Fill the gaps in the following list: Tea, Coffee, Milk, S_ _ _ _.

If you answered sugar, it’s most likely because you were primed by the preceding words. Priming is one of the cognitive biases that can influence our thoughts and reactions. It occurs when previous experiences affect our response to a subsequent stimulus, without us being aware of the connection.1 While stimuli are often everyday words or images, they can also be sounds, smells or even physical movement. We’re all affected by priming – but being aware of it can help you to make use of its helpful effects, as well as mitigating its negative impacts.

Priming shows that our subsequent behaviour may be altered if we are first exposed to certain sights, words or sensations.2

So how does priming come about?

In common with other cognitive biases, priming is due to your brain’s efforts to simplify the complex world. Your brain stores units, or schemas, of information, and priming suggests that some related schemas are activated in unison without you necessarily being aware that they are linked.3,4 For instance the schemas related to rainstorms and slippery roads may be linked in your memories. When you drive in the rain, you might subconsciously think about slippery roads, leading you to slow down.4

Various types of priming work in specific ways and can have different effects.1 For example, positive priming increases brain processing speed and makes memory retrieval faster, while negative priming slows it down.4 Repetition priming occurs when a stimulus and response are repeatedly paired.4

How might it influence me?

Priming bias is evident is many aspects of everyday life. Words relating to the elderly (e.g. wrinkles) can make us walk slower and have poorer recall.5 A photo of a library makes us speak more quietly.6 Larger plates can encourage us take larger portions of food, and availability of trays increases the total volume of food chosen in a canteen.2,7 Likewise, larger glasses tend to mean that we pour larger amounts of alcohol. So if you want to lose weight or drink less, using smaller dinner plates and wine glasses is helpful.

Companies regularly use priming to influence our decisions by using subtle (and not so subtle) cues in advertising.1 These activate specific associations that make us more receptive to their products.1 That’s why you might smile when you see the logo and associate it with holidays and happiness.

What does this have to do with market access?

Well, words matter. And you can use them in various ways. For example, you might judiciously use priming in strategic communications to activate awareness of an issue before you dive into the detail.8 There are whole communications plans developed around raising awareness around a disease or therapy area. Helpful knowledge sharing in and of itself, but also helpful priming for future communications.

You might also think about using it to influence how readers think about a topic or to direct them to only use part of their knowledge when evaluating a topic. Here you’re potentially on shakier ground though. Exposure to previous stimuli has the potential to positively or negatively influence an individual’s responses to communications in ways that may be unpredictable and beyond your control.

So, while we can’t predict every response to our deliverables, being aware of priming bias and its influence can help us to understand how we can communicate more impactfully.

What can I do?

Plenty – and working with the redthread team is a great place to start. But for now, here’s a few things to think about the next time you’re writing:

  • Use headings effectively: Figure, table and sections headings that explain the take-away messages are more helpful than bland descriptions. Ensure titles are clear, active, objective, accurate and evidence-based; avoid superlatives, hyperbole and leading language.
  • Begin with conclusions: Start each paragraph with a factual one-sentence summary of the subsequent content of the paragraph. This helps the reader to understand the data more rapidly, particularly if it is complex. At redthread, we always talk about telling the reader what you’re going to tell them, and then telling them.
  • Ask better questions: Think about how to avoid introducing priming biases when designing questionnaires for payer research. Look at the order of questions and be aware that previous questions can prime responses to subsequent questions, leading to bias and unobjective responses.
  • Choose your words carefully: Cues acquired subconsciously can affect later responses or decision-making. Try to avoid words that you don’t want to associate with your product, even if you use them in a negative context. For example, saying “avoid delays in the onset of treatment effect” still has the potential to prime readers to associate your product with “delays in the onset of treatment effect”. So always check you’re using positive or negative words appropriately.

Primed and ready to explore further? Explore other blogs in our cognitive bias series or get in touch with our writing experts and see how they can improve your market access communications.


  1. The Decision Lab. Why do some ideas prompt other ideas later on without our conscious awareness? Priming, explained. Available at: Accessed 22 October, 2022.
  2. Institute for Government. MINDSPACE. Influencing behaviour through public policy. 2010.
  3. Camina E, Güell F. The Neuroanatomical, Neurophysiological and Psychological Basis of Memory: Current Models and Their Origins. Front Pharmacol. 2017;8:438.
  4. Cherry K. Priming and the Psychology of Memory. Available at: Accessed 22 October, 2022.
  5. Bargh JA, Chen M, Burrows L. Automaticity of social behavior: direct effects of trait construct and stereotype-activation on action. Journal of personality and social psychology. 1996;71 2:230-244.
  6. Aarts H, Dijksterhuis A. The silence of the library: environment, situational norm, and social behavior. J Pers Soc Psychol. 2003;84(1):18-28.
  7. Wansink B, Cheney MM. Super Bowls: Serving Bowl Size and Food Consumption. JAMA. 2005;293(14):1727-1728.
  8. Luoma-aho V, Pirttimäki T, Maity D, Munnukka J, Reinikainen H. Primed Authenticity: How Priming Impacts Authenticity Perception of Social Media Influencers. International Journal of Strategic Communication. 2019;13:352-365.