1
|
Jones D, Morgan A, Moodie C, Alexandrou G, Ford A, Mitchell D. The Role of e-Cigarette Packaging as a Health Communications Tool: A Focus Group Study With Adolescents and Adults in England and Scotland. Nicotine Tob Res 2024:ntae107. [PMID: 38839060 DOI: 10.1093/ntr/ntae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/26/2024] [Accepted: 04/25/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION In the United Kingdom, e-cigarette and refill packaging must display a nicotine addiction warning. This study explored how this message is perceived, responses to alternative on-pack messages, and other options for using e-cigarette packaging to discourage youth and people who neither smoke nor use e-cigarettes while encouraging smokers to switch. AIMS AND METHODS Between August and September 2022, 16 focus groups (n = 70) were conducted to explore these topics with adolescents (n = 31, aged 11-17 years) and adults (n = 39, nonsmokers, smokers that use e-cigarettes, smokers that do not use e-cigarettes) in England and Scotland. RESULTS While several participants thought the current nicotine addiction warning could help increase awareness of nicotine addiction, most reported that it failed to capture attention and was not a deterrent. Alternative messages shown on packs (about harm, toxicity, wellness, litter, or relative risk) received mixed responses. Relative risk messages were perceived as most beneficial for smokers switching but also thought to potentially encourage uptake among nonsmokers. Some participants considered certain harm and toxicity messages to potentially dissuade uptake. Participants proposed several ideas to reduce the appeal of e-cigarette packaging and devices to deter youth uptake, including more prominent warnings, standardized packaging, and devices that are plain or include health messages. CONCLUSIONS Packaging can play a crucial role in communicating product and health messages to different consumer groups. Further consideration of how packaging and labeling can meet the needs of non-nicotine users while simultaneously reaching those who may benefit from using e-cigarettes to stop smoking is warranted. IMPLICATIONS While some viewed the nicotine addiction warning required on e-cigarettes and refill packaging in the United Kingdom as helpful in raising awareness of nicotine addiction, it did not resonate with most of our sample of adolescents and adults. The findings suggest that e-cigarette packaging could be better used to encourage smokers to switch to a less harmful alternative, with relative risk messages showing promise. Furthermore, strengthening on-pack messaging (eg increasing salience and rotating messages) and reducing the appeal of packaging (eg drab colors) and devices (eg including warnings) may help increase awareness of e-cigarette harms while deterring use among adolescents and nonsmokers.
Collapse
Affiliation(s)
- Daniel Jones
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Amber Morgan
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Georgia Alexandrou
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Allison Ford
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Danielle Mitchell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| |
Collapse
|
2
|
East K, Vu G, Sun T, D'Mello K, Perman-Howe PR, Taylor E, Nottage M, Brose LS, Robson D, McNeill A. Harm perceptions across vaping product features: An on-line cross-sectional survey of adults who smoke and/or vape in the United Kingdom. Addiction 2024. [PMID: 38839597 DOI: 10.1111/add.16572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/01/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND AND AIMS Vaping products are diverse with a wide variety of features, and popular products change rapidly. This study examined the features and types of vaping products that people who smoke and/or vape perceive contribute to the health harms of vaping. DESIGN, SETTING AND PARTICIPANTS This was a cross-sectional survey co-designed with adults who smoked/vaped and pre-registered. An on-line survey (November 2022) was used of a convenience sample of adults in the United Kingdom who smoked and/or vaped (n = 494). MEASUREMENTS As primary outcomes, respondents were asked to select any of 15 vaping product features they perceived might have any effect on the health harms of vaping (for each: selected, not selected). Independent variables were smoking/vaping status (smoke and vape; vape, formerly smoked; vape, never regularly smoked; smoke, do not currently vape); relative vaping harm perceptions [less harmful than smoking (accurate), equally/more harmful than smoking or do not know/refused (other)]. Binary logistic regressions were used to compare outcomes by current vaping/smoking status and relative harm perceptions, adjusting for age and sex. FINDINGS Most people (54.7%) selected between one and three features. The most frequently selected were nicotine concentration (62.2%) and amount of e-liquid consumed (59.1%), followed by nicotine type (e.g. salt or freebase; 33.0%), source/purchase location (25.3%), flavours (24.7%), temperature to heat e-liquid (21.1%), heat produced by device (20.9%), e-liquid brand (20.9%), amount of emissions (18.6%), device type (e.g. disposable, pod, tank; 17.2%), material of tank (17.0%), power/wattage (13.0%), device brand (8.1%), device size (4.1%) and device weight (2.4%). Higher nicotine concentrations, more e-liquid and salt (versus freebase) nicotine were perceived to confer greater harms. Disposables were perceived as slightly more harmful than reusable devices. There were few differences by current vaping/smoking status and between those with accurate (versus other) harm perceptions of vaping relative to smoking (P > 0.05 for most contrasts, adjusting for age and sex). CONCLUSIONS Certain features and types of vaping products [higher nicotine concentrations, more e-liquid consumed and salt (versus freebase) nicotine] were perceived to confer greater health harms among a sample of UK adults who smoked and/or vaped. Findings are consistent with pervasive misperceptions that nicotine is a major cause of harm, although e-liquid volume is likely to contribute to harms.
Collapse
Affiliation(s)
- Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Giang Vu
- National Centre for Youth Substance Use Research, University of Queensland, St Lucia, Queensland, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, University of Queensland, St Lucia, Queensland, Australia
| | - Kimberly D'Mello
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Parvati Rose Perman-Howe
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Eve Taylor
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matilda Nottage
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Leonie Sarah Brose
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Deborah Robson
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
3
|
Popova L, Massey ZB, Giordano NA. Warning Labels as a Public Health Intervention: Effects and Challenges for Tobacco, Cannabis, and Opioid Medications. Annu Rev Public Health 2024; 45:425-442. [PMID: 38166502 DOI: 10.1146/annurev-publhealth-060922-042254] [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] [Indexed: 01/04/2024]
Abstract
Warning labels help consumers understand product risks, enabling informed decisions. Since the 1966 introduction of cigarette warning labels in the United States, research has determined the most effective message content (health effects information) and format (brand-free packaging with pictures). However, new challenges have emerged. This article reviews the current state of tobacco warning labels in the United States, where legal battles have stalled pictorial cigarette warnings and new products such as electronic cigarettes and synthetic nicotine products pose unknown health risks. This article describes the emerging research on cannabis warnings; as more places legalize recreational cannabis, they are adopting lessons from tobacco warnings. However, its uncertain legal status and widespread underestimation of harms impede strict warning standards. The article also reviews opioid medication warning labels, suggesting that lessons from tobacco could help in the development of effective and culturally appropriate FDA-compliant opioid warning labels that promote safe medication use and increased co-dispensing of naloxone.
Collapse
Affiliation(s)
- Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA;
| | - Zachary B Massey
- School of Journalism, University of Missouri, Columbia, Missouri, USA
| | - Nicholas A Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
4
|
Wang L, Siau CS, Baharom N, Hairol MI, Huang L, Wee LH. Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China. Int J Gen Med 2024; 17:895-907. [PMID: 38476623 PMCID: PMC10929557 DOI: 10.2147/ijgm.s430997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use. Participants and Methods This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC. Results There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models. Conclusion There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.
Collapse
Affiliation(s)
- Li Wang
- Ya’an Polytechnic College, Ya’an, Sichuan, 625000, People’s Republic of China
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Nizam Baharom
- Primer Healthcare Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, 71800, Malaysia
| | - Mohd Izzuddin Hairol
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Lixin Huang
- Chengdu Sport University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Lei Hum Wee
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, 47500, Malaysia
- Non-Communicable Diseases and Public Health Research Group, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, 47500, Malaysia
- Digital Health and Innovations Impact Lab, Taylor’s University, Subang Jaya, 47500, Malaysia
| |
Collapse
|
5
|
East K, Taylor E, Simonavičius E, Nottage M, Reid JL, Burkhalter R, Brose L, Wackowski OA, Liber AC, McNeill A, Hammond D. Noticing education campaigns or public health messages about vaping among youth in the United States, Canada and England from 2018 to 2022. HEALTH EDUCATION RESEARCH 2024; 39:12-28. [PMID: 38165724 PMCID: PMC10805379 DOI: 10.1093/her/cyad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 01/04/2024]
Abstract
Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the United States and Canada since 2018 and in England since 2017 but with differing focus: youth vaping prevention (United States/Canada) and smoking cessation (England). We therefore examined country differences and trends in noticing vaping campaigns among youth and, using 2022 data only, perceived valence of campaigns and associations with harm perceptions. Seven repeated cross-sectional surveys of 16-19 year-olds in United States, Canada and England (2018-2022, n = 92 339). Over half of youth reported noticing vaping campaigns, and noticing increased from August 2018 to February 2020 (United States: 55.2% to 74.6%, AOR = 1.21, 95% CI = 1.18-1.24; Canada: 52.6% to 64.5%, AOR = 1.13, 1.11-1.16; England: 48.0% to 53.0%, AOR = 1.05, 1.02-1.08) before decreasing (Canada) or plateauing (England/United States) to August 2022. Increases were most pronounced in the United States, then Canada. Noticing was most common on websites/social media, school and television/radio. In 2022 only, most campaigns were perceived to negatively portray vaping and this was associated with accurately perceiving vaping as less harmful than smoking among youth who exclusively vaped (AOR = 1.46, 1.09-1.97). Consistent with implementation of youth vaping prevention campaigns in the United States and Canada, most youth reported noticing vaping campaigns/messages, and most were perceived to negatively portray vaping.
Collapse
Affiliation(s)
- Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Eve Taylor
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
| | - Erikas Simonavičius
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
| | - Matilda Nottage
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Leonie Brose
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
| | - Olivia A Wackowski
- School of Public Health, Rutgers, The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ 08854, USA
| | - Alex C Liber
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Road NW, Washington, DC 20007, USA
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, London SE5 8BB, UK
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| |
Collapse
|
6
|
Sala M, Gotti C. Electronic nicotine delivery systems (ENDS): A convenient means of smoking? Pharmacol Res 2023; 195:106885. [PMID: 37634554 DOI: 10.1016/j.phrs.2023.106885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023]
Abstract
Electronic nicotine delivery systems (ENDS), which are becoming increasingly popular in many parts of the world, have recently become more sophisticated in terms of their more active content and better controlled vaporisation. This review begins by describing how cigarette smoking led to the development of ENDS as a means of combatting nicotine addiction. ENDS are usually categorised as belonging to one of only three main generations, but a fourth has been added in order to differentiate the latest, most powerful, most advanced and innovative that have improved heating efficiency. Descriptions of the principal substances contained in ENDS are followed by considerations concerning the risk of toxicity due to the presence of albeit low concentrations of such a variety of compounds inhaled over a long time, and the increasingly widespread use of ENDS as a means of smoking illicit drugs. We also review the most widely used pharmacotherapeutic approaches to smoking cessation, and recent epidemiological data showing that ENDS can help some people to stop smoking. However, in order to ensure their appropriate regulation, there is a need for higher-quality evidence concerning the health effects and safety of ENDS, and their effectiveness in discouraging tobacco smoking.
Collapse
Affiliation(s)
- Mariaelvina Sala
- Institute of Neuroscience, CNR-Milan Unit, c/o Bldg. U28, University of Milano-Bicocca, Via Follereau 3, 20854 Vedano al Lambro, MB, Italy; NeuroMi Milan Center for Neuroscience University of Milano Bicocca,Italy.
| | - Cecilia Gotti
- Institute of Neuroscience, CNR-Milan Unit, c/o Bldg. U28, University of Milano-Bicocca, Via Follereau 3, 20854 Vedano al Lambro, MB, Italy; NeuroMi Milan Center for Neuroscience University of Milano Bicocca,Italy
| |
Collapse
|
7
|
Ma H, Kieu TKT, Ribisl KM, Noar SM. Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies. HEALTH COMMUNICATION 2023; 38:1709-1722. [PMID: 36882378 PMCID: PMC10258164 DOI: 10.1080/10410236.2023.2185578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vaping prevention messages are widely used to communicate the health harms and addiction risks of vaping and discourage vaping among adolescents and young adults. We conducted a meta-analysis of experimental studies to examine the effects of these messages and to understand their theoretical mechanisms. Systematic, comprehensive searches generated 4,451 references, among which 12 studies (cumulative N = 6,622) met inclusion criteria for the meta-analysis. Across these studies, a total of 35 different vaping-related outcomes were measured, and 14 outcomes assessed in two or more independent samples were meta-analyzed. Results showed that compared to control, exposure to vaping prevention messages led to higher vaping risk perceptions, including harm perceptions (d = 0.30, p < .001), perceived likelihood of harm (d = 0.23, p < .001), perceived relative harm (d = 0.14, p = .036), addiction perceptions (d = 0.39, p < .001), perceived likelihood of addiction (d = 0.22, p < .001), and perceived relative addiction (d = 0.33, p = .015). Also, compared to control, exposure to vaping prevention messages led to more vaping knowledge (d = 0.37, p < .001), lower intentions to vape (d = -0.09, p = .022), and higher perceived message effectiveness (message perceptions; d = 0.57, p < .001; effects perceptions; d = 0.55, p < .001). Findings suggest vaping prevention messages have an impact, yet may operate through different theoretical mechanisms than cigarette pack warnings.
Collapse
Affiliation(s)
- Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Talia Klm-Thanh Kieu
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kurt M. Ribisl
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Seth M. Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
8
|
Kumar N, Hampsher S, Walter N, Nyhan K, De Choudhury M. Interventions to mitigate vaping misinformation: protocol for a scoping review. Syst Rev 2022; 11:214. [PMID: 36210470 PMCID: PMC9548303 DOI: 10.1186/s13643-022-02094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/01/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The impact of misinformation about vapes' relative harms compared with smoking may lead to increased tobacco-related burden of disease. To date, no systematic efforts have been made to chart interventions that mitigate vaping-related misinformation. We plan to conduct a scoping review that seeks to fill gaps in the current knowledge of interventions that mitigate vaping-related misinformation. METHODS A scoping review focusing on interventions that mitigate vaping-related misinformation will be conducted. We will search (no date restrictions) MEDLINE, Scopus, EMBASE, CINAHL, PsycINFO, Web of Science Core Collection, Global Health, ERIC, and Sociological Abstracts. Gray literature will be identified using Disaster Lit, Google Scholar, Open Science Framework, governmental websites, and preprint servers (e.g., EuropePMC, PsyArXiv, MedRxiv, JMIR Preprints). Study selection will conform to Joanna Briggs Institute Reviewers' Manual 2020 Methodology for JBI Scoping Reviews. Only English language, original studies will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. Where possible, a single effect size of exposure to the mitigation of vaping-related misinformation will be calculated per sample. Similarly, where possible, each study will be coded for moderating characteristics to find and account for systematic differences in the size of the effect or outcome that is being analyzed. Quality will be appraised with the study quality assessment tools utilized by the National Heart, Lung, and Blood Institute. Findings will be subjected to several different publication bias tests: Egger's regression test, Begg and Mazumdar's ran correlation test, and generation of a funnel plot with effect sizes plotted against a corresponding standard error. DISCUSSION Original research is urgently needed to design interventions to mitigate vaping-related misinformation. The planned scoping review will help to address this gap. SYSTEMATIC REVIEW REGISTRATION Open Science Framework osf/io/hy3tk.
Collapse
Affiliation(s)
- Navin Kumar
- Yale School of Medicine, New Haven, CT, USA.
| | | | | | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar Street, New Haven, CT, 06520-8014, USA.,Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | | |
Collapse
|
9
|
Kim S, Shiffman S, Sembower MA. US adult smokers' perceived relative risk on ENDS and its effects on their transitions between cigarettes and ENDS. BMC Public Health 2022; 22:1771. [PMID: 36123722 PMCID: PMC9484256 DOI: 10.1186/s12889-022-14168-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Perceived risk reduction motivates smokers to switch to electronic nicotine delivery systems (ENDS). This research examines US smokers’ relative risk perceptions and their prospective association with various behavioral stages of switching to ENDS. Methods Data from the nationally representative, longitudinal Population Assessment of Tobacco and Health (PATH) Adult survey, Waves 1 (2014) through 5 (2019), were analyzed. We assessed the association between the perceived risk of ENDS relative to cigarettes (“less harmful” vs. “equally harmful” or “more harmful”) and 1) adoption of ENDS (among never-ENDS-using smokers), 2) complete switching to ENDS (i.e., stopping smoking, among ever-ENDS-using smokers), and 3) avoiding reversion to smoking (among smokers who had switched to ENDS), at the next wave. Results The proportion of US smokers perceiving ENDS as less harmful than cigarettes continually decreased, reaching 17.4% in Wave 5 (2019). Current smokers with such belief were more likely to adopt ENDS (aOR 1.31; 95% CI 1.15–1.50) and switch completely to ENDS (aOR 2.24; 95% CI 1.89–2.65) in the subsequent wave. Among smokers who had switched within the past year, such beliefs predicted avoidance of resumption of smoking in the next wave (aOR 0.55; 95% CI 0.33–0.93). Conclusions Smokers’ beliefs about the relative risk of ENDS compared to cigarettes had a strong and consistent association with transitions between smoking and ENDS use. Addressing the growing misperception about ENDS has the potential to contribute to public health by encouraging smokers’ switching to ENDS. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14168-8.
Collapse
Affiliation(s)
- Sooyong Kim
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA.
| | - Saul Shiffman
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA
| | - Mark A Sembower
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA
| |
Collapse
|
10
|
Cabedo-Peris J, González-Sala F, Merino-Soto C, Pablo JÁC, Toledano-Toledano F. Decision Making in Addictive Behaviors Based on Prospect Theory: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10091659. [PMID: 36141271 PMCID: PMC9498454 DOI: 10.3390/healthcare10091659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 01/10/2023] Open
Abstract
Traditionally, research on addictive behaviors has been based on the study of their risk factors, with impulsivity being the main risk factor. However, this study aims to approach this topic from the analysis of decision making. According to the prospect theory, low levels of loss and risk aversion will increase the probability of showing addictive behaviors. A systematic review of the possible relationships between these behaviors and prospect theory was carried out. To this end, the works that have studied loss and risk aversion in populations with addictive behaviors to date (N = 15) were compiled. Apart from other eligibility criteria, the selection process was only performed with studies that included the prospect theory or cumulative prospect theory, in English or Spanish, since 1979. WoS, Scopus, Dialnet and PsycInfo were the information sources selected. For this purpose, PRISMA guidelines have been followed. It was found that users of addictive substances show less loss aversion than nonusers. These results cannot be transferred to pathological gamblers. The significance of this work for future research and the implementation of prevention and intervention programs is highlighted. The results show an approach to addictions from a novel perspective.
Collapse
Affiliation(s)
- Javier Cabedo-Peris
- Departamento de Psicología Básica, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - Francisco González-Sala
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain
| | - César Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, 15011 Lima, Peru
| | - José Ángel Cahua Pablo
- Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Lázaro Cárdenas, El Centenario, Chilpancingo de los Bravo, Chilpancingo 39086, Mexico
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez National Institute of Health, Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Sociomédica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Correspondence: ; Tel.: +52-5580094677
| |
Collapse
|
11
|
Lee DN, Liu J, Keller-Hamilton B, Patterson JG, Wedel AV, Vázquez-Otero C, Stevens EM. Associations between perceived source credibility, e-cigarettes, and e-cigarette ad perceptions. Prev Med Rep 2022; 28:101862. [PMID: 35733610 PMCID: PMC9207267 DOI: 10.1016/j.pmedr.2022.101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/25/2022] [Accepted: 06/09/2022] [Indexed: 10/28/2022] Open
Abstract
The use of e-cigarettes among U.S. adults remains high, and aggressive industry advertising is a contributor. Consumer opinions of the e-cigarette industry's credibility can influence e-cigarette product and ad perceptions. The purpose of this study was to examine the association of perceived source credibility of e-cigarette ads and consumer attitudes toward e-cigarette ads and product use. In October 2021, we conducted a survey using an online convenience sample (N = 497, Mage = 31.9). Participants viewed two randomly selected e-cigarette ads and were asked questions regarding source credibility, perceptions of the ads, and e-cigarette use. Linear mixed effects models with random intercepts were used to estimate associations between perceived source credibility with perceived ad relevance, effectiveness, liking, product use interest, and e-cigarette harms perceptions. We also tested whether associations between perceived source credibility and ad and e-cigarette perceptions were moderated by e-cigarette use. Models controlled for cigarette smoking status, age, sex, race, ethnicity, sexual orientation, and income. Perceived source credibility was positively associated with increased perceived ad relevance, effectiveness, liking, and product use interest (ps < 0.001). E-cigarette use moderated associations of perceived source credibility and perceived ad relevance, perceived ad effectiveness, and interest in using e-cigarettes, with associations being strongest among never users. Findings suggest that tobacco control messaging aiming to reduce the credibility of the e-cigarette industry might be most effective among adults who have never used e-cigarettes.
Collapse
Affiliation(s)
- Donghee N. Lee
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
| | - Jessica Liu
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, The Ohio State University College of Medicine, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Joanne G. Patterson
- Division of Epidemiology, The Ohio State University College of Public Health, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Amelia V. Wedel
- Department of Clinical Psychology, Syracuse University, Syracuse, NY, USA
| | - Coralia Vázquez-Otero
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
| |
Collapse
|
12
|
Demeshko A, Buckley L, Morphett K, Adams J, Meany R, Cullerton K. Characterising trusted spokespeople in noncommunicable disease prevention: A systematic scoping review. Prev Med Rep 2022; 29:101934. [PMID: 35942296 PMCID: PMC9356185 DOI: 10.1016/j.pmedr.2022.101934] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 12/03/2022] Open
Abstract
Noncommunicable diseases (NCD) are an increasing global threat. Utilising public policy to address NCDs can reduce incidence and prevalence. However, NCD-relevant public policy action is minimal in many countries as changing public policy is difficult and multifactorial. Two factors that may influence this process is the message people receive and the messenger delivering it. To date, much health communication research has focused on message content, with limited research on messengers that are trusted by policymakers and the public to communicate NCD matters. We aimed to review the literature to characterise who the public and policymakers consider to be trustworthy and/or credible for NCD messaging, and why this might be the case. Arksey and O'Malley's scoping review methodology guided the review. A systematic search of three databases up to June 2021 combined with hand searching of review reference lists was undertaken. Nineteen articles were included. Data extraction focused on study design, issue being influenced, spokesperson studied, and measures of trust. Results showed health professionals were the most-frequently trusted sources of information. Other spokespeople, such as government sources or religious leaders, were only trustworthy in some contexts, and even distrusted in others. Reasons why spokespeople were trusted included technical expertise, strategic engagement with stakeholders, and reputation. However, we also found the nature of trust and credibility of spokespeople is dependent on the studied population and context. Overall, characteristics of influential messengers were nonspecific. Thus, trusted messengers and their characteristics in NCD-messaging must be better understood to develop and maintain the trust of the public and policymakers.
Collapse
Affiliation(s)
- Anastassia Demeshko
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Lisa Buckley
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Kylie Morphett
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge CB2 0QQ, United Kingdom
| | - Roger Meany
- Health and Wellbeing Queensland, Ground Floor, 139 Coronation Drive, Milton Green, Milton, QLD 4064, Australia
| | - Katherine Cullerton
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
- Corresponding author.
| |
Collapse
|
13
|
Yong HH, Gravely S, Borland R, Gartner C, Cummings KM, East K, Tagliaferri S, Elton-Marshall T, Hyland A, Bansal-Travers M, Fong GT. Do smokers' perceptions of the harmfulness of nicotine replacement therapy and nicotine vaping products as compared to cigarettes influence their use as an aid for smoking cessation? Findings from the ITC Four Country Smoking and Vaping Surveys. Nicotine Tob Res 2022; 24:1413-1421. [PMID: 35368082 PMCID: PMC9356684 DOI: 10.1093/ntr/ntac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 12/02/2022]
Abstract
Introduction This study examined whether smokers’ harm perceptions of nicotine replacement therapy (NRT) and nicotine vaping products (NVPs) relative to cigarettes predicted their subsequent use as smoking cessation aids during their last quit attempt (LQA). Aims and Methods We analyzed data from 1,315 current daily smokers (10+ cigarettes per day) who were recruited at Wave 1 (2016), and who reported making a quit attempt by Wave 2 (2018) of the International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England, and the United States. We used multinomial logistic regression models to examine prospective associations between harm perceptions of (a) NRT and (b) NVPs and their use at LQA, controlling for socio-demographic and other potential confounders. Results Smokers who perceive that (a) NRT and (b) NVPs are much less harmful than cigarettes were more likely to subsequently use the respective product as an aid than using no aid or other aids during LQA (adjusted relative risk ratio [aRRR] = 3.79, 95%CI = 2.16–6.66; and aRRR = 2.11, 95%CI = 1.29–3.45, respectively) compared to smokers who perceive these products as equally or more harmful. Additionally, those who perceive NVPs as much less harmful than cigarettes were less likely to use NRT as a quit aid (aRRR = 0.34, 95%CI = 0.20–0.60). No country variations for these associations were found. Conclusions This study found that smokers’ perceptions of the harmfulness of (a) NRT and (b) NVPs relative to cigarettes predicted the respective product use when trying to quit smoking. Corrective education targeting misperceptions of nicotine products’ relative harmfulness may facilitate their use for smoking cessation. Implications Nicotine replacement therapy and nicotine vaping products are two commonly used smoking cessation aids. This study demonstrates that misperceptions of the harms of nicotine products relative to cigarettes influence their use for smoking cessation. Believing that nicotine vaping products are much less harmful than cigarette smoking may lead some smokers to prefer these products over nicotine replacement therapy to aid smoking cessation. Education targeting misperceptions of nicotine products’ harmfulness relative to cigarettes may enable smokers to make informed choices about which are appropriate to aid smoking cessation.
Collapse
Affiliation(s)
| | | | - Ron Borland
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Coral Gartner
- The University of Queensland, Brisbane, Queensland, Australia
| | | | - Katherine East
- University of Waterloo, Waterloo, Ontario, Canada.,King's College London, London, UK
| | | | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | | | - Geoffrey T Fong
- University of Waterloo, Waterloo, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| |
Collapse
|
14
|
East K, Reid JL, Burkhalter R, Wackowski OA, Thrasher JF, Tattan-Birch H, Boudreau C, Bansal-Travers M, Liber AC, McNeill A, Hammond D. Exposure to negative news stories about vaping, and harm perceptions of vaping, among youth in England, Canada, and the US before and after the outbreak of E-cigarette or Vaping-Associated Lung Injury (EVALI). Nicotine Tob Res 2022; 24:1386-1395. [PMID: 35368062 PMCID: PMC9356695 DOI: 10.1093/ntr/ntac088] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 02/02/2023]
Abstract
Introduction Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’) on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16–19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the ‘EVALI’ outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and February–March 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the United States (18.0% to 64.6%), accelerating during (2019) and immediately after (February–March 2020) the outbreak (p < .001) before returning to 2019 levels by August 2020. Similarly, the accurate perception that vaping is less harmful than smoking declined between 2017 and February–March 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the United States (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p < .001). The perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p ≤ .001). Time trends were most pronounced in the United States. Exposure to negative news stories predicted the perception that vaping takes less than a year to harm health (Adjusted Odds Ratio = 1.55, 1.48-1.61) and worry that vaping will damage health (Adjusted Odds Ratio = 1.32, 1.18-1.48). Conclusions Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the United States. Implications This is the first study examining changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the United States before, during, and after ‘EVALI’. Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of the three harm perception measures. Overall, findings suggest that ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.
Collapse
Affiliation(s)
- Katherine East
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jessica L Reid
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Olivia A Wackowski
- School of Public Health, Rutgers, The State University of New Jersey, NJ, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alex C Liber
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Hammond
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| |
Collapse
|
15
|
Janmohamed K, Walter N, Sangngam N, Hampsher S, Nyhan K, De Choudhury M, Kumar N. Interventions to Mitigate Vaping Misinformation: A Meta-Analysis. JOURNAL OF HEALTH COMMUNICATION 2022; 27:84-92. [PMID: 35220901 DOI: 10.1080/10810730.2022.2044941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The impact of misinformation about vapes' relative harms compared with smoking may lead to increased tobacco-related burden of disease and youth vaping. Unfortunately, vaping misinformation has proliferated. Despite growing attempts to mitigate vaping misinformation, there is still considerable ambiguity regarding the ability to effectively curb the negative impact of misinformation. To address this gap, we use a meta-analysis to evaluate the relative impact of interventions designed to mitigate vaping-related misinformation. We searched (from January 2020 till August 2021) various databases and gray literature. Only English language, original studies that employed experimental designs where participants were randomly assigned either to receive mitigating information or to a no-mitigation condition (either misinformation-only or neutral control) were included. Meta-analysis was conducted for the four eligible studies. The mean effect size of attempts to mitigate vaping misinformation was positive but not statistically significant (d = 0.383, 95% CI [-0.029, 0.796], p = .061, k = 5) with lack of evidence for publication bias. Given limited studies included, we were unable to determine factors affecting the efficacy of interventions. The limited focus on non-US studies and youth populations is concerning given the popularity of vaping in low- to middle-income countries (LMICs) and among youth. The findings of this meta-analysis describe the current state of the literature and prescribe specific recommendations to better address the proliferation of vaping misinformation, providing insights helpful in limiting the tobacco mortality burden and curtailing youth vaping.
Collapse
Affiliation(s)
| | - Nathan Walter
- Department of Communication Studies, Northwestern University, Evanston, Illinois, USA
| | | | - Sam Hampsher
- BOTEC Analysis, LLC, Woodland Hills, California, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Navin Kumar
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
16
|
Taylor E, Aleyan S, East K, Cummings KM, Thrasher JF, Fong GT, Quah ACK, Li G, Borland R, Hammond D, Hitchman SC. Associations Between Noticing Nicotine Vaping Product Health Warning Labels, Harm Perceptions, and Use among adult vapers, current and former smokers. Findings From the 2018 ITC Four Country Smoking and Vaping Survey. Nicotine Tob Res 2021; 24:1020-1027. [PMID: 34893915 DOI: 10.1093/ntr/ntab256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/19/2021] [Accepted: 12/08/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The number of countries mandating a nicotine addiction warning label ('warnings') on nicotine vaping products (NVPs) has been increasing. This study examined associations between noticing NVP warnings, perceptions of NVPs, and intentions to use NVPs. METHODS Cross-sectional analysis of 12,619 adult NVP users, cigarette smokers, concurrent users of both cigarettes and NVPs, and quitters who participated in the 2018 International Tobacco Control (ITC) Project Four Country Smoking and Vaping Survey (England, Australia, Canada, US). Logistic regression analyses examined associations between noticing warnings in the past 30 days and perceptions of nicotine harm, NVP harm relative to cigarettes, and NVP addictiveness relative to cigarettes. Associations were also explored between noticing warnings and intentions to use NVPs. RESULTS Noticing warnings was higher among NVP users (18.8%) than non-users (2.1%). Noticing warnings was associated with perceiving nicotine to pose little or no harm to health among NVP users, but there was no association among non-users. There was little evidence of an association between noticing warnings and perceptions of NVP harms relative to smoking among NVP users and non-users. Noticing warnings was associated with perceiving NVPs as less addictive than cigarettes among non-users but not NVP users. Among exclusive smokers, noticing warnings was associated with intending to start using NVPs. Among NVP users, there was little evidence of an association between noticing warnings and intentions to continue using/stopping NVPs. CONCLUSIONS Noticing NVP warnings was not associated with increased NVP and nicotine harm perceptions or decreased intentions to use NVPs among adult smokers and vapers.
Collapse
Affiliation(s)
- Eve Taylor
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Sarah Aleyan
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Katherine East
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.,School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - K Michael Cummings
- Department of Psychiatry and Behavioural Science, Medical University of South Carolina, Charleston, South Carolina, USA.,Hollings Cancer Centre, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behaviour, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Tobacco Research Department, Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.,School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Grace Li
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Sara C Hitchman
- Department of Communication and Media Research, University of Zurich, Switzerland
| |
Collapse
|
17
|
Brett E, Krissinger R, King A. The rise and fall of e-cigarette cloud chasing appealing to youth. Prev Med Rep 2021; 24:101644. [PMID: 34849332 PMCID: PMC8609162 DOI: 10.1016/j.pmedr.2021.101644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/29/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022] Open
Abstract
Electronic cigarette (e-cigarette) use continues to rise among youth with new devices and technology outpacing regulation. The "cloud chasing" phenomenon, whereby vapers compete or otherwise showcase the production of large or artistic exhaled aerosols from e-cigarettes, played a role in the early appeal of e-cigarette use in youth. This paper describes the sudden rise in the phenomenon of cloud chasing on social media and at vaping conventions due to the proliferation of second and third-generation powerful e-cigarette devices in their peak in 2015 and then their subsequent decline in the past few years. We describe four distinct factors that affected both the rise and fall in cloud chasing, including: 1) the rapid evolution of powerful e-cigarette devices, 2) the increase in social media promotions, 3) an inability of regulatory bodies to keep up with evolving ENDS technology, and 4) two recent widespread health concerns and conditions. Conclusions highlight the importance of swift regulation and effective health communication to mitigate unintended consequences of product evolution. It remains unknown whether such vape tricks and related competitions will reemerge and appeal to youth as store fronts reopen and devices continue to evolve.
Collapse
Affiliation(s)
- Emma Brett
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
| | - Robert Krissinger
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
| | - Andrea King
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
| |
Collapse
|
18
|
Kresovich A, Sanzo N, Brothers W, Prentice-Dunn H, Boynton MH, Sutfin EL, Sheeran P, Noar SM. What’s in the message? An analysis of themes and features used in vaping prevention messages. Addict Behav Rep 2021; 15:100404. [PMID: 35434246 PMCID: PMC9006740 DOI: 10.1016/j.abrep.2021.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
As youth vaping grows, vaping prevention campaigns are emerging rapidly. Our study systematically examines prevention messages used by public health groups. Nicotine addiction and chemicals were the most common message themes. Most messages included imagery, yet just over half had a message source. Results can guide message testing and highlight messaging gaps.
Introduction Federal, state, local, and non-government officials have developed and implemented a variety of vaping prevention messages to curtail the vaping epidemic among youth in the US. This study sought to collect a comprehensive set of vaping prevention messages and characterize the themes and features of those messages. Methods We used a two-fold search strategy to identify messages, utilizing the existing content database from Vaping Prevention Resource (vapingprevention.org) and supplementing those messages with web searches. Potential messages were included if they were vaping prevention-oriented, appropriate or relevant for youth, and in a static web or print format. Results A total of 220 messages met criteria. Messages were coded on the presence or absence of 37 objective features within five categories: message themes, imagery, text features, message perspective, and other (e.g., source). The most common themes were nicotine addiction (32%), chemicals (30%), health effects (24%), and industry targeting (19%). Eighty-five percent of messages included imagery, with 27% showing a vaping device, 22% showing smoke or vapor, and 21% showing a person’s face. Just over half (56%) included a message source. Conclusions Vaping prevention messages for youth have commonly focused on addiction and health risks of vaping, and they vary on a series of text and image features. Further research is needed to understand the efficacy of messaging approaches in preventing vaping among youth.
Collapse
|