Adolescents' Neural Response to Tobacco Prevention Messages and Sharing Engagement

Contingent Effects of E-Cigarette Warning Label Messages on Cognitive Elaboration and Fear Among U.S. Youth Ages 14-17 by Vaping Experience and Peer Vaping Behavior

The U.S. Food and Drug Administration (FDA) currently requires a warning about the addictive nature of nicotine to be placed on electronic cigarette advertisements and packaging. To consider the value of additional warning messages on public health outcomes, this study examines the additive effect of new warnings that are based on recent claims from U.S. federal authorities. We conducted a secondary analysis of recent data from 1,202 U.S. youth ages 14-17 to test the impact of exposure to additional warnings placed on advertisements for vaping products on cognitive elaboration, fear, and willingness to vape and smoke. This investigation also looked closely at effects on youth who may have increased risk of future vaping due to prior vaping experiences or having friends who vape. Exposure to the alternative warnings did not amplify cognitive elaboration compared to the current FDA warning alone, but it did increase fear. Youth elaboration on both the benefits and risks of vaping was associated with willingness to both vape and smoke, but fear was not associated with either outcome. The effects of warning label exposure and cognitive elaboration varied by prior vaping experience and having at least one friend who vapes. We conclude by discussing the implications of this contingent pattern of effect and association.

Face Value: Remote facial expression analysis adds predictive power to perceived effectiveness for selecting anti-tobacco PSAs

Perceived effectiveness (PE) is a validated tool for predicting the potential impact of anti-tobacco public service announcements (PSAs). We set out to evaluate the added predictive value of facial expression analysis when combined with PE in a remote (online) survey. Each of 302 tobacco users watched 3 PSAs and allowed transmission of webcam videos from which metrics for "attention" (head position) and "facial action units" (FAU) were computed. The participants completed scales for their subjective emotions, willingness to share on social media, and intention to quit smoking using the Tobacco Free Florida website. Based on PE, both ready to quit (RTQ) and not ready (NR) respondents favored the same PSAs but RTQs assigned higher PE scores. Negative PSAs ("sad" or "frightening") were more compelling overall but RTQs also favored surprising ads and were more willing to share them on social media. Logistic regression showed that the combination of Attention + FAU+ PE (AUC = .816, p < .0001) outperformed single factors or factor combinations in distinguishing RTQ from NR. This study demonstrates that on-line assessment of facial expressions enhances the predictive value of PE and can be deployed on large remote samples.

The Effectiveness of Online Messages for Promoting Smoking Cessation Resources: Predicting Nationwide Campaign Effects From Neural Responses in the EX Campaign

What are the key ingredients that make some persuasive messages resonate with audiences and elicit action, while others fail? Billions of dollars per year are put towards changing human behavior, but it is difficult to know which messages will be the most persuasive in the field. By combining novel neuroimaging techniques and large-scale online data, we examine the role of key health communication variables relevant to motivating action at scale. We exposed a sample of smokers to anti-smoking web-banner messages from a real-world campaign while measuring message-evoked brain response patterns via fMRI, and we also obtained subjective evaluations of each banner. Neural indices were derived based on: (i) message-evoked activity in specific brain regions; and (ii) spatially distributed response patterns, both selected based on prior research and theoretical considerations. Next, we connected the neural and subjective data with an independent, objective outcome of message success, which is the per-banner click-through rate in the real-world campaign. Results show that messages evoking brain responses more similar to signatures of negative emotion and vividness had lower online click-through-rates. This strategy helps to connect and integrate the rapidly growing body of knowledge about brain function with formative research and outcome evaluation of health campaigns, and could ultimately further disease prevention efforts.

Strong health messages increase audience brain coupling

Mass media messaging is central for health communication. The success of these efforts, however, depends on whether health messages resonate with their target audiences. Here, we used electroencephalography (EEG) to capture brain responses of young adults - an important target group for alcohol prevention - while they viewed real-life video messages of varying perceived message effectiveness about risky alcohol use. We found that strong messages, which were rated to be more effective, prompted enhanced inter-subject correlation (ISC). In further analyses, we linked ISC to subsequent drinking behavior change and used time-resolved EEG-ISC to model functional neuroimaging data (fMRI) of an independent audience. The EEG measure was not only related to sensory-perceptual brain regions, but also to regions previously related to successful messaging, i.e., cortical midline regions and the insula. The findings suggest EEG-ISC as a marker for audience engagement and effectiveness of naturalistic health messages, which could quantify the impact of mass communication within the brains of small target audiences.