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Ma H, Gottfredson NC, Kieu T, Rohde JA, Hall MG, Brewer NT, Noar SM. Examining the Longitudinal Relationship Between Perceived and Actual Message Effectiveness: A Randomized Trial. HEALTH COMMUNICATION 2024; 39:1510-1519. [PMID: 37316818 PMCID: PMC10719418 DOI: 10.1080/10410236.2023.2222459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
We sought to examine the relationship between perceived message effectiveness (PME) and actual message effectiveness (AME) in a 3-week randomized trial of vaping prevention advertisements. Participants were US adolescents (n = 1,514) recruited in 2021. We randomly assigned them to view The Real Cost vaping prevention ads or control videos online. Participants viewed three videos at Visit 1, again at Visits 2 and 3, and completed a survey at each visit that assessed AME (susceptibility to vaping) and two types of PME - effects perceptions (potential for behavioral impact) and message perceptions (potential for message processing). At Visit 4, AME was measured. Compared to control, The Real Cost ads led to improved AME (lower susceptibility to vaping at Visit 4, p < .001). This was anticipated by The Real Cost ads eliciting higher PME ratings (higher effects and message perceptions at Visit 1, both p < .001). Furthermore, PME (both effects and message perceptions) at Visit 1 predicted susceptibility to vaping at Visits 1, 2, 3, and 4 (all p < .001). Finally, effects perceptions fully mediated the impact of The Real Cost ads on susceptibility to vaping (β = -.30; p < .001), while message perceptions only partially mediated the effect (β = -.04; p = .001). Our findings indicate a relationship between PME and AME, especially effects perceptions, and suggest that PME may be useful in message pre-testing to select messages with greater behavior change potential.
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Affiliation(s)
- Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S
| | - Nisha C. Gottfredson
- Substance Use Prevention, Evaluation, and Research Program, Research Triangle Institute, Research Triangle, NC, U.S
| | - Talia Kieu
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, U.S
| | - Jacob A. Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, U.S
| | - Marissa G. Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, U.S
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, U.S
| | - Noel T. Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, U.S
| | - Seth M. Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, U.S
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Kwon M, Nam E, Lee J. Poly-tobacco use and mental health in South Korean adolescents. Tob Induc Dis 2024; 22:TID-22-83. [PMID: 38779296 PMCID: PMC11110650 DOI: 10.18332/tid/187077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION With the advent of new tobacco products, poly-tobacco use among adolescents is increasing. Smoking among adolescents negatively impacts both their physical and mental health. This study aimed to determine poly-tobacco use among adolescents in South Korea and to identify the mental health problems caused by single-, dual-, and poly-tobacco use. METHODS Data from 54948 adolescents in the 2020 Korea Youth Behavior Web-based Survey were included. Mental health variables of our primary outcome were loneliness, anxiety, and depression. Descriptive statistics, Rao-Scott χ2 test and complex sample multivariable logistic regression analysis were conducted to determine the association between the type of tobacco product use and mental health. RESULTS Among the subjects, 95.2% were non-tobacco users, followed by single (3.0%), dual (1.1%), and poly users (0.7%). The subjects with poly-tobacco use had significantly higher rates of loneliness (33.2%, p<0.001), anxiety (22.3%, p<0.001), and depression (49.9%, p<0.001) than those who used fewer tobacco products. Subjects who used poly-tobacco products were 2.13 (95% CI: 1.61-2.83) times more likely to report loneliness, 1.52 (95% CI: 1.12-2.07) times more likely to report anxiety, and 2.18 (95% CI: 1.68-2.82) times more likely to report depression than non-tobacco users. CONCLUSIONS Among adolescents, poly-tobacco use is associated with symptoms of loneliness, depression, and anxiety, which are internalized mental health problems. Poly-tobacco use warrants early assessment of high-risk groups, education on the need for tobacco-use cessation, and active intervention for the psychological difficulties that these high-risk groups experience.
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Affiliation(s)
- Min Kwon
- Department of Nursing, The University of Suwon, Hwaseong-si, Republic of Korea
| | - Eunjeong Nam
- Department of Nursing, Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Jinhwa Lee
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
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Lee DN, Liu J, Stevens H, Oduguwa K, Stevens EM. Does source matter? Examining the effects of health experts, friends, and social media influencers on young adult perceptions of Instagram e-cigarette education messages. Drug Alcohol Depend 2024; 258:111270. [PMID: 38522212 PMCID: PMC11088517 DOI: 10.1016/j.drugalcdep.2024.111270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/28/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Young adults' e-cigarette use is a leading public health concern. Using messages from credible sources can help improve message acceptance, yet little research has examined the role of source credibility on young adults' responses to e-cigarette education messages. METHODS We examined the impact of source on young adults' perceptions of e-cigarette education messages and e-cigarettes. In July 2022, we conducted an experimental study using an online sample of young adults (N=459, Mage=24.6) who were randomized to one of three source conditions: expert, friend, or influencer, and viewed e-cigarette education messages. We used one-way ANOVA to estimate the association between the conditions and outcomes (perceived source credibility, message trust, curiosity, use interests, perceived message effectiveness, beliefs, harm perceptions, and intentions to refrain). RESULTS The expert condition was associated with significantly higher perceived source credibility (vs. friend, influencer; p<0.001), message trust (vs. friend, influencer; p<0.001), and curiosity (vs. influencer; p's<0.05). CONCLUSIONS Public health campaigns may leverage health experts to deliver e-cigarette education messages targeting young adults to improve effectiveness of the messages.
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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
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Hannah Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
| | - Katherine Oduguwa
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Elise M Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
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Zhou R, Xie Z, Tang Q, Li D. Social Network Analysis of e-Cigarette-Related Social Media Influencers on Twitter/X: Observational Study. JMIR Form Res 2024; 8:e53666. [PMID: 38557555 PMCID: PMC11019427 DOI: 10.2196/53666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND An e-cigarette uses a battery to heat a liquid that generates an aerosol for consumers to inhale. e-Cigarette use (vaping) has been associated with respiratory disease, cardiovascular disease, and cognitive functions. Recently, vaping has become increasingly popular, especially among youth and young adults. OBJECTIVE The aim of this study was to understand the social networks of Twitter (now rebranded as X) influencers related to e-cigarettes through social network analysis. METHODS Through the Twitter streaming application programming interface, we identified 3,617,766 unique Twitter accounts posting e-cigarette-related tweets from May 3, 2021, to June 10, 2022. Among these, we identified 33 e-cigarette influencers. The followers of these influencers were grouped according to whether or not they post about e-cigarettes themselves; specifically, the former group was defined as having posted at least five e-cigarette-related tweets in the past year, whereas the latter group was defined as followers that had not posted any e-cigarette-related tweets in the past 3 years. We randomly sampled 100 user accounts among each group of e-cigarette influencer followers and created corresponding social networks for each e-cigarette influencer. We compared various network measures (eg, clustering coefficient) between the networks of the two follower groups. RESULTS Major topics from e-cigarette-related tweets posted by the 33 e-cigarette influencers included advocating against vaping policy (48.0%), vaping as a method to quit smoking (28.0%), and vaping product promotion (24.0%). The follower networks of these 33 influencers showed more connections for those who also post about e-cigarettes than for followers who do not post about e-cigarettes, with significantly higher clustering coefficients for the former group (0.398 vs 0.098; P=.005). Further, networks of followers who post about e-cigarettes exhibited substantially more incoming and outgoing connections than those of followers who do not post about e-cigarettes, with significantly higher in-degree (0.273 vs 0.084; P=.02), closeness (0.452 vs 0.137; P=.04), betweenness (0.036 vs 0.008; P=.001), and out-of-degree (0.097 vs 0.014; P=.02) centrality values. The followers who post about e-cigarettes also had a significantly (P<.001) higher number of followers (n=322) than that of followers who do not post about e-cigarettes (n=201). The number of tweets in the networks of followers who post about e-cigarettes was significantly higher than that in the networks of followers who do not post about e-cigarettes (93 vs 43; P<.001). Two major topics discussed in the networks of followers who post about e-cigarettes included promoting e-cigarette products or vaping activity (55.7%) and vaping being a help for smoking cessation and harm reduction (44.3%). CONCLUSIONS Followers of e-cigarette influencers who also post about e-cigarettes have more closely connected networks than those of followers who do not themselves post about e-cigarettes. These findings provide a potentially practical intervention approach for future antivaping campaigns.
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Affiliation(s)
- Runtao Zhou
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Qihang Tang
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
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Seidenberg AB, Boynton MH, Brewer NT, Lazard AJ, Sheeran P, Ribisl KM. Effects of Modified Risk Tobacco Product Claims on Consumer Responses. Nicotine Tob Res 2024; 26:435-443. [PMID: 37791605 PMCID: PMC10959159 DOI: 10.1093/ntr/ntad187] [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: 01/31/2023] [Revised: 09/06/2023] [Accepted: 09/27/2023] [Indexed: 10/05/2023]
Abstract
INTRODUCTION US tobacco manufacturers can seek authorization from the US Food and Drug Administration (FDA) to market products using modified risk tobacco product (MRTP) claims. To inform regulatory decisions, we examined the impact of MRTP claim specificity and content, including whether the claims produced halo effects (ie, inferring health benefits beyond what is stated). AIMS AND METHODS Participants were 3161 US adult cigarette smokers. Using a two (general vs. specific) × 2 (risk vs. exposure) plus independent control design, we randomized participants to view one message from these conditions: general risk claim (eg, "smoking-related diseases"), general exposure claim (eg, "chemicals in smoke"), specific risk claim (eg, "lung cancer"), specific exposure claim (eg, "arsenic"), or control. Claims described the benefits of completely switching from cigarettes to the heated tobacco product IQOS. RESULTS MRTP claims of any sort elicited a higher willingness to try IQOS relative to control (d = 0.09, p = .043). Claims also elicited lower perceived risk of disease and exposure to harmful chemicals for completely switching from cigarettes to IQOS (d = -0.32 and -0.31) and partially switching (d = -0.25 and d = -0.26; all p < .05). Relative to specific MRTP claims, general MRTP claims led to lower perceived risk and exposure for complete switching (d = -0.13 and d = -0.16) and partial switching (d = -0.14 and d = -0.12; all p < .05). Risk and exposure MRTP claims had similar effects (all p > .05). DISCUSSION MRTP claims led to lower perceived risk and exposure, and higher willingness to try IQOS. General claims elicited larger effects than specific claims. MRTP claims also promoted unintended halo effects (eg, lower perceived risk of disease and chemical exposure for partial switching). IMPLICATIONS We found evidence that MRTP claims promoted health halo effects. In light of these findings, the FDA should require research on halo effects prior to authorization. Further, if an MRTP claim is authorized, FDA should require tobacco manufacturers to conduct post-market surveillance of how the claim affects consumer understanding, including partial switching perceived risk and exposure beliefs, as well as monitoring of dual-use behaviors.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Marcella H Boynton
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, School of Medicine, 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
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, 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
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, 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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MacMonegle A, Bennett M, Speer JL, O'Brien EK, Pitzer L, Jaarsma A, Nguyen Zarndt A, Duke J. Evaluating The Real Cost Digital and Social Media Campaign: Longitudinal Effects of Campaign Exposure on E-cigarette Beliefs. Nicotine Tob Res 2024; 26:S19-S26. [PMID: 38366338 DOI: 10.1093/ntr/ntad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Over the past decade, youth e-cigarette use has risen exponentially. At the same time, digital media use increased markedly while the use of traditional broadcast TV declined. In response, the U.S. Food and Drug Administration's The Real Cost public education campaign shifted to communicating the harms of e-cigarette via primarily digital and social platforms. This study evaluated longitudinal associations between exposure to campaign advertisements and changes in campaign-specific beliefs among US youth. METHODS A nationally representative longitudinal cohort of youth (aged 11-16 years at baseline) was surveyed five times. Building on earlier work, we analyzed data from the last three waves (April-July 2020; January-April 2021; and August-October 2021; N = 2625). We assessed self-reported exposure to six ads and agreement with 11 beliefs that were each targeted by one or more ads. Eleven weighted panel regression models assessed whether ad exposure predicted changes in campaign-specific beliefs over time. RESULTS We observed significant associations between ad exposure and increases in at least one campaign-specific belief for five of the six ads. Across the 11 beliefs, we observed associations between increased exposure and increases in 6 beliefs related to e-cigarettes and toxic metals, lung damage, dangerous ingredients, anxiety, cigarette use, and disappointing important people. CONCLUSIONS We found evidence that self-reported exposure to this digital and social media campaign was successful at influencing youth, providing support for the effectiveness of the campaign's adaption to address youth's changes in tobacco and media use habits. IMPLICATIONS The Food and Drug Administration's The Real Cost public education campaign educates youth about the dangers of e-cigarette use. This study evaluates longitudinal associations between exposure to The Real Cost's advertisements and changes in campaign-specific beliefs among youth. Considering evolving trends in youth media consumption, the campaign adapted its media approach to increase delivery across digital and social media platforms. Our findings indicate that the campaign reached its intended audience and increased youth beliefs around the harm of e-cigarettes and the consequences of e-cigarette use, offering evidence for the effectiveness of digital and social media youth prevention efforts within a fragmented digital environment.
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Affiliation(s)
- Anna MacMonegle
- RTI International, Research Triangle Park, North Carolina, USA
| | - Morgane Bennett
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jessica L Speer
- RTI International, Research Triangle Park, North Carolina, USA
| | - Erin Keely O'Brien
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lindsay Pitzer
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Allie Jaarsma
- RTI International, Research Triangle Park, North Carolina, USA
| | - Anh Nguyen Zarndt
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jennifer Duke
- RTI International, Research Triangle Park, North Carolina, USA
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Steinberg ML, Rosen RL, Ganz O, Wackowski OA, Jeong M, Delnevo CD. Communicating the benefits of quitting smoking on mental health increases motivation to quit in people with anxiety and/or depression. Addict Behav 2024; 149:107903. [PMID: 37924583 DOI: 10.1016/j.addbeh.2023.107903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/22/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Although smoking rates have declined over time, this decline has not been observed among those with mental health concerns. It is therefore important to develop effective messaging to support quitting in this population. METHODS We conducted an online experiment with 419 adults who smoke cigarettes daily. Participants with, or without a lifetime history of anxiety and/or depression were randomized to view a message focused on the benefits of quitting smoking on mental or physical health. Participants then reported motivation to quit smoking, mental health concerns about quitting, and perceived effectiveness of the message. RESULTS Participants with a lifetime history of anxiety and/or depression who saw the message focused on the benefits of quitting smoking on mental health reported greater motivation to quit than when they saw a message focused on the benefits to physical health. This was not replicated when examining current symptoms instead of lifetime history. Pre-existing beliefs that smoking improves one's mood were greater in those experiencing current symptoms and in those with a lifetime history of anxiety and/or depression. There was no main or interaction (message type X mental health status) effect of message type received on mental health related concerns about quitting. CONCLUSIONS This study is one of the first to evaluate a smoking cessation message with content specifically targeted to those with mental health concerns about quitting smoking. Additional work is needed to determine how to best target those with mental health concerns with messages focused on the benefits of quitting on mental health.
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Affiliation(s)
- Marc L Steinberg
- Rutgers Robert Wood Johnson Medical School, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA.
| | - Rachel L Rosen
- Rutgers, The State University of New Jersey, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA
| | - Ollie Ganz
- Rutgers School of Public Health, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA
| | - Olivia A Wackowski
- Rutgers School of Public Health, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA
| | - Michelle Jeong
- Rutgers School of Public Health, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA
| | - Cristine D Delnevo
- Rutgers School of Public Health, USA; Rutgers Institute for Nicotine & Tobacco Studies, USA
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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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Denison B, Dahlen H, Kim JEC, Williams C, Kranzler E, Luchman JN, Trigger S, Bennett M, Nighbor T, Vines M, Petrun Sayers EL, Kurti AN, Weinberg J, Hoffman L, Peck J. Evaluation of the "We Can Do This" Campaign Paid Media and COVID-19 Vaccination Uptake, United States, December 2020-January 2022. JOURNAL OF HEALTH COMMUNICATION 2023; 28:573-584. [PMID: 37528606 PMCID: PMC10529331 DOI: 10.1080/10810730.2023.2236976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Public education campaigns are promising methods for promoting vaccine uptake. In April 2021, the U.S. Department of Health and Human Services launched the We Can Do This COVID-19 public education campaign. This study is one of the first evaluations of this COVID-19 public education campaign. We tested associations between channel-specific campaign exposure (i.e. digital, TV, radio, print, and out-of-home advertising) and COVID-19 first-dose vaccinations among a nationally representative online sample of 3,278 adults. The study introduces novel ways to simultaneously evaluate short- and long-term cumulative media dose, filling an important gap in campaign evaluation literature. We observed a positive, statistically significant relationship between the short-term change in digital media dose and the likelihood of first-dose vaccination, and a positive, statistically significant relationship between long-term cumulative TV dose and the likelihood of first-dose vaccination. Results suggest that both digital and TV ads contributed to vaccination, such that digital media was associated with more immediate behavioral changes, whereas TV gradually shifted behaviors over time. As findings varied by media channel, this study suggests that public education campaigns should consider delivering campaign messages across multiple media channels to enhance campaign reach across audiences.
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Affiliation(s)
| | | | | | | | | | | | - Sarah Trigger
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Morgane Bennett
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Tyler Nighbor
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Monica Vines
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Elizabeth L. Petrun Sayers
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Allison N. Kurti
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | - Jessica Weinberg
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
| | | | - Joshua Peck
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs, Washington, District of Columbia, United States
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Heley K, D'Angelo H, Oh A, Vanderpool RC, McQueen A, Kreuter MW, Everson NS. Understanding Associations of Personal Values With Support for Tobacco and Alcohol Control Policies. Am J Prev Med 2023; 65:448-457. [PMID: 36933752 PMCID: PMC10505251 DOI: 10.1016/j.amepre.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION This cross-sectional analysis of the 2020 Health Information National Trends Survey (N=3,604) examines the associations of personal values with tobacco and alcohol control policy support, which may inform policy-related communication efforts. METHODS Respondents selected which of 7 value options they considered most important in their daily life and rated their support for 8 proposed tobacco and alcohol control policies (1=strongly oppose, 5=strongly support). Weighted proportions for each value were described across sociodemographic characteristics, smoking status, and alcohol use. Weighted bivariate and multivariable regressions tested the associations of values with mean policy support (alpha=0.89). Analyses occurred from 2021 to 2022. RESULTS The most frequently selected values were assuring my family is safe and secure (30.2%), being happy (21.1%), and making my own decisions (13.6%). Selected values varied across sociodemographic and behavioral characteristics. For example, people with lower education and incomes were overrepresented among those selecting making my own decisions and keeping myself in good health. After adjusting for sociodemographics, smoking, and alcohol use, people selecting family safety (β=0.20, 95% CI=0.06, 0.33) or religious connection (β=0.34, 95% CI=0.14, 0.54) as most important reported higher policy support than those selecting making their own decisions, the value associated with the lowest mean policy support. Mean policy support did not significantly differ across any other value comparisons. CONCLUSIONS Personal values are associated with support for alcohol and tobacco control policies, with making my own decisions associated with the lowest policy support. Future research and communication efforts may consider aligning tobacco and alcohol control policies with the idea of supporting autonomy.
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Affiliation(s)
- Kathryn Heley
- Health Communication and Informatics Research Branch (HCIRB), Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland.
| | - Heather D'Angelo
- Health Communication and Informatics Research Branch (HCIRB), Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - April Oh
- Implementation Science, Office of the Director, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Robin C Vanderpool
- Health Communication and Informatics Research Branch (HCIRB), Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Amy McQueen
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Matthew W Kreuter
- Health Communication Research Laboratory, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Nicole Senft Everson
- Health Communication and Informatics Research Branch (HCIRB), Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
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11
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Noar SM, Gottfredson N, Vereen RN, Kurtzman R, Sheldon JM, Adams E, Hall MG, Brewer NT. Development of the UNC Perceived Message Effectiveness Scale for Youth. Tob Control 2023; 32:553-558. [PMID: 34930810 PMCID: PMC9238328 DOI: 10.1136/tobaccocontrol-2021-056929] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Tobacco prevention media campaigns are an important tool to address youth tobacco use. We developed a theory-based perceived message effectiveness (PME) Scale to use when vetting messages for campaigns. METHODS Participants were a national sample of N=623 US adolescents (ages 13-17 years) recruited from a national probability-based panel. In an online experiment, we randomised adolescents to view tobacco prevention ads. All participants viewed an ad on smoking or vaping from the US Food and Drug Administration's The Real Cost campaign and a control video, in a random order. After ad exposure, we assessed PME using nine candidate items and constructs for convergent and criterion validity analyses. We used confirmatory factor analysis and examined information curves to select the scale items. RESULTS A brief PME scale with three items (α=0.95) worked equally well for demographically diverse adolescents with different patterns of tobacco use. The Real Cost ads generated higher PME scores than the control videos for both vaping and smoking (convergent validity; p<0.05). Higher PME scores were associated with greater attention, fear, cognitive elaboration and anticipated social interactions (convergent validity; r=0.31-0.66), as well as more negative attitudes toward and lower susceptibility to vaping and smoking (criterion validity; r=-0.14 to -0.37). A single-item PME measure performed similarly to the three-item version. CONCLUSIONS The University of North Carolina PME Scale for Youth is a reliable and valid measure of the potential effectiveness of vaping and smoking prevention ads. Employing PME scales during message development and selection may help youth tobacco prevention campaigns deploy more effective ads.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nisha Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel Kurtzman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer Mendel Sheldon
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Elizabeth Adams
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
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12
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Hair EC, Kreslake JM, Tulsiani S, McKay T, Vallone D. Reducing e-cigarette use among youth and young adults: evidence of the truth campaign's impact. Tob Control 2023:tc-2023-057992. [PMID: 37553244 DOI: 10.1136/tc-2023-057992] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/15/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Mass media campaigns have been shown to be effective in reducing cigarette use. However, evidence is limited for whether campaigns can shift e-cigarette use among youth and young adults (YYA). To assess the impact of the truth anti-e-cigarette campaign, which focused on the effects of vaping on mental health, this study examines the relationship between campaign awareness and e-cigarette behaviour among YYA. METHODS Data from weekly cross-sectional surveys of YYA aged 15-24 years from September 2021 to October 2022 were used for multilevel models assessing how weekly campaign awareness is related to intentions to use e-cigarettes and current e-cigarette use (past 30 days). Weekly campaign awareness was calculated by averaging individual-level awareness for each week. Control variables included individual-level campaign awareness, sociodemographics, perceived financial situation, parental smoking, sensation seeking, and mental health. RESULTS Weekly campaign awareness ranged from 50% to 78%, with most weeks (77%) being within 65% and 75% of weekly campaign awareness. At weekly awareness levels between 65% and 75%, there was a significant association with lower intentions to use e-cigarettes. A dose-response relationship was observed for current use: compared with weeks with lower (<65%) awareness, weeks with awareness of 65-70% had 14% lower odds of current use, weeks with 70-75% awareness had 16% lower odds and weeks with >75% weekly awareness had 18% lower odds (p=0.018, p=0.009 and p=0.007, respectively). CONCLUSIONS Findings from this analysis of weekly campaign awareness demonstrate that exposure to the truth anti-e-cigarette campaign is associated with significantly lower odds of intentions to use and current use of e-cigarette among YYA.
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Affiliation(s)
- Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Global Institute of Public Health, New York University, New York, New York, USA
| | - Jennifer M Kreslake
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Tatum McKay
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Donna Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Global Institute of Public Health, New York University, New York, New York, USA
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13
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Boynton MH, Sanzo N, Brothers W, Kresovich A, Sutfin EL, Sheeran P, Noar SM. Perceived effectiveness of objective elements of vaping prevention messages among adolescents. Tob Control 2023; 32:e228-e235. [PMID: 35534230 PMCID: PMC9643679 DOI: 10.1136/tobaccocontrol-2021-057151] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION In recent years, vaping prevention campaigns have proliferated in response to a surge of e-cigarette use among adolescents in the USA. To date, the research literature has provided minimal guidance as to what vaping prevention message elements have the greatest potential for discouraging vaping, are ineffective or have unintended negative effects. The purpose of the current study was to identify and test a large set of vaping prevention ads used by federal, state, local and non-governmental agencies, examining how objectively coded message elements of vaping prevention messages might affect youth. METHODS A convenience sample of adolescents (N=1501) completed an online survey with each participant rating seven randomly selected vaping prevention ads from a pool of 220 ads on perceived message effectiveness (PME) and vaping appeal. Ads were coded on 37 objective elements in three message categories: themes, imagery and other features. Analyses examined how objective elements predicted PME. RESULTS Addiction, chemicals, negative health symptoms and effects, and cigarette comparison themes were associated with higher PME, as were graphic images and warning symbols. Industry targeting, environmental impact, flavour themes, images of food and people's faces were associated with lower PME, as were hashtags, statistics and first-person language or the word 'teen'. Most elements were not associated with appeal, but ads with a flavour theme were associated with increased vaping appeal. CONCLUSION Promising vaping prevention messages focus on the adverse consequences of vaping, use negative imagery and avoid speaking for teens using their vernacular or perspective.
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Affiliation(s)
- Marcella H Boynton
- Division of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- NC TraCS Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nora Sanzo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Whitney Brothers
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
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14
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Lyew T, Ikhlas A, Sayed F, Vincent A, Lydon-Staley D. Curiosity, Surprise, and the Recall of Tobacco-Related Health Information in Adolescents. JOURNAL OF HEALTH COMMUNICATION 2023; 28:446-457. [PMID: 37318238 PMCID: PMC10330854 DOI: 10.1080/10810730.2023.2224254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A key goal of health communications designed to prevent smoking initiation during adolescence is for the tobacco-related information to be retained in memory beyond immediate message exposure. Here, we test the role for epistemic emotions, specifically curiosity and surprise, in facilitating memory for tobacco-related health information. Participants (n = 294 never-smoking adolescents, ages 14-16 years) performed a trivia guessing task wherein they guessed the answers to general trivia and smoking-related trivia questions. A subset of participants (n = 154) completed a surprise trivia memory task one week later and answered the previously viewed questions. Results indicate that curiosity about the answers to smoking-related trivia is associated with more accurate recall of smoking-related trivia answers one week later. Surprise also facilitated memory for smoking-related trivia, but the association was limited to cases where confidence in prior knowledge was low. Indeed, when participants had high confidence in their prior knowledge, surprise about the answer to trivia questions was associated with worse recall. Findings suggest that engendering states of curiosity for smoking-related information may facilitate retention of that information in never-smoking adolescents and highlight the need to examine both surprise and confidence in health communications to avoid low message recall.
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Affiliation(s)
- T. Lyew
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - A. Ikhlas
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - F. Sayed
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - A. Vincent
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - D.M Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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15
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Hair EC, Kreslake JM, Rath JM, Pitzer L, Bennett M, Vallone D. Early evidence of the associations between an anti-e-cigarette mass media campaign and e-cigarette knowledge and attitudes: results from a cross-sectional study of youth and young adults. Tob Control 2023; 32:179-187. [PMID: 34290134 DOI: 10.1136/tobaccocontrol-2020-056047] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 06/15/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Antismoking mass media campaigns have contributed to significant declines in combustible tobacco use among young people. This study evaluates a national anti-e-cigarette campaign to determine its association with knowledge, attitudes and beliefs in the context of increasing e-cigarette use in the USA. METHODS A national sample of respondents aged 15-24 years (n=8421) was drawn from a repeated cross-sectional online panel survey (220 participants/week) (October 2018 to December 2019). Self-reported exposure to the truth anti-e-cigarette campaign was measured according to level of ad awareness. Outcomes were subjective knowledge of campaign-targeted facts about e-cigarettes and attitudinal constructs about perceived e-cigarette harm, social unacceptability and anti-industry sentiments. Covariates included respondent demographics, current e-cigarette use and cigarette use, parental smoking, sensation seeking, mental health and growth in e-cigarette sales. RESULTS Ad awareness was associated with knowledge that e-cigarette users are more likely to start smoking (low OR: 1.28, 95% CI 1.14 to 1.44; high OR: 1.88, 95% CI 1.66 to 2.13) and of the nicotine content of JUUL compared with cigarettes (low OR: 1.63, 95% CI 1.45 to 1.82; high OR: 2.50, 95% CI 2.21 to 2.84). High ad awareness was associated with knowledge that the long-term health effects of JUUL use are unknown (OR: 1.88, 95% CI 1.57 to 2.28). High ad awareness was associated with significantly higher perceived product harm (OR: 1.35, 95% CI 1.18 to 1.54), social unacceptability (OR: 1.32, 95% CI 1.15 to 1.53) and anti-industry attitudes (OR: 1.40, 95% CI 1.21 to 1.62), compared with respondents with no awareness. CONCLUSIONS Young people with awareness of anti-e-cigarette ads demonstrate higher levels of campaign-targeted knowledge, attitudes and beliefs. Future campaign evaluation priorities include measuring the campaign effects on e-cigarette use behaviours.
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Affiliation(s)
- Elizabeth C Hair
- Truth Initiative Schroeder Institute, Washington, DC, USA .,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, NY, USA
| | - Jennifer M Kreslake
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jessica Miller Rath
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lindsay Pitzer
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Donna Vallone
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, NY, USA
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16
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Steinberg ML, Rosen RL, Ganz O, Wackowski OA, Jeong M, Delnevo CD. Communicating the benefits of quitting smoking on mental health increases motivation to quit in people with anxiety and/or depression: A randomized trial of two health messages. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.17.23286103. [PMID: 36865337 PMCID: PMC9980264 DOI: 10.1101/2023.02.17.23286103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background Although smoking rates have declined over time, this decline has not been observed among those with mental health concerns. It is therefore important to develop effective messaging to support quitting in this population. Methods We conducted an online experiment with 419 adults who smoke cigarettes daily. Participants with, or without a lifetime history of anxiety and/or depression were randomized to view a message focused on the benefits of quitting smoking on mental or physical health. Participants then reported motivation to quit smoking, mental health concerns about quitting, and perceived effectiveness of the message. Results Participants with a lifetime history of anxiety and/or depression who saw the message focused on the benefits of quitting smoking on mental health reported greater motivation to quit than when they saw a message focused on the benefits to physical health. This was not replicated when examining current symptoms instead of lifetime history. Pre-existing beliefs that smoking improves one's mood were greater in those experiencing current symptoms and in those with a lifetime history of anxiety and/or depression. There was no main or interaction (message type X mental health status) effect of message type received on mental health related concerns about quitting. Conclusions This study is one of the first to evaluate a smoking cessation message with content specifically targeted to those with mental health concerns about quitting smoking. Additional work is needed to determine how to best target those with mental health concerns with messages focused on the benefits of quitting on mental health. Implications These data can begin to inform regulatory efforts to address tobacco use in those with comorbid anxiety and/or depression by providing information on how to effectively communicate the benefits of quitting smoking on mental health.
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Affiliation(s)
- Marc L. Steinberg
- Rutgers Robert Wood Johnson Medical School
- Rutgers Center for Tobacco Studies
| | - Rachel L. Rosen
- Rutgers, The State University of New Jersey
- Rutgers Center for Tobacco Studies
| | - Ollie Ganz
- Rutgers School of Public Health
- Rutgers Center for Tobacco Studies
| | | | - Michelle Jeong
- Rutgers School of Public Health
- Rutgers Center for Tobacco Studies
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Kowitt SD, Mendel Sheldon J, Vereen RN, Kurtzman RT, Gottfredson NC, Hall MG, Brewer NT, Noar SM. The Impact of The Real Cost Vaping and Smoking Ads across Tobacco Products. Nicotine Tob Res 2023; 25:430-437. [PMID: 36006858 PMCID: PMC9910139 DOI: 10.1093/ntr/ntac206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/07/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Little research has examined the spillover effects of tobacco communication campaigns, such as how anti-smoking ads affect vaping. AIMS AND METHODS Participants were a national sample of 623 U.S. adolescents (ages 13-17 years) from a probability-based panel. In a between-subjects experiment, we randomly assigned adolescents to view one of four videos online: (1) a smoking prevention video ad from the Food and Drug Administration's (FDA) The Real Cost campaign, (2) a neutral control video about smoking, (3) a vaping prevention video ad from The Real Cost campaign, or (4) a neutral control video about vaping. We present effect sizes as Cohen's d, standardized mean differences, with 95% confidence intervals (CIs). RESULTS Exposure to The Real Cost vaping prevention ads led to more negative attitudes toward vaping compared with control (d = 0.30, 95% CI: 0.07, 0.53), while exposure to The Real Cost smoking prevention ads did not affect smoking-related outcomes compared with control (p-values > .05). Turning to spillover effects, exposure to The Real Cost smoking prevention ads led to less susceptibility to vaping (d = -0.34, 95% CI: -0.56, -0.12), more negative attitudes toward vaping (d = 0.43, 95% CI: 0.20, 0.65) and higher perceived likelihood of harm from vaping (d = 0.26, 95% CI: 0.04, 0.48), compared with control. Exposure to The Real Cost vaping prevention ads did not affect smoking-related outcomes compared with control (p-values > .05). CONCLUSIONS This experiment found evidence of beneficial spillover effects of smoking prevention ads on vaping outcomes and found no detrimental effects of vaping prevention ads on smoking outcomes. IMPLICATIONS Little research has examined the spillover effects of tobacco communication campaigns, such as how anti-smoking ads affect vaping. Using a national sample of 623 U.S. adolescents, we found beneficial evidence of spillover effects of smoking prevention ads on vaping outcomes, which is promising since it suggests that smoking prevention campaigns may have the additional benefit of reducing both smoking and vaping among adolescents. Additionally, we found that vaping prevention campaigns did not elicit unintended consequences on smoking-related outcomes, an important finding given concerns that vaping prevention campaigns could drive youth to increase or switch to using combustible cigarettes instead of vaping.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer Mendel Sheldon
- 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
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Rachel T Kurtzman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- 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
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- 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
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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18
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Shams M, Pariani A, Raeisi A, Maleki M, Shariatinia S, Jamalizadeh A, Poorkarami A, Ostovar A. The Iranian National Blood Pressure Measurement Campaign: What Do the Process and Output Evaluation say? ARCHIVES OF IRANIAN MEDICINE 2022; 25:718-724. [PMID: 37543895 PMCID: PMC10685855 DOI: 10.34172/aim.2022.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/29/2021] [Indexed: 08/08/2023]
Abstract
BACKGROUND The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. METHODS For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. RESULTS The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. CONCLUSION The INBPMC was successful and accomplished its objectives.
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Affiliation(s)
- Mohsen Shams
- School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Abbas Pariani
- Department of Non-Communicable Diseases Management, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Maleki
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Shariatinia
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
- School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Jamalizadeh
- Health Deputy, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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19
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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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20
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Cornacchione Ross J, K Suerken C, Reboussin BA, Denlinger-Apte RL, Spangler JG, Sutfin EL. Cigar Harm Beliefs and Associations with Cigar Use among Young Adults. Subst Use Misuse 2022; 57:1478-1485. [PMID: 35786154 PMCID: PMC9680833 DOI: 10.1080/10826084.2022.2092149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Cigar use, including little cigars and cigarillos (LCCs) and large traditional cigars, continues to harm young adults. Research on harm beliefs about cigars, particularly large cigars, is sparse. The current study examined cigar harm beliefs and associations with cigar use. Methods: Data are from a 2019 survey of a young adult cohort study recruited in fall 2010. Participants were asked questions about their beliefs about the harm of LCC and large cigar use. Those reporting ever use of cigars were asked how frequently they inhale the smoke into their lungs. Results: Participants (N = 1910) were 51.9% female with a mean age of 26.7 (SD = 0.6). Ever cigar use was 44.2% for large cigars and 43% for LCCs. Compared to those who have never used large cigars or LCCs, those reporting ever use of large cigars or LCCs reported lower harm beliefs about inhaling harmful chemicals and becoming addicted (ps <.0001). Those who reported higher harm beliefs also reported inhaling the smoke into their lungs more frequently for large cigars and LCCs (ps<.05). Conclusions: Cigar use harm beliefs were lower among participants reporting ever use of cigars compared to those reporting never use. Contrary to predictions, those reporting greater harm beliefs were more likely to report inhaling smoke more frequently than those with lower harm beliefs.
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Affiliation(s)
- Jennifer Cornacchione Ross
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Cynthia K Suerken
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rachel L Denlinger-Apte
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - John G Spangler
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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21
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Guillory J, Curry L, Farrelly M, Henes A, Homsi G, Saunders M, MacMonegle A, Fiacco L, Alexander T, Delahanty J, Mekos D, Hoffman L, Ganz O. Reach, Receptivity, And Beliefs Associated With the Fresh Empire Campaign to Prevent and Reduce Cigarette Use Among Youth in the United States. Am J Health Promot 2022; 36:789-800. [PMID: 35081751 PMCID: PMC9258634 DOI: 10.1177/08901171211069991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the association between exposure to FDA's Fresh Empire tobacco public education campaign and tobacco-related beliefs. DESIGN Repeated cross-sectional data collection design with embedded longitudinal cohort over six data collection waves. SETTING 30 US evaluation markets. SAMPLE Hip Hop peer crowd-identified US youth aged 12-18 (N = 5,378). MEASURES Self-reported brand and video ad awareness (saw any ad at least sometimes) and perceived effectiveness (1-5 scale) to describe campaign awareness and receptivity. Exogenous exposure was measured using population-adjusted broadcast and digital video impressions. Tobacco-related beliefs included beliefs about smoking risks, attitudes towards tobacco-free people and lifestyles, and normative beliefs about smoking. ANALYSIS Descriptive analyses of awareness, receptivity, and agreement with tobacco-related beliefs. Logistic regression models to determine the relationship between broadcast and digital video impressions and beliefs. INTERVENTION Fresh Empire campaign. RESULTS The campaign generated a high level of reach (71% brand and 66% video ad awareness at final wave) and messages were well-received (across waves 3.5-4.1 mean perceived effectiveness scores). Higher broadcast television exposure was associated with increased agreement with five beliefs related to addiction/control, being a bad influence on family/friends, and cosmetic effects of smoking (breath and attractiveness) (ORs = 1.16-1.27, (Ps < .05)). CONCLUSION Fresh Empire successfully reached and resonated with Hip Hop-identified youth. The campaign was associated with a limited number of targeted beliefs.
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Affiliation(s)
| | | | | | - Amy Henes
- RTI International, Research Triangle Park, NC, USA
| | - Ghada Homsi
- RTI International, Research Triangle Park, NC, USA
| | | | | | - Leah Fiacco
- RTI International, Research Triangle Park, NC, USA
| | - Tesfa Alexander
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Janine Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Debra Mekos
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | | | - Ollie Ganz
- Rutgers University, New Brunswick, NJ, USA
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22
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Zhao X, Toronjo H, Shaw CC, Murphy A, Taxman FS. Perceived communication effectiveness in implementation strategies: a measurement scale. Implement Sci Commun 2022; 3:38. [PMID: 35395790 PMCID: PMC8991666 DOI: 10.1186/s43058-022-00284-4] [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: 10/11/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Communication-based activities and products (i.e., training programs, webinars) are a critical component of implementation strategies that relay information to various audiences. Audience perceptions of communication effectiveness contribute important insight into the processes and mechanisms through which an implementation effort may succeed or fail. To advance research on this front, a psychometrically sound instrument for measuring perceived communication effectiveness (PCE) is needed. METHODS An expert panel identified the theoretical foundations and conceptual domains of PCE and drafted preliminary items. Five focus groups of correctional professionals who had recently completed an implementation leadership training reviewed the items and provided feedback for refinement. Revised items were then included in a survey-based evaluation of an ongoing eLearning curriculum designed to improve the practices used by front-line probation officers in supervising individuals in the field. The factorial structure of a final 6-item scale as well as its convergent, divergent, and predictive validity was evaluated using data from the evaluation surveys (Nfollow-up = 358, Nbaseline+follow-up = 159). RESULTS Confirmatory factor analysis of the final scale of PCE demonstrated adequate fit. PCE was strongly correlated with measures of implementation outcomes (acceptability, r = .819, p < .001; appropriateness, r = .809, p < .001; and feasibility, r = .754, p < .001), yet uncorrelated with a scale of need to evaluate (r = - .051, p = .422), demonstrating both convergent and divergent validities. The predictive validity of PCE was evidenced by significant associations between PCE and key training outcomes, including perceived staff use of evidence-based practices (β = .230, p < .05), agency climate (β = .261, p < .05), and value concordance (β = .209, p < .05), after controlling for baseline values and other confounders. CONCLUSIONS The PCE scale is psychometrically sound and can be a useful tool for gauging audience receptivity to and the potential impact of communication-based implementation activities and products.
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Affiliation(s)
- Xiaoquan Zhao
- Department of Communication, George Mason University, 3D6, 4400 University Drive, Fairfax, VA, 22030, USA.
| | - Heather Toronjo
- Center for Advancing Correctional Excellence, Schar School of Policy and Government, George Mason University, Arlington, USA
| | - Cameron C Shaw
- Center for Advancing Correctional Excellence, Schar School of Policy and Government, George Mason University, Arlington, USA
| | - Amy Murphy
- Center for Advancing Correctional Excellence, Schar School of Policy and Government, George Mason University, Arlington, USA
| | - Faye S Taxman
- Center for Advancing Correctional Excellence, Schar School of Policy and Government, George Mason University, Arlington, USA
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23
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MacMonegle AJ, Smith AA, Duke J, Bennett M, Siegel-Reamer LR, Pitzer L, Speer JL, Zhao X. Effects of a National Campaign on Youth Beliefs and Perceptions About Electronic Cigarettes and Smoking. Prev Chronic Dis 2022; 19:E16. [PMID: 35389831 PMCID: PMC8992685 DOI: 10.5888/pcd19.210332] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Our study assesses the relationship between the exposure of youth to the US Food and Drug Administration's national tobacco public education campaign, The Real Cost, and changes in campaign-focused risk perceptions and beliefs. METHODS A nationally representative cohort study of youth was conducted from June 2018 to July 2019, consisting of a baseline and one follow-up survey. We performed logistic regressions to examine the association between campaign exposure and beliefs. Exposure was measured by self-report as the frequency of exposure to individual campaign advertisements about the health consequences of e-cigarette use and of smoking cigarettes. RESULTS We found that increased levels of exposure to campaign advertising was associated with a significant increase in the odds of reporting agreement with campaign-specific beliefs. Positive patterns of findings were found across multiple items selected by specific advertisements, whereas unrelated beliefs were not associated with advertisement exposure. CONCLUSION A sustained national tobacco public education campaign can change beliefs about the harms of e-cigarette use and cigarette smoking among youth. Combined with other findings from The Real Cost evaluation, results indicate that prevention mass media campaigns continue to be an effective and cost-efficient approach to reduce the health and financial cost of tobacco use in the US.
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Affiliation(s)
- Anna J MacMonegle
- RTI International, 3040 E Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709.
| | - Alexandria A Smith
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Jennifer Duke
- RTI International, Research Triangle Park, North Carolina
| | - Morgane Bennett
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | | | - Lindsay Pitzer
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | | | - Xiaoquan Zhao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
- Department of Communication, George Mason University, Fairfax, Virginia
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24
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Zhao X, Delahanty JC, Duke JC, MacMonegle AJ, Smith AA, Allen JA, Nonnemaker J. Perceived Message Effectiveness and Campaign-Targeted Beliefs: Evidence of Reciprocal Effects in Youth Tobacco Prevention. HEALTH COMMUNICATION 2022; 37:356-365. [PMID: 33140985 DOI: 10.1080/10410236.2020.1839202] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Perceived message effectiveness (PE) has been widely used in campaign formative research and evaluation. The relationship between PE and actual message effectiveness (AE) is often assumed to be causal and unidirectional, but careful conceptualization and empirical testing of this and other causal possibilities are generally lacking. In this study, we investigated the potential reciprocity in the relationship between PE and AE in the context of a national youth tobacco education campaign. In so doing, we also sought to generate much needed evidence on PE's utility to predict campaign-targeted outcomes in youth tobacco prevention. Using five waves of campaign evaluation data (N = 1,128), we found significant lagged associations between PE and campaign-targeted beliefs, and vice versa. These results suggest a dynamic, mutually influencing relationship between PE and AE and call for greater attention to such dynamics in campaign research.
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Affiliation(s)
- Xiaoquan Zhao
- Center For Tobacco Products, Food and Drug Administration
- Department of Communication, George Mason University
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25
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Patterson JG, Keller-Hamilton B, Wedel AV, Wagener TL, Stevens EM. Responses to e-cigarette health messages among young adult sexual minoritized women and nonbinary people assigned female at birth: Assessing the influence of message theme and format. Drug Alcohol Depend 2022; 231:109249. [PMID: 35030509 PMCID: PMC8815305 DOI: 10.1016/j.drugalcdep.2021.109249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Young adult sexual minority women (YSMW) report disproportionate e-cigarette (EC) use and low EC harm perceptions. Health messages that effectively communicate EC harms to YSMW are needed. We tested the effect of culturally targeted EC health messages with varying themes and image formats on attitudes and intentions to use ECs in this population. METHODS N = 501 YSMW and nonbinary people assigned female at birth (AFAB) aged 18-30 years-old completed an online experiment. Participants were randomized into a control or one of nine experimental conditions in a 3 (theme: harms, wellness, pride) by 3 (image format: individual, couple, cartoon) study design. We modeled associations between message condition and message effectiveness, discouragement from vaping, change in feelings toward vaping, perceived threat, and intentions to abstain from vaping. RESULTS Among YSMW and nonbinary people AFAB, harm and wellness themes discouraged vaping more than pride-themed messages (p's < 0.001). Harms messages resulted in worse feelings about vaping than wellness and pride messages (p's < 0.02). Images of couples were perceived as more effective than cartoon images (p = .008). Among current EC users, viewing images of individuals resulted in greater readiness to avoid ECs and higher intentions to abstain than the couple or cartoon conditions (p's < 0.001). CONCLUSIONS Message theme and image format were associated with YSMW and nonbinary people AFAB's EC attitudes and behavioral intentions. Future studies should evaluate how to optimize harms messages; including if wellness or pride messages can be re-framed to better affect EC use in this population.
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Affiliation(s)
- Joanne G Patterson
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, OH, USA; The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Brittney Keller-Hamilton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Amelia V Wedel
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Theodore L Wagener
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Elise M Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
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26
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Crankshaw E, Gaber J, Guillory J, Curry L, Farrelly M, Saunders M, Hoffman L, Ganz O, Delahanty J, Mekos D, Alexander T. Final Evaluation Findings for This Free Life, a 3-Year, Multi-Market Tobacco Public Education Campaign for Gender and Sexual Minority Young Adults in the United States. Nicotine Tob Res 2022; 24:109-117. [PMID: 34270739 PMCID: PMC8666114 DOI: 10.1093/ntr/ntab146] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/14/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This Free Life was the first multi-market, primarily digital campaign designed to change tobacco-related beliefs among lesbian, gay, bisexual, and transgender (LGBT) young adults. Our evaluation sought to determine whether campaign exposure resulted in changes in tobacco-related beliefs. We summarize awareness and receptivity at the conclusion of the campaign and assess the effect of campaign exposure on tobacco-related beliefs in campaign treatment markets compared with control markets. AIMS AND METHODS Twenty-four US designated market areas were selected to receive the campaign or serve as control markets. A baseline survey was conducted in 2016, with six follow-up surveys conducted approximately 6 months apart over the course of the 3-year campaign. 12 324 LGBT young adult survey participants were recruited via intercept interviews and social media. Campaign effects on outcomes were estimated using difference-in-difference panel regression models, with p-values corrected for multiple comparisons. RESULTS Brand and ad awareness peaked in treatment markets approximately 2.5 years into the 3-year campaign and were significantly higher in treatment than control markets. Brand equity and ad receptivity were generally high and similar across LGBT subgroups. There were small but significant campaign effects on five tobacco-related beliefs, with difference-in-difference estimates ranging from 1.9 to 5.6 percentage points. CONCLUSIONS This Free Life, the first multi-market tobacco public education campaign for LGBT young adults, reached and resonated with a large and diverse population, and had a small effect on beliefs involving social aspects of smoking. These findings should inform future communication efforts aimed at reducing tobacco use among LGBT young adults. IMPLICATIONS Modest overall campaign effects suggest that further research on effective campaign messaging and delivery to LGBT young adults is needed. Campaign messaging style, delivery channels, and targeted outcomes likely contributed to these findings. Health communication efforts for LGBT young adults should consider the limitations of digital media in achieving sufficient exposure. Ad style and content optimized for a digital environment is an area that will benefit from further development.
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Affiliation(s)
- Erik Crankshaw
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - Jennifer Gaber
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | | | - Laurel Curry
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - Matthew Farrelly
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - McKinley Saunders
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | | | - Ollie Ganz
- Rutgers School of Public Health, Piscataway, NJ, USA
| | - Janine Delahanty
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
| | - Debra Mekos
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
| | - Tesfa Alexander
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
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27
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Rohde JA, Noar SM, Prentice-Dunn H, Kresovich A, Hall MG. Comparison of Message and Effects Perceptions for The Real Cost E-Cigarette Prevention Ads. HEALTH COMMUNICATION 2021; 36:1222-1230. [PMID: 32268799 PMCID: PMC9004315 DOI: 10.1080/10410236.2020.1749353] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Perceived message effectiveness (PME) is commonly used in health communication research and practice, yet there has been a dearth of studies comparing different operationalizations of the PME construct. In the present study, we compared the two major types of PME - message perceptions and effects perceptions - among N = 557 young adults. Participants were randomized to one of two conditions: 1) The Real Cost e-cigarette prevention ads developed by the Food and Drug Administration (FDA condition) or 2) information-only e-cigarette control ads developed by the Mayo Clinic (control ad condition). Study predictors were message and effects perceptions measures and actual message effectiveness (AME) outcomes were risk beliefs about vaping and intentions to vape. Results showed that both message perceptions (M = 3.82 vs M = 3.29; p < .001) and effects perceptions (M = 4.13 vs M = 3.82; p < .001) were higher in the FDA ad condition compared to control. Risk beliefs about vaping were also higher in the FDA ad condition than control (M = 3.95 vs M = 3.79; p =.022), but we found no differences in participants' intentions to vape, which were low overall (M = 1.59 in FDA vs M = 1.58 in control). In multivariate analyses adjusting for covariates and including both types of PME, only effects perceptions (not message perceptions) were associated with risk beliefs about vaping (b =.37, p < .001) and intentions to vape (b = -.26, p < .001). Our findings advance PME research by demonstrating the differing nature of message and effects perceptions, and suggest that effects perceptions should be utilized during message pretesting.
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Affiliation(s)
- Jacob A. Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, US
| | - Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, US
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, US
| | - Hannah Prentice-Dunn
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, US
| | - Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, US
| | - Marissa G. Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, US
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, US
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28
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Wagoner KG, King JL, Alexander A, Tripp HL, Sutfin EL. Adolescent Use and Perceptions of JUUL and Other Pod-Style e-Cigarettes: A Qualitative Study to Inform Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094843. [PMID: 34062740 PMCID: PMC8125112 DOI: 10.3390/ijerph18094843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022]
Abstract
JUUL, a discrete pod-style e-cigarette, popular among adolescents, delivers high levels of nicotine. Limited research has assessed social and environmental influences that contribute to use of JUUL and other pod-style devices. We examined how these factors, as well as individual characteristics, shape adolescent use. Twenty-nine middle and high school students participated in six focus groups in June 2019 (58.6% female, 65.5% White, 27.6% Hispanic). Groups were stratified by e-cigarette use status and grade to understand perceptions and experiences among groups. Transcripts were coded using thematic analysis for individual, social, and environmental factors contributing to use. Users (n = 13) described their first experience with JUUL as mostly negative, mentioning reactions such as burning in the throat, coughing, wheezing, and headaches. Despite a negative first experience, stress relief and addiction were mentioned as reasons for continued use. Users and non-users identified vaping as a source of disruption to their daily life. Social factors included peer and parental influences, lack of support for quitting, and accessibility. Environmental factors included contrasting messages about long- and short-term health effects of e-cigarettes, as well as a lack of school vaping policy enforcement, health education, medical screenings, and cessation resources. Findings highlight the complex social system that influences adolescent e-cigarette use and have important implications for school and community responses. Strategies to prevent or reduce use may include reviewing existing school tobacco policies, providing counseling and cessation resources, training staff, and increasing knowledge through public education campaigns.
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Affiliation(s)
- Kimberly G. Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA;
- Correspondence: ; Tel.: +1-336-713-4223
| | - Jessica L. King
- College of Health, University of Utah, Salt Lake City, UT 84112, USA;
| | - Amir Alexander
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA;
| | - Hollie L. Tripp
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA;
| | - Erin L. Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA;
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29
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Chew R, Kery C, Baum L, Bukowski T, Kim A, Navarro M. Predicting Age Groups of Reddit Users Based on Posting Behavior and Metadata: Classification Model Development and Validation. JMIR Public Health Surveill 2021; 7:e25807. [PMID: 33724195 PMCID: PMC8087286 DOI: 10.2196/25807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media are important for monitoring perceptions of public health issues and for educating target audiences about health; however, limited information about the demographics of social media users makes it challenging to identify conversations among target audiences and limits how well social media can be used for public health surveillance and education outreach efforts. Certain social media platforms provide demographic information on followers of a user account, if given, but they are not always disclosed, and researchers have developed machine learning algorithms to predict social media users' demographic characteristics, mainly for Twitter. To date, there has been limited research on predicting the demographic characteristics of Reddit users. OBJECTIVE We aimed to develop a machine learning algorithm that predicts the age segment of Reddit users, as either adolescents or adults, based on publicly available data. METHODS This study was conducted between January and September 2020 using publicly available Reddit posts as input data. We manually labeled Reddit users' age by identifying and reviewing public posts in which Reddit users self-reported their age. We then collected sample posts, comments, and metadata for the labeled user accounts and created variables to capture linguistic patterns, posting behavior, and account details that would distinguish the adolescent age group (aged 13 to 20 years) from the adult age group (aged 21 to 54 years). We split the data into training (n=1660) and test sets (n=415) and performed 5-fold cross validation on the training set to select hyperparameters and perform feature selection. We ran multiple classification algorithms and tested the performance of the models (precision, recall, F1 score) in predicting the age segments of the users in the labeled data. To evaluate associations between each feature and the outcome, we calculated means and confidence intervals and compared the two age groups, with 2-sample t tests, for each transformed model feature. RESULTS The gradient boosted trees classifier performed the best, with an F1 score of 0.78. The test set precision and recall scores were 0.79 and 0.89, respectively, for the adolescent group (n=254) and 0.78 and 0.63, respectively, for the adult group (n=161). The most important feature in the model was the number of sentences per comment (permutation score: mean 0.100, SD 0.004). Members of the adolescent age group tended to have created accounts more recently, have higher proportions of submissions and comments in the r/teenagers subreddit, and post more in subreddits with higher subscriber counts than those in the adult group. CONCLUSIONS We created a Reddit age prediction algorithm with competitive accuracy using publicly available data, suggesting machine learning methods can help public health agencies identify age-related target audiences on Reddit. Our results also suggest that there are characteristics of Reddit users' posting behavior, linguistic patterns, and account features that distinguish adolescents from adults.
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Affiliation(s)
- Robert Chew
- Center for Data Science, RTI International, Research Triangle Park, NC, United States
| | - Caroline Kery
- Center for Data Science, RTI International, Research Triangle Park, NC, United States
| | - Laura Baum
- Center for Health Analytics, Media, and Policy, RTI International, Atlanta, GA, United States
| | - Thomas Bukowski
- Center for Health Analytics, Media, and Policy, RTI International, Berkeley, CA, United States
| | - Annice Kim
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, NC, United States
| | - Mario Navarro
- Office of Health Communications and Education, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, United States
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30
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Guillory J, Crankshaw E, Farrelly MC, Alam I, Fiacco L, Curry L, Hoffman L, Ganz O, Delahanty J. LGBT young adults' awareness of and receptivity to the This Free Life tobacco public education campaign. Tob Control 2021; 30:63-70. [PMID: 31941821 DOI: 10.1136/tobaccocontrol-2019-055239] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/15/2019] [Accepted: 10/31/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE This study measures awareness of and receptivity to the Food and Drug Administration's This Free Life campaign seeking to change tobacco-related attitudes and beliefs among lesbian, gay, bisexual and/or transgender (LGBT) young adults. METHODS Participants were young adults who self-identify as LGBT. The evaluation uses a treatment-control design. This study includes data from four survey rounds with participants from each round invited to participate in subsequent rounds and new participants invited to account for attrition. Bivariate analyses assess treatment-control differences in campaign awareness by round. We used multivariable logistic regression models with a time×treatment interaction and covariates to assess whether increases in awareness were greater in treatment than control from follow-ups 1 to 4. Descriptive statistics describe perceived effectiveness and models explore covariates of perceived effectiveness. RESULTS At each round, an increasing number of participants in treatment were brand aware (25%-67%) and reported high (16%-34%) and medium (16%-25%) video awareness compared with control (all p<0.001). Regressions revealed interactions in brand and video awareness, wherein the effect of treatment on awareness increased more over time, with significant treatment-control differences in change from follow-up 1 to 4 (all p<0.05). Reactions to all but one ad were positive (one neutral) with mean perceived effectiveness scores from 3.21 to 3.92 ('neither disagree nor agree' to 'agree' on 5-point scale). Perceived effectiveness differed by LGBT identity (all p<0.05). CONCLUSIONS At follow-up 4, This Free Life reached most of the campaign audience in treatment markets and has achieved higher awareness in treatment than control markets, at individual survey rounds and over time.
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Affiliation(s)
| | - Eric Crankshaw
- Center for Health Policy Science and Tobacco Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Matthew C Farrelly
- Center for Health Policy Science and Tobacco Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Ishrat Alam
- Center for the Health of At-Risk Populations, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Leah Fiacco
- Center for Health Policy Science and Tobacco Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Laurel Curry
- Center for Health Policy Science and Tobacco Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Leah Hoffman
- Center for Tobacco Products, Office of Health Communication and Education, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Ollie Ganz
- Center for Tobacco Products, Office of Health Communication and Education, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Janine Delahanty
- Center for Tobacco Products, Office of Health Communication and Education, US Food and Drug Administration, Silver Spring, Maryland, USA
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31
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Lazard AJ. Social Media Message Designs to Educate Adolescents About E-Cigarettes. J Adolesc Health 2021; 68:130-137. [PMID: 32654836 DOI: 10.1016/j.jadohealth.2020.05.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/05/2020] [Accepted: 05/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE E-cigarette use is increasing among adolescents, despite potential harms. Social media messages are a promising way to educate youth about e-cigarettes, yet little is known about what message topics and formats will have beneficial impacts for message reception, reach, e-cigarette knowledge, and beliefs about harms. METHODS A national convenience sample of adolescents (n = 928, aged 15-18 years) in high school was recruited for an online experiment. In October 2019, participants were randomized to view one of three social media formats (visual based, quiz, and text only) or a no-message control. Participants in format conditions viewed six unique topics in a random order. Outcomes were e-cigarette knowledge and beliefs. Message reactions and sharing preferences were also assessed among youth who saw social media messages. RESULTS Social media messages led to greater knowledge (Cohen's f = .19; p < .001) and beliefs (f = .16; p < .001) about harms of e-cigarettes compared with the control, regardless of format. Almost four in five adolescents (79%) reported they would share the social media messages, most likely in person (49%) and with friends (52%). Message topics for missing out because of lung damage, having uncontrolled moods, and ingesting specific harmful chemicals elicited higher intended message reactions. CONCLUSIONS Social media messages can educate about e-cigarette harms. Social media campaigns are a promising e-cigarette education strategy to reach youth, directly and potentially through peer-to-peer sharing.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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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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33
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Jeong M, Noar SM, Zhang D, Mendel JR, Agans RP, Boynton MH, Byron MJ, Baig SA, Ranney LM, Ribisl KM, Brewer NT. Public Understanding of Cigarette Smoke Chemicals: Longitudinal Study of US Adults and Adolescents. Nicotine Tob Res 2020; 22:747-755. [PMID: 30852611 DOI: 10.1093/ntr/ntz035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 03/05/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The US Food and Drug Administration has increased communication efforts that aim to raise public awareness of the harmful constituents (ie, chemicals) in cigarette smoke. We sought to investigate whether the public's awareness of these chemicals has increased in light of such efforts. METHODS Participants were national probability samples of 11 322 US adults and adolescents recruited in 2014-2015 (wave 1) and 2016-2017 (wave 2). Cross-sectional telephone surveys assessed awareness of 24 cigarette smoke chemicals at both timepoints. RESULTS The proportion of US adults aware of cigarette smoke chemicals did not differ between waves 1 and 2 (25% and 26%, p = .19). In contrast, awareness of chemicals among adolescents fell from 28% to 22% (p < .001), mostly due to lower awareness of carbon monoxide, arsenic, benzene, and four other chemicals. Belief that most of the harmful chemicals in cigarette smoke come from burning the cigarette also fell from waves 1 to 2 (adults: 31% vs. 26%; adolescents: 47% vs. 41%, both ps < .05). Participants were more likely to be aware of cigarette smoke chemicals if they had been exposed to anti-smoking campaign advertisements (p < .05) or had previously sought chemical information (p < .05). Cigarette smoke chemical awareness did not differ between smokers and nonsmokers. CONCLUSION Awareness of cigarette smoke chemicals remains low and unchanged among adults and decreased somewhat among adolescents. The association of chemical awareness with information exposure via campaigns and information seeking behavior is promising. More concerted communication efforts may be needed to increase public awareness of cigarette smoke chemicals, which could potentially discourage smoking. IMPLICATIONS Awareness of the toxic chemicals in cigarette smoke may contribute to quitting. The US Food and Drug Administration is making efforts to increase public awareness of these chemicals. Two national surveys (2014-2017) found that chemical awareness was low among adults and adolescents. Although awareness did not change among adults, awareness among adolescents dropped over time. In addition, exposure to anti-smoking campaigns and chemical information seeking behavior were associated with higher awareness of chemicals in cigarette smoke. Campaigns and other efforts may be needed to increase awareness of cigarette smoke chemicals.
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Affiliation(s)
- Michelle Jeong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.,School of Media and Journalism, University of North Carolina, Chapel Hill, NC
| | - Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, DC
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Robert P Agans
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Carolina Survey Research Laboratory, University of North Carolina, Chapel Hill, NC
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - M Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Leah M Ranney
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Noar SM, Rohde JA, Prentice-Dunn H, Kresovich A, Hall MG, Brewer NT. Evaluating the actual and perceived effectiveness of E-cigarette prevention advertisements among adolescents. Addict Behav 2020; 109:106473. [PMID: 32521287 DOI: 10.1016/j.addbeh.2020.106473] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/18/2020] [Accepted: 05/14/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND The efficacy of e-cigarette prevention ads among adolescents has seldom been studied. We examined the impact of ads from the The Real Cost vaping prevention media campaign on what adolescents think and believe about vaping. We also sought to test whether perceived message effectiveness (PME) served as a proxy for ad impact. METHODS Participants were 543 U.S. adolescents ages 13-17. In an online experiment, we randomized participants to either: 1) persuasive e-cigarette prevention video ads from the Food and Drug Administration's The Real Cost campaign that was targeted to adolescents or 2) information-only e-cigarette harms control videos (control condition). Participants in each condition viewed 2 videos in a random order. After ad exposure, the survey assessed PME (message and effects perceptions), risk beliefs about vaping, attitudes toward vaping, and intentions to vape. RESULTS The FDA's The Real Cost ads led to higher beliefs about the harms of vaping (p < .001), more negative attitudes toward vaping (p < .001), and lower intentions to vape (p < .05) compared to the control videos. The Real Cost ads also scored higher on both message perceptions (p < .001) and effects perceptions (p < .001) compared to control videos. Effects perceptions were associated with all three outcomes (all ps < 0.001, adjusting for both types of PME and covariates), but message perceptions did not offer additional predictive value. CONCLUSIONS Exposure to The Real Cost vaping prevention ads gave adolescents a more negative view of vaping and lowered their intentions to vape compared to control videos. Effects perceptions may be superior to message perceptions as a proxy for e-cigarette prevention ad impact.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA.
| | - Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Prentice-Dunn
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- 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; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- 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
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35
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Zhao X. Health communication campaigns: A brief introduction and call for dialogue. Int J Nurs Sci 2020; 7:S11-S15. [PMID: 32995373 PMCID: PMC7501494 DOI: 10.1016/j.ijnss.2020.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/23/2020] [Indexed: 11/25/2022] Open
Abstract
This article provides a brief introduction to health communication campaigns as an important method for health promotion. The general approach to campaign development is described and patterns of campaign effects across behavioral contexts are noted. Several high-profile campaigns in the United States are presented as examples and key learnings from each campaign are highlighted. The roles of theory, as well as major types of theories commonly used in campaign research, are also discussed. The article urges greater efforts to document and understand diverse campaign experience around the world.
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36
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Miech R. Marijuana Legalization and Marijuana Prevalence Among Adolescents. Am J Public Health 2020; 110:1268-1269. [PMID: 32783708 DOI: 10.2105/ajph.2020.305847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Richard Miech
- Richard Miech is with the Institute for Social Research, University of Michigan, Ann Arbor
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37
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Chan L, O'Hara B, Phongsavan P, Bauman A, Freeman B. Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns. J Med Internet Res 2020; 22:e17432. [PMID: 32348272 PMCID: PMC7448186 DOI: 10.2196/17432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/12/2020] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Mass media campaigns for public health are increasingly using digital media platforms, such as web-based advertising and social media; however, there is a lack of evidence on how to best use these digital platforms for public health campaigns. To generate this evidence, appropriate campaign evaluations are needed, but with the proliferation of digital media-related metrics, there is no clear consensus on which evaluation metrics should be used. Public health campaigns are diverse in nature, so to facilitate analysis, this review has selected tobacco control campaigns as the scope of the study. OBJECTIVE This literature review aimed to examine how tobacco control campaigns that use traditional and digital media platforms have been evaluated. METHODS Medicine and science databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus), and a marketing case study database (World Advertising Research Center) were searched for articles published between 2013 and 2018. Two authors established the eligibility criteria and reviewed articles for inclusion. Individual campaigns were identified from the articles, and information on campaigns and their evaluations were supplemented with searches on Google, Google Scholar, and social media platforms. Data about campaign evaluations were tabulated and mapped to a conceptual framework. RESULTS In total, 17 campaigns were included in this review, with evaluations reported on by 51 articles, 17 marketing reports, and 4 grey literature reports. Most campaigns were from English-speaking countries, with behavioral change as the primary objective. In the process evaluations, a wide range of metrics were used to assess the reach of digital campaign activities, making comparison between campaigns difficult. Every campaign in the review, except one, reported some type of engagement impact measure, with website visits being the most commonly reported metric (11 of the 17 campaigns). Other commonly reported evaluation measures identified in this review include engagement on social media, changes in attitudes, and number of people contacting smoking cessation services. Of note, only 7 of the 17 campaigns attempted to measure media platform attribution, for example, by asking participants where they recalled seeing the campaign or using unique website tracking codes for ads on different media platforms. CONCLUSIONS One of the key findings of this review is the numerous and diverse range of measures and metrics used in tobacco control campaign evaluations. To address this issue, we propose principles to guide the selection of digital media-related metrics for campaign evaluations, and also outline a conceptual framework to provide a coherent organization to the diverse range of metrics. Future research is needed to specifically investigate whether engagement metrics are associated with desired campaign outcomes, to determine whether reporting of engagement metrics is meaningful in campaign evaluations.
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Affiliation(s)
- Lilian Chan
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Blythe O'Hara
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Adrian Bauman
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Becky Freeman
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
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38
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Morgan JC, Sutton JA, Yang S, Cappella JN. Impact of Graphic Warning Messages on Intentions to Use Alternate Tobacco Products. JOURNAL OF HEALTH COMMUNICATION 2020; 25:613-623. [PMID: 33063619 PMCID: PMC8262429 DOI: 10.1080/10810730.2020.1827097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Graphic cigarette warnings increase quit attempts. Perceived message effectiveness and message avoidance are predictive of later quit attempts. We sought to examine whether randomized exposure to warning messages would inadvertently increase intentions to use alternate tobacco products while enhancing attempts to quit cigarettes. An online survey of 1392 adult smokers in the US asked participants to rate six randomly selected tobacco warnings (from a set of 319) on perceived effectiveness and avoidance intentions. These two indicators of message effectiveness were calculated at the message-level and then at the individual campaign-level to facilitate causal inference. After viewing a message campaign of six warning messages, participants indicated their intentions to use alternate tobacco products. Sixty-eight percent of participants reported some intention to use e-cigarettes and intentions to use other alternate tobacco products ranged from 31% to 40%. Campaigns of messages eliciting higher avoidance increased the odds of intending to use hookah (aOR: 4.32), smokeless tobacco (aOR: 4.88), and snus (aOR: 8.06), but not the intention to use electronic cigarettes. These relationships are mediated by intentions to quit smoking (all p <.05). Viewing campaigns with higher campaign-level perceived effectiveness increased the intentions to quit, which in turn increased intentions to try alternate tobacco products. Our findings increase the tobacco control community's understanding of unintended consequences of graphic tobacco warnings.
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Affiliation(s)
- Jennifer C. Morgan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Jazmyne A. Sutton
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Sijia Yang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Joseph N. Cappella
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
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39
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Lee SJ. The Effect of Temporal Frames in Anti-Smoking Messages on the Extension of Anti-Smoking Arguments to Smokers. JOURNAL OF HEALTH COMMUNICATION 2020; 25:421-429. [PMID: 32584651 DOI: 10.1080/10810730.2020.1778820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study focused on how exposure to different health message characteristics can affect extension-i.e., the sharing of arguments that were not targeted by the messages but are consistent with the message theme. In the context of anti-smoking campaigns, many messages have either emphasized reasons to quit smoking (why-quit) or ways to quit smoking (how-to-quit). Therefore, guided by construal level theory, the study aimed to examine whether the message characteristic of temporal frames can increase or decrease extension when incorporated into why-quit and how-to-quit anti-smoking messages. Results from a randomized experiment showed that exposure to why-quit messages with distant temporal frames increased extension (vs. no-message control) while why-quit messages with proximal temporal frames did not. Findings further illustrated a potential mechanism, where why-quit messages with proximal frames significantly reduced extension compared to why-quit messages with no temporal frames. Temporal frames did not have a significant effect on extension for how-to-quit messages. Results indicate that emphasizing the present in anti-smoking messages could be detrimental for the extension of why-quit arguments. Implications for applying construal level theory to health message effects research are also discussed.
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Affiliation(s)
- Stella Juhyun Lee
- Department of Media and Communication, Konkuk University , Seoul, Republic of Korea
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40
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Delahanty J, Ganz O, Bernat JK, Trigger S, Smith A, Lavinghouze R, Rao P. Awareness of "The Real Cost" Campaign Among US Middle and High School Students: National Youth Tobacco Survey, 2017. Public Health Rep 2020; 135:82-89. [PMID: 31835009 DOI: 10.1177/0033354919889992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Monitoring awareness of a public education campaign can help to better understand the extent of sustained population-level exposure to the campaign. We examined unaided awareness (awareness that does not include a visual image to remind the respondent of the campaign or advertisement) and correlates of unaided awareness of "The Real Cost," a national youth tobacco education campaign developed by the US Food and Drug Administration and implemented in 2014. METHODS This secondary analysis examined unaided campaign awareness by using data from the 2017 National Youth Tobacco Survey, a nationally representative school-based sample of young persons aged 9-19 years (n = 17 269) surveyed approximately 3 years after campaign launch. We compared unaided campaign awareness among various cigarette user groups (experimenters, susceptible nonsmokers, current or former smokers, and nonsusceptible nonsmokers). We examined associations between unaided campaign awareness and demographic and tobacco-related correlates, overall and by cigarette user group. RESULTS Three years after "The Real Cost" campaign was launched, most middle and high school students (58.5%) still reported unaided campaign awareness. Of 17 269 middle and high school students in the sample, 62.0% of susceptible nonsmokers and 64.5% of experimenters reported unaided campaign awareness. Among susceptible nonsmokers, unaided campaign awareness differed by age and race/ethnicity and was higher among students with greater tobacco-related harm perceptions (vs lower harm perceptions) and exposure to pro-tobacco marketing (vs no exposure). CONCLUSIONS Future surveillance and research could examine awareness of "The Real Cost" campaign and effects of the campaign on young persons' knowledge, attitudes, and beliefs to further assess the public health impact of tobacco prevention campaigns.
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Affiliation(s)
- Janine Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Ollie Ganz
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer K Bernat
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Sarah Trigger
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Alexandria Smith
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - René Lavinghouze
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pamela Rao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA.,Akira Technologies, Washington, DC, USA
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Villanti AC, Niaura RS, Abrams DB, Mermelstein R. Preventing Smoking Progression in Young Adults: the Concept of Prevescalation. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020. [PMID: 29525899 DOI: 10.1007/s11121-018-0880-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
As adolescents cross the threshold to young adulthood, they encounter more opportunities to engage in or accelerate previously discouraged or prohibited behaviors. Young adults, therefore, are more apt to initiate cigarette smoking and, more importantly, to accelerate their use if they tried and experimented as an adolescent. Preventing the escalation and entrenchment of smoking in the young adult years is critically important to reducing tobacco's long-term health toll. However, traditional interventions for youth have focused on preventing smoking initiation, and interventions for adults have focused on smoking cessation; both have failed to address the needs of young adults. We introduce the concept of "prevescalation" to capture the need and opportunity to prevent the escalation of risk behaviors that typically occur during young adulthood, with a focus on the example of cigarette smoking. Prevescalation negates the notion that prevention has failed if tobacco experimentation occurs during adolescence and focuses on understanding and interrupting transitions between experimentation with tobacco products and established tobacco use that largely occur during young adulthood. However, since risk behaviors often co-occur in young people, the core concept of prevescalation may apply to other behaviors that co-occur and become harder to change in later adulthood. We present a new framework for conceptualizing, developing, and evaluating interventions that better fit the unique behavioral, psychosocial, and socio-environmental characteristics of the young adult years. We discuss the need to target this transitional phase, what we know about behavioral pathways and predictors of cigarette smoking, potential intervention considerations, and research challenges.
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Affiliation(s)
- Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA. .,Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA. .,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - David B Abrams
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Robin Mermelstein
- Department of Psychology and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Lazard AJ, Pikowski J, Horrell L, Ross JC, Noar SM, Sutfin EL. Adolescents' and Young Adults' Aesthetics and Functionality Preferences for Online Tobacco Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:373-379. [PMID: 30734263 PMCID: PMC6687578 DOI: 10.1007/s13187-019-1475-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
As cigarette use rates decline among adolescents and young adults, public health officials face new challenges with high use of non-cigarette tobacco products (NCTPs). Online tobacco education is a potential solution to discourage use, yet limited information is available for how online media should look and function. This study aims to fill this gap by conducting focus group interviews to identify adolescents and young adults' aesthetic and functionality preferences for online tobacco education (phase 1) followed by interviews to assess a NCTP education website developed (phase 2). We found preferences for use of font and colors to highlight tobacco information in organized designs. Interactive features (quizzes) motivated engagement, and participants desired responsive designs that function similarly across devices. Public health researchers and educators should apply aesthetic and functionality preferences to reduce NCTP use and help create a tobacco-free future for youth.
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Affiliation(s)
- Allison J Lazard
- School of Media and Journalism, University of North Carolina at Chapel Hill, 384 Carroll Hall (CB 3365), Chapel Hill, NC, 27599-3365, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Jessica Pikowski
- School of Media and Journalism, University of North Carolina at Chapel Hill, 384 Carroll Hall (CB 3365), Chapel Hill, NC, 27599-3365, USA
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, NC, 27709, USA
| | - Lindsey Horrell
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | | | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, 384 Carroll Hall (CB 3365), Chapel Hill, NC, 27599-3365, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Erin L Sutfin
- Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
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Validating Self-Reported Ad Recall as a Measure of Exposure to Digital Advertising: An Exploratory Analysis Using Ad Tracking Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072185. [PMID: 32218265 PMCID: PMC7177256 DOI: 10.3390/ijerph17072185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/19/2020] [Accepted: 03/22/2020] [Indexed: 02/07/2023]
Abstract
Many mass media campaigns aimed at changing young people’s health behavior air on digital platforms rather than on broadcast media (e.g., television), given the intended audience’s preference for web-based communication. While research suggests self-reported ad recall correlates with exposure to television advertising, it remains unclear whether self-report measures are correlated with exposure to digital advertising. This study examined the association between an objective measure of digital ad exposure and self-reported recall of digital ads from the truth® tobacco prevention campaign. Digital ad tracking methodology was employed to identify members of an online panel (ages 18−34) who had been exposed to ads during their regular web browsing. Demographics of exposed participants were used to develop a matched control group of non-exposed panel members. Members of the Exposed group (n = 458) and matched Control participants (n = 506) were surveyed on recall of truth ads, media use, and demographics. Results indicated that Exposed participants had significantly higher odds of reporting ad recall compared to Control participants. With each additional ad exposure, the odds of self-reporting higher frequency of ad exposure increased by 8% (OR = 1.08, 95% CI = 1.01−1.16). Findings suggest self-reported measures of ad recall are a valid measure of campaign exposure in a digital media environment.
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Ye Q, Anwar MA, Zhou R, Asmi F, Ahmad I. China's green future and household solid waste: Challenges and prospects. WASTE MANAGEMENT (NEW YORK, N.Y.) 2020; 105:328-338. [PMID: 32113124 DOI: 10.1016/j.wasman.2020.02.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 06/10/2023]
Abstract
China is facing the dual challenge of economic development and environment protection. Recently, Shanghai (tier-1 city) implemented the pilot project of household solid waste (HSW) management and expects to execute a similar project in 45 cities across China by 2020. The current research's aim is to examine the pilot project's progress by comparing it with existing HSW management practice in other cities. From a theoretical perspective, a socio-ecological framework is used to examine citizens' HSW sorting behavior (HSWSB), which is further mapped based on the theory of planned behavior to enrich the findings. A total of 1409 citizen responses are utilized to generalize the findings. The study concludes that replicating tier-1 practices in other cities could produce unsatisfactory results. The regulatory environment should focus on comparatively long-lasting citizen behavior change by designing a citizen-centric approach (i.e., awareness campaigns) related to ecological concerns (i.e., climate change) because it could define the future of HSWSB practice in Chinese society.
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Affiliation(s)
- Qing Ye
- FuYang Normal University, FuYang, Anhui, China
| | | | - Rongting Zhou
- University of Science and Technology of China, Hefei, Anhui, China
| | - Fahad Asmi
- University of Science and Technology of China, Hefei, Anhui, China.
| | - Intikhab Ahmad
- University of Science and Technology of China, Hefei, Anhui, China
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Awareness of and Receptivity to the Fresh Empire Tobacco Public Education Campaign Among Hip Hop Youth. J Adolesc Health 2020; 66:301-307. [PMID: 31704108 DOI: 10.1016/j.jadohealth.2019.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/21/2019] [Accepted: 09/08/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to assess awareness of and receptivity to the U.S. Food and Drug Administration's Fresh Empire tobacco public education campaign designed to reach Hip Hop-identified youth, who are at higher smoking risk. METHODS The evaluation uses a randomized treatment-control design with 15 campaign-targeted treatment and 15 control markets. We conducted surveys among 12- to 17-year-olds before campaign launch and at approximately 6-month intervals. Analyses explore treatment-control differences in Fresh Empire brand and video advertisement awareness at individual survey rounds and over time and perceived effectiveness of advertisements. RESULTS Awareness of the Fresh Empire brand was higher among youth in treatment than control markets following campaign launch (ps < .01). Awareness of the Fresh Empire brand increased more in treatment than control over time (adjusted odds ratio = 3.26, 95% confidence interval = 1.90-5.58). At follow-ups 1 and 3, youth in treatment (vs. control) were more likely to report high and less likely to report low awareness of video advertisements (ps < .05). There were no treatment-control differences in video awareness at follow-up 2 (not significant). Fresh Empire video advertisements had perceived effectiveness scores ranging from 3.66 to 4.11 (1-5 scale) across three survey rounds. CONCLUSIONS Among the campaign audience of Hip Hop-identified youth, awareness of the Fresh Empire campaign was higher in treatment than control markets at individual survey rounds, and increases in campaign awareness were greater in treatment than control markets over time. Campaign advertisements also elicited positive audience reactions. Findings suggest that heavily digital campaigns may take longer to achieve Centers for Disease Control and Prevention-recommended 75% quarterly awareness.
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Noar SM, Barker J, Bell T, Yzer M. Does Perceived Message Effectiveness Predict the Actual Effectiveness of Tobacco Education Messages? A Systematic Review and Meta-Analysis. HEALTH COMMUNICATION 2020; 35:148-157. [PMID: 30482058 PMCID: PMC6538475 DOI: 10.1080/10410236.2018.1547675] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Target audience ratings of the likely impact of persuasive messages, known as perceived message effectiveness (PME), are commonly used in health communication campaigns. However, applications of PME rely on a critical assumption-that is, that PME is a valid indicator of the likely effectiveness of messages. To examine the evidence supporting this assumption, we conducted a systematic review and meta-analysis of longitudinal studies in the tobacco education campaigns literature. Six longitudinal studies examining the predictive validity of PME met inclusion criteria. Results indicated that PME ratings were significantly associated with the majority of outcomes studied. In fact, each of the six studies found PME to be associated with at least one outcome, and across the six studies, PME was associated with message recall, conversations about ads, beliefs about smoking and quitting smoking, quit intentions, and cessation behavior. Meta-analyses demonstrated that PME predicted quit intentions (r = .256, p < .001) and cessation behavior (r = .201, p < .001), revealing effects that were small to medium in magnitude. Our results suggest that PME provides some predictive value as to the likely effectiveness of messages, although additional work using different validation designs, with other health behaviors, and among other populations is needed.
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Affiliation(s)
- Seth M. Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Joshua Barker
- School of Media and Journalism, University of North Carolina at Chapel Hill
| | - Trevor Bell
- School of Media and Journalism, University of North Carolina at Chapel Hill
| | - Marco Yzer
- Hubbard School of Journalism and Mass Communication, University of Minnesota
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Adults' favorability toward prohibiting flavors in all tobacco products in the United States. Prev Med 2019; 129:105862. [PMID: 31655175 DOI: 10.1016/j.ypmed.2019.105862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/18/2019] [Accepted: 10/11/2019] [Indexed: 12/25/2022]
Abstract
In November 2018, US Food and Drug Administration announced its intent to prohibit menthol in combustible tobacco products, prohibit flavored cigars, and prohibit flavored e-cigarettes unless they are sold in age-restricted, in-person locations. This study assessed adult attitudes toward prohibiting flavors in all tobacco products, including e-cigarettes. Data were from the 2016 Summer Styles survey of 4203 US adults aged ≥18 years. Respondents were asked whether they favored or opposed prohibiting flavors (e.g., menthol, spicy, sweet, or fruity flavor) in all tobacco products. Prevalence and correlates of favorability were assessed using weighted percentages and adjusted prevalence ratios (aPR) respectively. Assessed correlates were: sex, age, race/ethnicity, income, US Census region, marital status, children <18 years living in the home, perceptions toward e-cigarette advertising, and current (past 30-day) tobacco product use. Overall, 47.3% of adults reported favorable attitudes toward prohibiting flavors in all tobacco products. By tobacco product use status, prevalence was 52.0%, 48.4%, and 34.8% among never, former, and current users, respectively (p < .05). Among current tobacco product users, favorability was more likely among adults who believed e-cigarette ads exposure makes youth think about smoking (aPR = 1.82; 95% CI = 1.20-2.78) and those with any children aged <18 years in their household (aPR = 1.38; 95% CI = 1.05-1.82). To conclude, nearly half of adults favored prohibiting flavors in all tobacco products, including e-cigarettes. Prohibiting flavors in tobacco products could benefit public health by reducing both individual-level and population-level harms, including tobacco use initiation especially among youth.
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Kranzler EC, Schmälzle R, Pei R, Hornik RC, Falk EB. Message-Elicited Brain Response Moderates the Relationship Between Opportunities for Exposure to Anti-Smoking Messages and Message Recall. THE JOURNAL OF COMMUNICATION 2019; 69:589-611. [PMID: 32009669 PMCID: PMC6977712 DOI: 10.1093/joc/jqz035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 08/09/2019] [Accepted: 08/10/2019] [Indexed: 06/10/2023]
Abstract
Campaign success is contingent on adequate exposure; however, exposure opportunities (e.g., ad reach/frequency) are imperfect predictors of message recall. We hypothesized that the exposure-recall relationship would be contingent on message processing. We tested moderation hypotheses using 3 data sets pertinent to "The Real Cost" anti-smoking campaign: past 30-day ad recall from a rolling national survey of adolescents aged 13-17 (n = 5,110); ad-specific target rating points (TRPs), measuring ad reach and frequency; and ad-elicited response in brain regions implicated in social processing and memory encoding, from a separate adolescent sample aged 14-17 (n = 40). Average ad-level brain activation in these regions moderates the relationship between national TRPs and large-scale recall (p < .001), such that the positive exposure-recall relationship is more strongly observed for ads that elicit high levels of social processing and memory encoding in the brain. Findings advance communication theory by demonstrating conditional exposure effects, contingent on social and memory processes in the brain.
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Affiliation(s)
- Elissa C Kranzler
- Wharton Risk Management and Decision Processes Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ralf Schmälzle
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, 48824, USA
| | - Rui Pei
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Robert C Hornik
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, PA, 19104, USA
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Ranney LM, Kowitt SD, Queen TL, Jarman KL, Goldstein AO. An Eye Tracking Study of Anti-Smoking Messages on Toxic Chemicals in Cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4435. [PMID: 31726727 PMCID: PMC6888389 DOI: 10.3390/ijerph16224435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/28/2019] [Accepted: 11/07/2019] [Indexed: 12/04/2022]
Abstract
The US Food and Drug Administration is tasked with communicating information to the public about the harmful chemicals in cigarette smoke. Our study used eye tracking method to test the effectiveness of messages about the harmful chemicals in cigarettes smoke among adult smokers. A sample size of 211 current cigarette smokers viewed four communication messages that included: Health effects of a chemical in cigarette smoke and an image depicting the health effect. The messages focused on arsenic, formaldehyde, uranium, and general health. Eye tracking recorded the length of time participants viewed the text and the image. After each message, the participants were asked about the messages' effectiveness in changing attitudes towards smoking. We analyzed the data using multilevel modeling, and of the 211 smokers, 59.7% were female, 36.5% were Black, and 21.3% had a high school degree or less. Compared to the general message, the messages about formaldehyde and uranium were more discouraging to smoking (p < 0.05). Messages about formaldehyde were more believable and made participants want to quit more than the general messages. Increasing message dose was significantly associated with discouraging participants from smoking and made participants want to quit (p < 0.05). Our findings suggest that anti-smoking messages, containing chemical information, can successfully increase negative attitudes toward smoking cigarettes and potentially encourage quitting.
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Affiliation(s)
- Leah M. Ranney
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
| | - Sarah D. Kowitt
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
| | - Tara L. Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
| | - Kristen L. Jarman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
| | - Adam O. Goldstein
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
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Nonnemaker J, Feirman SP, MacMonegle A, Ambrose BK, Jackson KJ, Schroeder MJ, Smith AA, Ridgeway W, Rass O. Examining the role of menthol cigarettes in progression to established smoking among youth. Addict Behav 2019; 98:106045. [PMID: 31302310 DOI: 10.1016/j.addbeh.2019.106045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Menthol, a flavoring compound added to cigarettes, makes cigarettes more appealing to youth and inexperienced smokers and increases cigarettes' abuse liability. However, limited studies are available on menthol's role in smoking progression. METHODS To assess the association between menthol in cigarettes and progression to established smoking, we used five waves of data from the Evaluation of Public Education Campaign on Teen Tobacco Cohort Study, a nationally representative longitudinal survey of U.S. youth conducted as part of "The Real Cost" evaluation. We used discrete time survival analysis to model the occurrence of two event outcomes-progression to established, current smoking and progression to established, frequent smoking-using a logit model with a menthol use indicator as the key explanatory variable. Based on this framework, we estimated the effect of prior menthol use on the odds of smoking progression. RESULTS In the progression to established, current smoking model, prior menthol use was significantly associated with progression [adjusted odds ratio (aOR) = 1.80, p < .05, confidence interval (CI) = (1.03-3.16)]. While results were in a similar direction for the model of progression to established, frequent smoking, the association between prior menthol use and this progression model did not reach significance [aOR = 1.56, CI = (0.80-3.03)]. CONCLUSION The results suggest a relationship between using menthol cigarettes and progression from experimental to established, current smoking among youth. This study adds to a growing literature base that supports that menthol cigarettes, compared to nonmenthol cigarettes, put youth at increased risk for regular cigarette use.
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Affiliation(s)
- James Nonnemaker
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America.
| | - Shari P Feirman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
| | - Anna MacMonegle
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Bridget K Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
| | - Kia J Jackson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
| | - Megan J Schroeder
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
| | - Alexandria A Smith
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
| | - William Ridgeway
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Olga Rass
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States of America
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