The Effects of Self vs. Group Affirmation and Message Framing on College Students' Vape-Free Campus Policy Support

How Do Behavioral Framing, Linguistic Certainty, and Target Specification Impact Responses to Vaping Prevention Messages?

While research on youth vaping prevention has begun to grow, little work has examined language choice in vaping prevention messages. This study examined adolescents' responses to vaping prevention statements that varied on three features: behavioral framing, linguistic certainty, and target specification. We conducted a 2 (behavioral framing) by 2 (linguistic certainty) by 2 (target specification) by 3 (risk type) plus control condition between-subjects experiment using a national probability sample. Adolescents (N = 1,603) were randomly assigned to one of 25 conditions in which they viewed a vaping prevention statement (or a control statement about vape litter) followed by measures of perceived message effectiveness (PME), perceived severity and susceptibility of vaping risks, message trustworthiness, message relevance, and intentions to seek more information about vaping risks. Results showed main effects of behavioral framing, such that a declarative frame ("Vaping can … ") led to higher PME, higher perceived severity, and greater information seeking intentions than a contingent frame ("If you vape, it can…"), while an interaction revealed that most declarative frame effects were driven by adolescents who were susceptible to vaping. There were also main effects of linguistic certainty, such that the word "can" ("Vaping can … ") led to higher PME, higher perceived susceptibility and severity, and greater information seeking intentions than the word "could" ("Vaping could … "). No main effect of target specification ("you" vs. "teens") was observed. Overall, findings suggest that vaping prevention messages that communicate greater certainty have greater behavior change potential.

Tobacco-free university campus policies: A systematic review

Objective: This systematic review aims to provide an update of the scientific evidence regarding tobacco-free/smoke-free campus policies (TFC/SFC), using a complex interventions approach.

PARTICIPANTS/METHODS

We searched the PubMed, Scopus and Web of Science databases using a combination of 'tobacco-free' or 'smoke-free', 'campus', 'university or college' and 'policy' search terms on all indexed articles published up until June 2023. Studies were included if they presented research on pre-/post-implementation of TFC/SFC or policy components. Two coders extracted and synthesized the data and assessed the risk of bias.

RESULTS

A total of 113 studies were included, reporting data from 2005 to 2023 across 17 countries. The data was categorized into three of the four phases of the Medical Research Council (MRC) framework, i.e. "feasibility (n=24), "implementation" (n=34), and "evaluation" (n=69). This review finds that a policy draft, communication, enforcement strategies, and cessation services are critical policy components. TCF/SFC are effective for reducing tobacco use and secondhand smoke exposure, but they also increase vaping. Little research has investigated the effect of TFC/SFC on smokeless tobacco use.

CONCLUSION

This review addresses remaining uncertainties in evidence on the TFC/SFC implementation process. We go on to provide a series of recommendations for university administrators.

Health Messaging Strategies for Vaping Prevention and Cessation Among Youth and Young Adults: A Systematic Review

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.

Scanned information exposure and support for tobacco regulations among US youth and young adult tobacco product users and non-users

The influences of information exposure on youth and young adults' (YYA) support for smoking/vaping regulations have been understudied. This study examines (i) the relationships between routine exposure to (i.e. scanning) anti-smoking/pro-vaping information and YYA support for anti-smoking/vaping regulations and (ii) whether these relationships differ across YYA users and non-users of tobacco products. We analyzed the data from a nationally representative two-wave rolling cross-sectional survey of YYA in the United States, collected from 2014 to 2017 (baseline n = 10 642; follow-up n = 4001). Less than 5% of the participants ever scanned pro-smoking and anti-vaping information. Scanning anti-smoking information had significant positive relationships with support for all anti-smoking policies cross-sectionally, and this pattern was longitudinally significant in two anti-smoking policy contexts. Scanning pro-vaping information had significant negative associations with support for anti-vaping policies cross-sectionally, but not longitudinally. The lagged positive relationships between scanning anti-smoking information and support for anti-smoking regulations were stronger among YYA smokers than among YYA non-smokers, whereas evidence from adult data suggested the opposite pattern. The findings suggest that scanning information can affect YYA support for tobacco regulations. Future efforts are required to investigate mechanisms underlying the influences of scanned information on YYA support for tobacco regulations.

Effects of Moral Frames Within Vaping Prevention Messages on Current smokers' Support for Electronic Cigarette Regulations

Given the rise of communication campaigns to prevent and reduce the use of electronic nicotine delivery systems among minors nationwide, it is important to examine whether certain preventive messages will spill over to affect current adult smokers' support for and compliance with vaping regulations. Drawing upon the Moral Foundations Theory, the current study experimentally examined the effects of moral frames on current adult smokers' support for vape-free policies and marketing restrictions. An online sample of current smokers (N = 630) was randomly assigned to a 3 (moral frames in vaping prevention : care, purity, non-moral control) × 2 (priming of anti-smoking messages: yes or no) between-subject survey experiment. Compared with non-moral framed messages, smokers exposed to both care and purity framed messages were more likely to support vape-free policies in public places. Such effects were stronger for smokers with higher pre-treatment endorsement of the purity value, driven less by anger or disgust but more by smokers' updating of both self-oriented and secondhand harm perceptions. Moral frames, especially those appealing to care and purity moral values, are thus promising messaging strategies for vaping prevention communication campaigns in terms of increasing current smokers' support for vape-free policies. The results also help improve our understanding of the moral roots of health policy opinions and the potential of deploying moral framing to improve message design for health campaigns.

Framing Youth Vaping Prevention Messages: The Role of Uncertainty Tolerance

Vaping is the most prevalent form of tobacco use among youth in the United States. Motivated by the certainty effect in prospect theory, this study investigated the role of uncertainty tolerance as a potential moderator of the effects of gain- vs. loss-framed text messages for youth vaping prevention. Youth susceptible to future vaping (N = 536) were randomized to view a series of eight gain- or loss-framed text messages about the health consequences of vaping. Cognitive and affective responses to the messages as well as beliefs, attitude, and intentions about vaping were assessed post-exposure. Results showed an overall advantage of the loss frame on several outcomes. Additionally, an interaction between framing and uncertainty tolerance was observed for most outcomes such that the loss frame was more effective for those high in uncertainty tolerance, while the gain frame held a slight edge for those low in uncertainty tolerance. Findings from this study have implications for further engaging prospect theory in message framing research. They may also inform audience segmentation and targeted message design for youth vaping prevention efforts.

Collective Value Promotes the Willingness to Share Pro-Vaccination Messages on Social Media in China: A Randomized Controlled Trial (Preprint)

Background

The proliferation of vaccine misinformation on social media has seriously corrupted the public’s confidence in vaccination. Proactively sharing provaccination messages on social media is a cost-effective way to enhance global vaccination rates and resist vaccine misinformation. However, few strategies for encouraging the public to proactively share vaccine-related knowledge on social media have been developed.

Objective

This research examines the effect of value type (individual vs collective) and message framing (gain vs loss) on influenza vaccination intention (experiment 1) and the willingness to share provaccination messages (experiment 2) among Chinese adults during the COVID-19 pandemic. The primary aim was to evaluate whether messages that emphasized collective value were more effective in increasing the willingness to share than messages that emphasized individual value.

Methods

We enrolled 450 Chinese adults for experiment 1 (n=250, 55.6%) and experiment 2 (n=200, 44.4%). Participants were randomly assigned to individual-gain, individual-loss, collective-gain, or collective-loss conditions with regard to the message in each experiment using the online survey platform’s randomization function. Experiment 1 also included a control group. The primary outcome was influenza vaccination intention in experiment 1 and the willingness to share provaccination messages in experiment 2.

Results

The valid sample included 213 adults in experiment 1 (females: n=151, 70.9%; mean age 29 [SD 9] years; at least some college education: n=202, 94.8%; single: n=131, 61.5%) and 171 adults in experiment 2 (females: n=106, 62.0%; mean age 28 [SD 7] years; at least some college education: n=163, 95.3%; single: n=95, 55.6%). Influenza vaccination intention was stronger in the individual-value conditions than in the collective-value conditions (F_3,166=4.96, P=.03, η²=0.03). The reverse result was found for the willingness to share provaccination messages (F_3,165=6.87, P=.01, η²=0.04). Specifically, participants who received a message emphasizing collective value had a higher intention to share the message than participants who read a message emphasizing individual value (F_3,165=6.87, P=.01, η²=0.04), and the perceived responsibility for message sharing played a mediating role (indirect effect=0.23, 95% lower limit confidence interval [LLCI] 0.41, 95% upper limit confidence interval [ULCI] 0.07). In addition, gain framing facilitated influenza vaccination intention more than loss framing (F_3,166=5.96, P=.02, η²=0.04). However, experiment 2 did not find that message framing affected message-sharing willingness. Neither experiment found an interaction between value type and message framing.

Conclusions

Strengthened individual value rather than collective value is more likely to persuade Chinese adults to vaccinate. However, these adults are more likely to share a message that emphasizes collective rather than individual value, and the perceived responsibility for message sharing plays a mediating role.