporal distortions manifest across consumer contexts: longer perceived wait times for services (Baker & Cameron, 1996; Fleisig et al., 2009), extended duration estimates for consumption experiences (Sackett et al., 2010), and increased sensitivity to temporal aspects of product claims (Mogilner et al., 2012). **P8**: *Disease cues lead consumers to perceive time as passing more slowly.* *Boundary Conditions - Information Processing.* The effects proposed above are likely moderated by different factors. For construal levels, a key moderator is whether the disease threat is perceived as personal versus collective. When the threat is highly personal, concrete construal should be particularly strong as individuals focus on specific ways to protect themselves (Chandran & Menon, 2004). However, when the threat is seen as affecting the broader community, more abstract construal might emerge as people consider larger-scale implications and solutions (Liberman et al., 2007). For time perception, the severity of the disease threat may serve as an important boundary condition. Mild threats that generate moderate anxiety might slow time perception as proposed (Bar-Haim et al., 2010; Tipples, 2011). However, extremely severe threats could actually speed up perceived time passage as individuals become overwhelmed and shift attention away from temporal monitoring (Hancock & Weaver, 2005; Fleisig et al., 2009). **Consumer Response Category: Evaluative Processes** Disease threats fundamentally alter how consumers evaluate products through multiple psychological pathways. First, the activation of self-protection motivation (Neuberg et al., 2011; Schaller & Park, 2011) heightens attention to product attributes related to safety and reliability. Second, the anxiety and fear triggered by disease threats (Mortensen et al., 2010; Miller & Maner, 2012) make safety-related features more salient and important in decision-making. Third, the narrowed cognitive processing characteristic of disease avoidance (Carretié et al., 2011; Gable & Harmon-Jones, 2010) enhances attention to specific safety-signaling product features. These psychological shifts manifest in various ways: increased attention to product safety information (Rahinel & Nelson, 2016), greater willingness to pay for safety-enhancing features (Dawar & Lei, 2009), enhanced preference for products with explicit reliability guarantees, and stronger attraction to familiar brands that signal security (Galoni et al., 2020). **P9**: *Disease cues increase the weight consumers place on safety and reliability attributes in product evaluation.* Disease cues also fundamentally reshape how consumers engage with different sensory aspects of products. The activation of self-protection motivation leads to heightened sensitivity toward sensory information that can be processed from a safe distance (visual, auditory) while reducing engagement with sensory modalities that require close contact or might transmit pathogens (tactile, gustatory, olfactory). This shift aligns with evolutionary perspectives on pathogen avoidance (Schaller & Park, 2011; Ackerman et al., 2018) and research showing that disease concerns reduce willingness for physical contact (Huang et al., 2017; White et al., 2020). Touch, taste, and smell are closely linked to the perception of potential disease threats (Krishna, 2012; Morales & Fitzsimons, 2007), leading consumers to avoid experiences that require these senses (Duong et al., 2022). The narrowing of cognitive scope under disease threat (Carretié et al., 2011) further enhances processing of visual information that can signal contamination risk. This sensory shift manifests across various consumption contexts: increased reliance on visual product information (DeFilippis et al., 2022; Morales & Fitzsimons, 2007), enhanced processing of sound-based marketing communications (Krishna & Schwarz, 2014), reduced interest in product sampling (Argo et al., 2006), and decreased engagement with scent marketing (Biswas & Szocs, 2019; Duong et al., 2022). **P10:** *Disease cues increase reliance on visual and auditory stimuli while decreasing engagement with tactile, gustatory, and olfactory stimuli*. *Boundary Conditions Evaluative Processes.* The effects proposed above are likely moderated by product category characteristics. For safety and reliability attributes, the moderating role of product category involvement is particularly relevant. In high-involvement categories where poor choices have significant consequences, disease cues should produce especially strong emphasis on safety and reliability (Dawar & Lei, 2009). However, in low-involvement categories where decisions are less consequential, the effect may be attenuated as the perceived need for protection is lower. For sensory engagement, the perceived necessity of the product likely serves as a key boundary condition (Argo et al., 2006; Krishna, 2012). While disease cues generally reduce engagement with close-contact sensory information, this effect may weaken or reverse for essential products where proper evaluation requires multiple sensory inputs (e.g., fresh produce, clothing). In such cases, consumers might develop compensatory strategies to enable necessary sensory engagement while maintaining a sense of safety, consistent with research on coping mechanisms under threat (Lazarus & Folkman, 1984; McEwen, 2007). **Consumer Response Category: Prosocial and Sustainable Behaviors** Disease threats significantly influence consumers\' engagement in behaviors that benefit others. When faced with disease cues, the activation of self-protection motivation (Neuberg et al., 2011; Schaller & Park, 2011) leads individuals to prioritize personal safety over collective welfare. This shift aligns with research showing that threats generally reduce prosocial behavior by activating self-focused mindsets (Van Lange et al., 2007). Additionally, heightened anxiety about contamination (Mortensen et al., 2010; Miller & Maner, 2012) combined with social avoidance tendencies (Ackerman et al., 2018; Park et al., 2007) reduces consumers\' willingness to engage with others or consider broader societal needs. The narrowed cognitive scope triggered by disease cues (Carretié et al., 2011; Harmon-Jones et al., 2012) further concentrates attention on personal rather than collective outcomes. These psychological shifts manifest in various prosocial contexts: reduced charitable giving (Bekkers & Wiepking, 2011), decreased volunteerism in community programs (Wilson, 2000), lower engagement in collaborative consumption initiatives (Belk, 2014), and diminished interest in supporting social causes (Aknin et al., 2013). **P11:** *Disease cues decrease prosocial consumer behavior.* Disease threats systematically impact consumers\' engagement in sustainable behaviors. The narrowing of cognitive scope triggered by disease cues (Carretié et al., 2011; Tyler & Tucker, 1982) leads individuals to focus on immediate personal circumstances rather than long-term collective outcomes, consistent with research showing that threats reduce consideration of future consequences (Griskevicius et al., 2012; Van der Wal et al., 2016). Furthermore, when self-protection motivation is active (Neuberg et al., 2011; Woody & Szechtman, 2011), environmental concerns become secondary to personal safety considerations. The heightened anxiety and uncertainty associated with disease threats (Mortensen et al., 2010) can also deplete the psychological resources needed to maintain sustainable practices, aligning with research on the cognitive demands of environmental behavior (Gifford, 2011; Levine & Strube, 2012). These effects appear across various sustainability domains: reduced recycling behavior (White et al., 2019), decreased preference for eco-friendly products (Luchs et al., 2010), lower willingness to pay price premiums for sustainable options (Van Doorn & Verhoef, 2011), and diminished engagement in environmental conservation efforts (Bamberg & Möser, 2007). **P12**: *Disease cues decrease sustainable consumer behavior.* *Boundary Conditions - Prosocial and Sustainable Behaviors.* The effects proposed above are likely moderated by different factors. For prosocial behavior, sense of community plays a crucial moderating role (Baumeister & Leary, 1995; McMillan & Chavis, 1986). While disease cues generally decrease prosocial behavior, this effect can weaken or reverse when individuals feel a strong sense of community belonging. Research shows that when social bonds are particularly salient, disease threats can actually increase prosocial behavior as people seek to strengthen community ties that provide protection (Wang et al., 2021). This suggests that factors that enhance feelings of community connection might buffer against the typical reduction in prosocial behavior under disease threat (Wilson, 2012). For sustainable behavior, the key moderating factor is individuals\' self-construal - whether they view themselves as independent entities or as interconnected with others and the environment (Markus & Kitayama, 1991; Arnocky et al., 2007). Those with interdependent self-construals, who see themselves as part of a larger ecological system, may maintain their sustainable behaviors even under disease threat as they recognize the connection between environmental and personal health (Sheehan & Dommer, 2020; White et al., 2019). In contrast, those with independent self-construals are likely to show the predicted decrease in sustainable behavior as they focus primarily on personal protection. The perceived connection between environmental and health outcomes may also moderate these effects - when consumers understand how environmental degradation can increase disease vulnerability, they might maintain or even increase sustainable behaviors despite disease threats (Wang et al., 2021). **GENERAL DISCUSSION** Our research advances understanding of how disease cues systematically influence consumer behavior through fundamental psychological changes. By integrating insights from evolutionary psychology and consumer behavior, we demonstrate how disease cues trigger shifts in affect (e.g., heightened disgust, anxiety), cognition (e.g., narrowed attention), and motivation (e.g., self-protection goals) that reshape consumer decision-making. These psychological changes manifest across multiple domains of consumer behavior, from self-regulation and social identity processes to information processing and prosocial behaviors. Our framework not only organizes existing findings but provides a theoretical foundation for predicting novel consumer responses to disease threats across various marketplace contexts. **Theoretical Contributions** This research makes several theoretical contributions. First, it bridges evolutionary psychology and consumer behavior by providing an integrative framework explaining how disease cues influence consumer responses through three fundamental psychological changes - affect, cognition, and motivation. By delineating these basic processes, we extend behavioral immune system theory (Schaller & Park, 2011; Schaller & Neuberg, 2012) into the consumer domain, providing a theoretical foundation that both explains existing findings and predicts novel consumer responses across multiple domains. Second, our framework advances understanding of threat responses in consumer behavior by highlighting the unique aspects of disease threats. While previous research has examined various threats (e.g., financial, social, existential), the behavioral immune system\'s distinct evolutionary history and activation patterns produce consumer responses that differ from other threat types (Ackerman et al., 2018; Murray & Schaller, 2016). Finally, we expand the scope of behavioral immune system research beyond its traditional focus on social and interpersonal responses (as shown in Table 1). Our framework demonstrates how disease avoidance motivation systematically influences a broader range of marketplace behaviors, from product evaluation to sustainable consumption, advancing our theoretical understanding of how pathogen-avoidance psychology shapes consumer decision-making. **Limitations and Future Research Directions** While our framework advances understanding of consumer responses to disease cues, several limitations suggest important directions for future research. First, our framework focuses primarily on individual-level psychological processes (affect, cognition, and motivation). Future research should examine how these processes interact with broader social psychological mechanisms, particularly in collective consumption contexts. For example, studies could investigate how disease cues influence group decision-making, collective consumption rituals, and marketplace communities. Second, our current understanding of contextual effects remains limited. Future research should examine how different consumption environments (e.g., retail, digital, service) moderate consumer responses to disease cues. For instance, how do disease cues encountered in retail settings (e.g., seeing someone sneeze) versus digital environments (e.g., online health warnings) differentially impact consumer behavior? Understanding these contextual differences would help marketers tailor their strategies more effectively. Third, while we identify several consumer responses to disease cues, additional behavioral domains warrant investigation. For example, research could explore how disease cues influence brand relationships, channel preferences, consumer financial decision making, and service experiences. Fourth, our framework could be enriched by examining how individual differences moderate these effects. Future studies should consider factors such as health-related self-efficacy, risk tolerance, and regulatory focus influence consumer responses to disease cues. Fifth, research should explore methods for enhancing positive outcomes in the face of disease threats. While disease avoidance motivation often leads to defensive responses, conditions may exist where it promotes beneficial consumer behaviors. For instance, Wang et al. (2021) found that disease cues can enhance sustainable consumption through heightened community connection. Understanding such positive pathways could help marketers and policymakers develop more effective interventions. Sixth, our model does not account for sickness behavior, which includes adaptive changes during an infection such as fatigue, social withdrawal, depressed mood, and reduced motor activity (Hart, 1988; Konsman et al., 2002; Shakhar & Shakhar, 2015). Future research should identify the marketing consequences of sickness behavior. Finally, our framework does not differentiate between different diseases or classes of pathogens. We assume that any perceived threat can activate disease avoidance motivation. Future research should investigate whether different types of diseases and pathogens affect disease avoidance motivation differently. **Conclusion** Understanding consumer responses to infectious disease cues has become increasingly critical for marketing theory and practice. Our framework integrates insights from evolutionary psychology and consumer behavior to explain how disease cues systematically influence consumer decision-making through fundamental shifts in psychological processes. These insights can help marketers better predict and address consumer responses during health crises while suggesting promising directions for future research. **ACKNOWLEDGEMENTS** The author thanks Chris Janiszewski, Aner Sela, Richard Lutz, and Amir Erez for comments on an earlier version of the manuscript. 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