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Kikut-Stein A, Givan K, Branson P, Fishman J, Bailey K, Paolicelli M, Crockett T, Morris T, Adesipo A, Allen D, Blanco-Liz A, Bonds LF, Brooks N, Carriker M, Francis K, Jean Pierre M, Konner H, Myers R, Newkirk N, Poole M, Riina N, Robinson M, Rubens V, Savage A, Savage M, Sy D, Zhou X, Tan A. Youth Participatory Action Communication Research: A Model for Developing Youth-Driven Health Campaigns. HEALTH COMMUNICATION 2024:1-16. [PMID: 39081194 DOI: 10.1080/10410236.2024.2386713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Youth offer valuable insight on health communication needs and solutions in their communities. We propose youth participatory action communication research (YPACR) as a model for health campaign development that engages youth perspectives in applying systematic theory-informed communication research to addressing youth-identified health priorities. YPACR informed a series of paid high school internship programs in West Philadelphia, in which youth interns identified mental health help-seeking communication as a need among peers. In Phase 1, guided by the reasoned action approach and Hornik & Woolf method, youth interns conducted a survey measuring behavioral beliefs, normative beliefs, and control beliefs associated with mental health help-seeking, as well as trusted sources of mental health information, among local high school students. Survey results suggested control (self-efficacy) was an important message target and peers were trusted mental health information sources. In Phase 2, youth interns developed TikTok-style messages focused on strengthening control beliefs and promoting a youth-selected mental health support resource. Youth interns distributed an online survey experiment to test whether youth-created messages shown alongside resource information increased help-seeking self-efficacy compared to an information-only control. The YPACR framework contributed to youth-relevant campaign goals, study measurements, recruitment approaches, data interpretation, and message design. We discuss the benefits and challenges of this youth-driven health campaign development model and recommendations for future research.
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Affiliation(s)
- Ava Kikut-Stein
- Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute
| | | | - Paulette Branson
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Jeffrey Fishman
- Annenberg School for Communication, University of Pennsylvania
| | - Kavon Bailey
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | - Toni Crockett
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Tamera Morris
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Ajibola Adesipo
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Dayana Allen
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | | | - Ny'zera Brooks
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Malaysia Carriker
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | - Micah Jean Pierre
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Holly Konner
- Annenberg School for Communication, University of Pennsylvania
| | - Ryen Myers
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Naiim Newkirk
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Milan Poole
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Nolan Riina
- Annenberg School for Communication, University of Pennsylvania
| | | | - Valerie Rubens
- Annenberg School for Communication, University of Pennsylvania
| | - Abdullah Savage
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Maryam Savage
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Dahirou Sy
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Xuefei Zhou
- Annenberg School for Communication, University of Pennsylvania
| | - Andy Tan
- Annenberg School for Communication, University of Pennsylvania
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Asfar T, Oluwole OJ, Pan Y, Casas A, Garayua AMH, Schmidt M, Noar SM. Youth Exposure and Response to the FDA Health Warning Label on Electronic Cigarettes Packaging: Policy Implications. Nicotine Tob Res 2024; 26:151-160. [PMID: 37688562 PMCID: PMC10803120 DOI: 10.1093/ntr/ntad175] [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: 10/31/2022] [Revised: 07/11/2023] [Accepted: 09/07/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION Youth represent a high-priority group for e-cigarette health communication. This study examined youth exposure to the Food and Drug Administration (FDA) e-cigarette warning label over 4 years and its association with change in youth harm perception and intention. AIMS AND METHODS We pooled data from the 2018-2021 National Youth Tobacco Survey (age 10-17; n = 67 159). Participants were divided into four groups: never users (58.5%), susceptible nonusers (16.3%), former users (12.7%), and current users (12.5%). We examined the prevalence, time-trend, correlates, and association of youth exposure to the warning with addictiveness and harm perception, intention to use e-cigarettes, and intention to quit all tobacco products. RESULTS Only 24.5% of youth were exposed to the warning. Exposure increased from 14.9% in 2018 to 30.8% in 2019, then declined to 25.2% in 2021. Hispanic (adjusted odds ratio (aOR) = 0.76 [95% CI = 0.641 to 0.89]) and non-Hispanic black current users (0.53 [0.40 to 0.69]) were less likely to be exposed to the warning than white current users. Youth exposure was positively associated with a higher perception of e-cigarette addictiveness (1.12 [1.04 to 1.19]) and intention to quit all tobacco products (1.28 [1.13 to 1.46]). However, exposure was negatively associated with harm perception (0.91 [0.85 to 0.96]) and the intention to use e-cigarettes among e-cigarette nonusers (2.38 [1.99 to 2.84]). CONCLUSIONS The decline in youth exposure to the warning indicates wear-out effects. Strengthening the label by using compelling designs, adding themes on e-cigarette harm to youth, periodically rotating warning content, and using culturally tailored messaging may improve its impact on youth and address racial/ethnic disparities. IMPLICATIONS The FDA e-cigarette label reached only 24.5% of youth, and exposure to the warning declined to indicate wear-out effects. Exposure was significantly lower among minorities. Exposure was associated with a higher perception of e-cigarette addictiveness and intention to quit all tobacco products. Still, it did not increase harm perception or reduce intention to use e-cigarettes among nonusers. Strengthening the label by using more compelling designs, including diverse themes focusing on e-cigarette harm relevant to youth, and periodically rotating warning content may improve its impact on youth. Continued surveillance of the implementation of e-cigarette policies is needed to ensure that they equally affect youth across racial/ethnic subpopulations.
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Affiliation(s)
- Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Olusanya J Oluwole
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yue Pan
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alejandra Casas
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Michael Schmidt
- Department of Art and School of Public Health, University of Memphis, Memphis, TN, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bandi P, Asare S, Majmundar A, Nargis N, Jemal A, Fedewa SA. Relative Harm Perceptions of E-Cigarettes Versus Cigarettes, U.S. Adults, 2018-2020. Am J Prev Med 2022; 63:186-194. [PMID: 35868816 DOI: 10.1016/j.amepre.2022.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION It is unknown how U.S. adults' relative harm perceptions of E-cigarettes versus cigarettes and associated behaviors changed during the E-cigarette or vaping product use‒associated lung injury epidemic (late 2019) and COVID-19 pandemic (since early 2020). METHODS Data from cross-sectional nationally representative Health Information National Trends Survey collected in 2018 (n=3,360), 2019 (n=3,217), and 2020 (n=3,677) (analyzed in 2021) were used to estimate changes in relative harm perceptions of E-cigarettes versus cigarettes (less harmful, as harmful, more harmful, don't know as a measure of uncertainty). In addition, changes in exclusive cigarette smoking, exclusive E-cigarette use, and dual use were estimated for each relative harm perception level. RESULTS Perceptions of E-cigarettes as more harmful than cigarettes doubled year on year, increasing most between 2019 and 2020 (2018: 6.8%, 2019: 12.8%, 2020: 28.3%), whereas uncertainty in relative harm declined (2018: 38.2%, 2019: 34.2%, 2020: 24.7%). Less harmful relative perceptions declined (2018:17.6%, 2019:15.3%, 2020:11.4%), whereas as harmful perceptions remained steady (2018: 37.4%, 2019: 37.7%, 2020: 35.6%). Exclusive cigarette smoking increased between 2019 and 2020 among those who perceived E-cigarettes as relatively more harmful (2018: 18.5%; 2019: 8.4%; 2020: 16.3%), exclusive E-cigarette use increased linearly among those who perceived them as relatively less harmful (7.9%, 15.3%, 26.7%), and dual use increased linearly in those who perceived them relatively as harmful (0.1%, 1.4%, 2.9%). CONCLUSIONS Perceptions of E-cigarettes as more harmful than cigarettes increased sharply between 2019 and 2020. Increases in tobacco product use were potentially guided by product-specific relative harm perceptions because changes occurred primarily in individuals who perceived their preferred product as relatively less harmful, suggesting the need for accurate messaging of relative and absolute product risks.
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Affiliation(s)
- Priti Bandi
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Samuel Asare
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Anuja Majmundar
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Stacey A Fedewa
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
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Vereen RN, Krajewski TJ, Wu EY, Zhang JH, Sanzo N, Noar SM. Aided recall of The Real Cost e-cigarette prevention advertisements among a nationally representative sample of adolescents. Prev Med Rep 2022; 28:101864. [PMID: 35774855 PMCID: PMC9237942 DOI: 10.1016/j.pmedr.2022.101864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022] Open
Abstract
E-cigarette use among youth remains a significant public health concern. In 2018, The Real Cost campaign began disseminating messages about the harms of vaping, primarily using digital media. We sought to determine the prevalence of aided recall of The Real Cost e-cigarette prevention ads and identify potential differences by participant characteristics. Participants were a nationally representative sample of adolescents living in United States (US) households recruited by the National Opinion Research Center (NORC) at the University of Chicago's AmeriSpeak panel in September and October of 2020. A total of 623 adolescents completed the survey. Analyses were weighted to represent the distribution of youth in the US, and effect sizes for individual characteristics were estimated using an adjusted marginalized two-part model. Seventy-one percent of adolescents recalled at least one of the five The Real Cost e-cigarette prevention ads, with individual ad recall ranging from a low of 38.8% (for Magic) to a high of 50.1% (for Narrative). Adjusted estimates of aided recall identified significantly higher recall among Black adolescents and those that used social media at medium or high frequencies (p < 0.05). Results support ongoing efforts by the FDA to reach youth with e-cigarette prevention messages using primarily digital media.
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Affiliation(s)
- Rhyan N. Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Taylor J. Krajewski
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Euphy Y. Wu
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jonathan H. Zhang
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nora Sanzo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kraus A, Moskowitz DA, Ma J, Macapagal K. Cigarette Use and Vaping Among Sexual and Gender Minority (SGM) Adolescents Assigned Male at Birth: Patterns of Use and Associations with Demographic and Psychosocial Factors. Int J Behav Med 2022; 29:685-690. [PMID: 35217994 DOI: 10.1007/s12529-021-10037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study described cigarette and electronic nicotine delivery systems (ENDs) use and their demographic and psychosocial correlates in a sample of sexual and gender minority (SGM) adolescents assigned male at birth. METHODS One-way ANOVA, multivariate linear regression, and correlation analyses were conducted to examine correlates of cigarettes/ENDs use on 159 SGM adolescent users, ages 15-18. RESULTS Fifty-three percent of the sample used cigarettes/ENDs, with differences based on sexual orientation: bisexual, pansexual, and queer adolescents used ENDs more than gay adolescents. White adolescents smoked more cigarettes than adolescents of color, independent of ENDs use. Regarding psychosocial correlates, alcohol use and depression were associated with greater daily cigarette use, while sexual orientation identity was associated with greater daily ENDs use. CONCLUSIONS This study characterized frequency and psychosocial correlates of cigarettes/ENDs use among SGM adolescents. Findings highlighted several risk factors for tobacco use and will inform future interventions for SGM adolescents.
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Affiliation(s)
- Ashley Kraus
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA. .,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.
| | - David A Moskowitz
- Associate Instructional Professor Department of Public Health Sciences, The University of Chicago, Biological Sciences Division, 5841 S. Maryland Ave., MC2000, Chicago, IL, 60637, USA
| | - Junye Ma
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Chicago, IL, 60611, USA
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Stevens EM, Hébert ET, Keller-Hamilton B, Frank-Pearce SG, Tackett AP, Leshner G, Wagener TL. Associations Between Exposure to The Real Cost Campaign, Pro-Tobacco Advertisements, and Tobacco Use Among Youth in the U.S. Am J Prev Med 2021; 60:706-710. [PMID: 33583677 PMCID: PMC8506651 DOI: 10.1016/j.amepre.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION E-cigarette use is rising among youth. Advertising and anti-tobacco campaigns may be associated with the use of E-cigarettes and other tobacco products. This study examines the associations between tobacco use and exposure to The Real Cost's first campaign focusing on E-cigarettes. METHODS Using the 2019 National Youth Tobacco Survey, a national survey of middle and high school students, the associations between exposure to The Real Cost anti-tobacco campaign, exposure to pro-tobacco advertising, and the use of tobacco products in the past 30 days (exclusive E-cigarettes, exclusive other tobacco use, and dual/poly use of E-cigarettes and other tobacco products) was examined. Other tobacco included anything but E-cigarettes. RESULTS Participants (N=13,165) were aged 11-17 years. Exposure to The Real Cost campaign was associated with decreased odds of using other tobacco products (AOR=0.60, 95% CI=0.43, 0.84) and dual/poly use (AOR=0.77, 95% CI=0.63, 0.94) but not E-cigarette use. Greater E-cigarette advertising exposure was associated with increased odds of being an exclusive E-cigarette user (AOR=1.90, 95% CI=1.52, 2.30) or dual/poly user (AOR=1.69, 95% CI=1.31, 2.18). Greater exposure to other tobacco advertising was associated with increased odds of being a dual/poly user (AOR=1.32, 95% CI=1.01, 1.71) but lower odds of exclusive E-cigarette use (AOR=0.76, 95% CI=0.60, 0.97). CONCLUSIONS Exposure to The Real Cost campaign was associated with decreased odds of using other tobacco products and dual/poly products. Exposure to pro-tobacco advertising was also associated with use. Future studies should assess the long-term effectiveness of anti-tobacco messaging.
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Affiliation(s)
- Elise M Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventative and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Summer G Frank-Pearce
- Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Glenn Leshner
- Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, Oklahoma
| | - Theodore L Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio; Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
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Hwang JH, Ryu DH, Park SW. Influence of School-Based Smoking Prevention Education on Reducing Gap in Exposure to Anti-Tobacco Media Message among Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8742. [PMID: 33255526 PMCID: PMC7727860 DOI: 10.3390/ijerph17238742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022]
Abstract
Korean adolescents at high risk for smoking are less exposed to anti-tobacco media messages. This study examines whether school-based smoking prevention education is related to media exposure and whether it can contribute to reducing the gap in exposure to anti-tobacco media messages between smoking vulnerable and non-vulnerable groups. A nationally representative dataset, the 2018 Korea youth risk behavior web-based survey, comprising 59,410 students from grades 7-12, was analyzed. Logistic regression models were designed to evaluate the association between school-based smoking prevention education and media messages exposure. Within-group differences in exposure levels based on sociodemographic characteristics were compared depending on participation or nonparticipation in school-based smoking prevention education. Experience of smoking prevention education within a year was significantly associated with exposure to anti-tobacco media messages. Among Korean adolescents who participated in smoking prevention education compared to those who did not, the media messages exposure rate was more than 20% higher, and the exposure gap within the subgroups by sociodemographic characteristics was narrower. Participation in school-based smoking prevention education was significantly related to media messages exposure. This relationship can be used to improve the overall media messages exposure rate and to reduce the differences in exposure rate based on sociodemographic traits.
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Affiliation(s)
| | | | - Soon-Woo Park
- Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea; (J.H.H.); (D.-H.R.)
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