1
|
Wills TA, Maziak W, Asfar T, Roy S. Current perspective on e-cigarette use and respiratory outcomes: mechanisms and messaging. Expert Rev Respir Med 2024; 18:597-609. [PMID: 39101843 PMCID: PMC11405137 DOI: 10.1080/17476348.2024.2387090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/20/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION There has been an increasing amount of research on the consequences of e-cigarette use for respiratory outcomes, which is significant for public health and respiratory medicine. We discuss recent findings and lay out implications for prevention and treatment. AREAS COVERED Based on literature searches using several databases (PubMed, Web of Science, Google Scholar) for keywords, including synonyms, 'e-cigarettes,' with 'pulmonary function,' 'oxidative stress,' and 'inflammation,' we review studies on acute effects of e-cigarette use for measures of pulmonary function and discuss selected laboratory studies on mechanisms of effect, focusing on processes with known relation to respiratory disease; oxidative stress and inflammation. We discuss available studies that have tested the effectiveness of communication strategies for prevention of e-cigarette use oriented to different audiences, including nonsmoking adolescents and adult smokers. EXPERT OPINION We conclude that the evidence presents a mixed picture. Evidence is found for adverse consequences of e-cigarette use on measures of lung function and two disease-related biological processes, sometimes but not always less than for cigarette smoking. How to best communicate these results to a complex audience of users, from younger susceptible adolescents to long-term adult smokers interested in quitting, is a question of significant interest and empirically validated communication strategies are greatly needed.
Collapse
Affiliation(s)
- Thomas A Wills
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Simanta Roy
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| |
Collapse
|
2
|
Wu J, Benjamin EJ, Ross JC, Fetterman JL, Hong T. Health Messaging Strategies for Vaping Prevention and Cessation Among Youth and Young Adults: A Systematic Review. HEALTH COMMUNICATION 2024:1-19. [PMID: 38742648 DOI: 10.1080/10410236.2024.2352284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging strategies were defined as the strategic process of developing messages with the intent to shape, reinforce, or change recipients' health attitudes and behaviors. McGuire's Communication/Persuasion Model guided the analysis of the messaging strategies, focusing on the model's five communication inputs (i.e. source, message, channel, audience, destination) and 14 persuasive outcomes. Nine databases were searched from January 2007 to September 2023. The inclusion criteria encompassed studies in English that presented quantitative data on messaging strategies aimed at discouraging vaping among youth and young adults. Each study was also coded for study characteristics and the utilization of theory. Out of 6,045 studies, 25 met the inclusion criteria. The reviewed studies exhibit a diverse array of research methods and a consistent integration of theories. The review emphasizes the nuanced main and interaction effects of various communication inputs, such as message features and audience characteristics, while also pointing out a research gap in message sources. In addition, the utilization of social media for effective messaging to engage the audience requires further research. Only one study specifically evaluated messaging strategies for vaping cessation. More research is imperative to develop targeted and tailored messages that effectively prevent and reduce vaping, especially among populations at higher risk of vaping-related harms, while also leveraging effective channels and innovative communication technologies to engage the audience.
Collapse
Affiliation(s)
- Jiaxi Wu
- Annenberg School for Communication, University of Pennsylvania
| | - Emelia J Benjamin
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine
- Department of Epidemiology, Boston University School of Public Health
| | | | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University Chobanian & Avedisian School of Medicine
| | - Traci Hong
- College of Communication, Boston University
| |
Collapse
|
3
|
Kowitt SD, Goldstein AO, Cornacchione Ross J, Clark SA, Jarman KL, Sheeran P, Thrasher JF, Ranney LM. Perceived Effectiveness of Cigar Warnings in Discouraging Blunt Use. Nicotine Tob Res 2024; 26:512-516. [PMID: 37819722 PMCID: PMC10959065 DOI: 10.1093/ntr/ntad199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Many people remove the tobacco leaf from cigars and replace it with cannabis (ie, blunts), but few studies have examined whether messages about the risks of cigars, like warnings on cigar packages, can affect blunt use. METHODS Participants were 438 U.S. adults who reported past 30-day cigar use and ever blunt use, recruited from a probability-based national panel to take an online survey. In a 2 × 2 experiment with a between-subjects design, we manipulated two cigar warning characteristics: (1) warning type: text-only versus pictorial (ie, text + image) and (2) warning size: 30% (smaller) versus 50% (larger) of the product package. Participants then viewed six different warnings on a fictious cigarillo package, within their randomly assigned condition. After evaluating all stimuli, participants were asked the extent to which the warnings discouraged them from wanting to use cigars to smoke cannabis (ie, blunt perceived warning effectiveness). Response options ranged from "not at all" (1) to "a great deal" (5). RESULTS We observed no main effects of warning type or size on blunt perceived warning effectiveness. However, a significant interaction existed between the two experimental manipulations (p = .009). Whereas adding images made no difference to blunt perceived warning effectiveness when warnings were smaller (simple effect: -0.22, p = .28), images mattered for larger warnings. Specifically, adding images increased blunt perceived warning effectiveness when warnings were 50% of the product package (simple effect: 0.52, p = .008). CONCLUSIONS This experiment provides preliminary evidence that larger pictorial cigar warnings may discourage blunt use relative to larger but text-only warnings. IMPLICATIONS Blunts, which are hollowed out cigars with tobacco leaf wrappers that are filled with cannabis leaf, are one of the most common ways in which tobacco and cannabis are used simultaneously, yet few studies have examined whether messages about the risks of cigars can affect blunt use. We conducted an online experiment concerning the perceived effectiveness of cigar warnings among people who use blunts recruited from a probability-based panel. Results provide novel, preliminary evidence that larger pictorial cigar warnings may discourage blunt use, relative to larger but text-only warnings. More research evaluating cigar warnings on blunt use is needed.
Collapse
Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam O Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | - Sonia A Clark
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen L Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Leah M Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
4
|
MacMonegle A, Bennett M, Speer JL, O'Brien EK, Pitzer L, Jaarsma A, Nguyen Zarndt A, Duke J. Evaluating The Real Cost Digital and Social Media Campaign: Longitudinal Effects of Campaign Exposure on E-cigarette Beliefs. Nicotine Tob Res 2024; 26:S19-S26. [PMID: 38366338 DOI: 10.1093/ntr/ntad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Over the past decade, youth e-cigarette use has risen exponentially. At the same time, digital media use increased markedly while the use of traditional broadcast TV declined. In response, the U.S. Food and Drug Administration's The Real Cost public education campaign shifted to communicating the harms of e-cigarette via primarily digital and social platforms. This study evaluated longitudinal associations between exposure to campaign advertisements and changes in campaign-specific beliefs among US youth. METHODS A nationally representative longitudinal cohort of youth (aged 11-16 years at baseline) was surveyed five times. Building on earlier work, we analyzed data from the last three waves (April-July 2020; January-April 2021; and August-October 2021; N = 2625). We assessed self-reported exposure to six ads and agreement with 11 beliefs that were each targeted by one or more ads. Eleven weighted panel regression models assessed whether ad exposure predicted changes in campaign-specific beliefs over time. RESULTS We observed significant associations between ad exposure and increases in at least one campaign-specific belief for five of the six ads. Across the 11 beliefs, we observed associations between increased exposure and increases in 6 beliefs related to e-cigarettes and toxic metals, lung damage, dangerous ingredients, anxiety, cigarette use, and disappointing important people. CONCLUSIONS We found evidence that self-reported exposure to this digital and social media campaign was successful at influencing youth, providing support for the effectiveness of the campaign's adaption to address youth's changes in tobacco and media use habits. IMPLICATIONS The Food and Drug Administration's The Real Cost public education campaign educates youth about the dangers of e-cigarette use. This study evaluates longitudinal associations between exposure to The Real Cost's advertisements and changes in campaign-specific beliefs among youth. Considering evolving trends in youth media consumption, the campaign adapted its media approach to increase delivery across digital and social media platforms. Our findings indicate that the campaign reached its intended audience and increased youth beliefs around the harm of e-cigarettes and the consequences of e-cigarette use, offering evidence for the effectiveness of digital and social media youth prevention efforts within a fragmented digital environment.
Collapse
Affiliation(s)
- Anna MacMonegle
- RTI International, Research Triangle Park, North Carolina, USA
| | - Morgane Bennett
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jessica L Speer
- RTI International, Research Triangle Park, North Carolina, USA
| | - Erin Keely O'Brien
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lindsay Pitzer
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Allie Jaarsma
- RTI International, Research Triangle Park, North Carolina, USA
| | - Anh Nguyen Zarndt
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jennifer Duke
- RTI International, Research Triangle Park, North Carolina, USA
| |
Collapse
|
5
|
Barnes C, Turon H, McCrabb S, Hodder RK, Yoong SL, Stockings E, Hall AE, Bialek C, Morrison JL, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2023; 11:CD015511. [PMID: 37965949 PMCID: PMC10646968 DOI: 10.1002/14651858.cd015511.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND The prevalence of e-cigarette use has increased globally amongst children and adolescents in recent years. In response to the increasing prevalence and emerging evidence about the potential harms of e-cigarettes in children and adolescents, leading public health organisations have called for approaches to address increasing e-cigarette use. Whilst evaluations of approaches to reduce uptake and use regularly appear in the literature, the collective long-term benefit of these is currently unclear. OBJECTIVES The co-primary objectives of the review were to: (1) evaluate the effectiveness of interventions to prevent e-cigarette use in children and adolescents (aged 19 years and younger) with no prior use, relative to no intervention, waitlist control, usual practice, or an alternative intervention; and (2) evaluate the effectiveness of interventions to cease e-cigarette use in children and adolescents (aged 19 years and younger) reporting current use, relative to no intervention, waitlist control, usual practice, or an alternative intervention. Secondary objectives were to: (1) examine the effect of such interventions on child and adolescent use of other tobacco products (e.g. cigarettes, cigars types, and chewing tobacco); and (2) describe the unintended adverse effects of the intervention on individuals (e.g. physical or mental health of individuals), or on organisations (e.g. intervention displacement of key curricula or learning opportunities for school students) where such interventions are being implemented. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Clarivate Web of Science Core Collection from inception to 1 May 2023. Additionally, we searched two trial registry platforms (WHO International Clinical Trials Registry Platform; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov), Google Scholar, and the reference lists of relevant systematic reviews. We contacted corresponding authors of articles identified as ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, factorial RCTs, and stepped-wedge RCTs. To be eligible, the primary targets of the interventions must have been children and adolescents aged 19 years or younger. Interventions could have been conducted in any setting, including community, school, health services, or the home, and must have sought to influence children or adolescent (or both) e-cigarette use directly. Studies with a comparator of no intervention (i.e. control), waitlist control, usual practice, or an alternative intervention not targeting e-cigarette use were eligible. We included measures to assess the effectiveness of interventions to: prevent child and adolescent e-cigarette use (including measures of e-cigarette use amongst those who were never-users); and cease e-cigarette use (including measures of e-cigarette use amongst children and adolescents who were e-cigarette current-users). Measures of e-cigarette use included current-use (defined as use in the past 30 days) and ever-use (defined as any lifetime use). DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of references, with any discrepancies resolved through consensus. Pairs of review authors independently assessed the full-text articles for inclusion in the review. We planned for two review authors to independently extract information from the included studies and assess risk of bias using the Cochrane RoB 2 tool. We planned to conduct multiple meta-analyses using a random-effects model to align with the co-primary objectives of the review. First, we planned to pool interventions to prevent child and adolescent e-cigarette use and conduct two analyses using the outcome measures of 'ever-use' and 'current-use'. Second, we planned to pool interventions to cease child and adolescent e-cigarette use and conduct one analysis using the outcome measure of 'current-use'. Where data were unsuitable for pooling in meta-analyses, we planned to conduct a narrative synthesis using vote-counting approaches and to follow the Cochrane Handbook for Systematic Reviews of Interventions and the Synthesis Without Meta-analysis (SWiM) guidelines. MAIN RESULTS The search of electronic databases identified 7141 citations, with a further 287 records identified from the search of trial registries and Google Scholar. Of the 110 studies (116 records) evaluated in full text, we considered 88 to be ineligible for inclusion for the following reasons: inappropriate outcome (27 studies); intervention (12 studies); study design (31 studies); and participants (18 studies). The remaining 22 studies (28 records) were identified as ongoing studies that may be eligible for inclusion in a future review update. We identified no studies with published data that were eligible for inclusion in the review. AUTHORS' CONCLUSIONS We identified no RCTs that met the inclusion criteria for the review, and as such, there is no evidence available from RCTs to assess the potential impact of interventions targeting children and adolescent e-cigarette use, tobacco use, or any unintended adverse effects. Evidence from studies employing other trial designs (e.g. non-randomised) may exist; however, such studies were not eligible for inclusion in the review. Evidence from studies using non-randomised designs should be examined to guide actions to prevent or cease e-cigarette use. This is a living systematic review. We search for new evidence every month and update the review when we identify relevant new evidence. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
Collapse
Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Heidi Turon
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Jacob L Morrison
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| |
Collapse
|
6
|
Agbonlahor O, Mattingly DT, Rai J, Hart JL, McLeish AC, Walker KL. Differences in health care provider screening for tobacco use among youth in the United States: The National Youth Tobacco Survey, 2021. Prev Med 2023; 175:107718. [PMID: 37793477 PMCID: PMC10681140 DOI: 10.1016/j.ypmed.2023.107718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Health care providers (HCP) are encouraged to screen youth for tobacco product use as a key step in preventing such use and associated health outcomes. However, recent data examining differences in HCP tobacco screening by sociodemographic characteristics and tobacco use is scant. METHODS Data from the 2021 National Youth Tobacco Survey (N = 14,685) were analyzed. Three types of HCP screening were examined: no screening, any e-cigarette use (e-cigarette only, e-cigarette and other tobacco), and non-e-cigarette tobacco product use. Differences by HCP screening were examined using multinomial logistic regression adjusted for age, sex, gender identity, sexual orientation, race/ethnicity, and tobacco use (non-current, sole, dual/poly). RESULTS Among the sample, 42.8% were screened for any tobacco use, with 30.6% screened for any e-cigarette use and 12.2% for non-e-cigarette tobacco product use only. Youth who were older (vs. younger) (OR = 5.98, 95% CI: 4.78-7.49) and gay/lesbian (vs. heterosexual) (OR = 1.47, 95% CI: 1.02-2.12) were more likely to be screened for e-cigarette use. Youth who were non-Hispanic Black (vs. non-Hispanic White) were less likely to be screened for e-cigarette use (OR = 0.53, 95% CI: 0.42-0.67) and more likely to be screened for non-e-cigarette tobacco use (OR = 1.34, 95% CI: 1.10-1.63). Current sole tobacco use (vs. non-current use) and dual/poly tobacco use (vs. non-current use) increased the likelihood for HCP screening for e-cigarette use. CONCLUSIONS The majority of U.S. youth continue to not be screened for tobacco use by their HCP. Evidence of disparities in tobacco use screening suggest the need for policies and training that promote equity in screening.
Collapse
Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, College of Arts and Sciences, University of Louisville, Louisville, KY, USA; Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Delvon T Mattingly
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA; Center for Health Equity Transformation, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Jayesh Rai
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Joy L Hart
- Department of Communication, College of Arts and Sciences, University of Louisville, Louisville, KY, USA; Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA; American Heart Association Tobacco Center for Regulatory Science, Dallas, TX, USA.
| | - Alison C McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA; American Heart Association Tobacco Center for Regulatory Science, Dallas, TX, USA; Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Kandi L Walker
- Department of Communication, College of Arts and Sciences, University of Louisville, Louisville, KY, USA; Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY, USA; American Heart Association Tobacco Center for Regulatory Science, Dallas, TX, USA
| |
Collapse
|
7
|
Noar SM, Gottfredson NC, Kieu T, Rohde JA, Hall MG, Ma H, Fendinger NJ, Brewer NT. Impact of Vaping Prevention Advertisements on US Adolescents: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2236370. [PMID: 36227597 PMCID: PMC9561946 DOI: 10.1001/jamanetworkopen.2022.36370] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022] Open
Abstract
Importance Understanding whether prevention advertisements reduce susceptibility to vaping is important owing to concerning levels of adolescent vaping. Objective To examine whether vaping prevention advertisements from the US Food and Drug Administration (FDA) national Real Cost campaign lead to lower susceptibility to vaping among adolescents. Design, Setting, and Participants For this 3-group randomized clinical trial with parallel assignment, participants were US adolescents aged 13 to 17 years who were susceptible to vaping or current e-cigarette users, recruited from online panels. Adolescents were randomized to 1 of 2 Real Cost vaping prevention trial groups (health harms- or addiction-themed advertisements) or to a control group (investigator-created neutral videos about vaping). Adolescents completed 4 weekly online surveys at visits 1 to 4 over a 3-week period. Data were analyzed from December 1, 2021, to August 25, 2022. Interventions Adolescents saw 3 randomly ordered 30-second video advertisements online at each of 3 weekly study visits (visits 1, 2, and 3). Main Outcomes and Measures The primary trial outcome was susceptibility to vaping. Surveys also assessed susceptibility to smoking cigarettes to examine any spillover effects of vaping prevention advertisements on smoking outcomes. Both susceptibility measures had 3 items and ranged from 1 (indicating not susceptible) to 4 (indicating highly susceptible). The primary analyses compared Real Cost groups (combined) with the control group, while exploratory analyses compared the Real Cost groups with each other. Results Participants were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years), including 504 randomized to the Real Cost health harms group, 506 randomized to the Real Cost addiction group, and 504 randomized to the control group. Adolescents in the Real Cost groups (combined) had lower susceptibility to vaping at visit 4 than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). The Real Cost groups did not differ from one another on susceptibility to vaping (visit 4: b = -0.05; 95% CI, -0.17 to 0.07). Adolescents in the Real Cost groups (combined) also had lower susceptibility to smoking cigarettes than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). For both vaping and smoking, Real Cost groups had less positive attitudes (vaping: b = -0.27; 95% CI, -0.40 to -0.14; smoking: b = -0.23; 95% CI, -0.39 to -0.08) compared with the control group. Conclusions and Relevance These findings suggest that vaping prevention advertisements from the FDA Real Cost campaign led to lower adolescent susceptibility to vaping and had beneficial spillover effects on cigarette smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco use. Trial Registration ClinicalTrials.gov Identifier: NCT04836455.
Collapse
Affiliation(s)
- Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | - Nisha C. Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Talia Kieu
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Jacob A. Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Marissa G. Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
- Carolina Population Center, University of North Carolina, Chapel Hill
| | - Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | | | - Noel T. Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| |
Collapse
|