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Chen-Sankey J, Weiger C, La Capria K, Vassey J, Jeong M, Phan L, Unger JB, Allem JP, Berg CJ, Choi K. Young adults' visual attention to features of social media marketing for disposable e-cigarettes and associated perceptions. Addiction 2024. [PMID: 38923723 DOI: 10.1111/add.16586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/09/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND AND AIMS E-cigarette marketing exposure on social media influences perceptions; however, limited knowledge exists regarding marketing features attracting the most visual attention. This study examined visual attention to features of social media marketing for disposable e-cigarettes and related product perceptions. DESIGN, SETTING AND PARTICIPANTS Participants viewed 32 disposable marketing post images from social media (Instagram) using computer-based eye-tracking technology to assess standardized attention metrics of marketing features. They then completed a survey assessing positive product perceptions. The study took place in New Jersey, USA, June-September 2022, comprising young adults (aged 18-29) who do not use tobacco (n = 72) or who smoke cigarettes (n = 42). MEASUREMENTS We examined associations between 14 marketing features (e.g. product package, personal item, fruit/candy descriptor, social media account) and standardized attention metrics of dwell time (fixation duration) and entry time (time to first fixation). Then, we assessed attention metrics for each feature in relation to positive product perceptions (appeal and positive use expectancy). FINDINGS Among all participants, dwell time was the longest for the product descriptor [marginal means (MM) = 1.77; 95% confidence interval (CI) = 1.69, 1.86], social media account (MM = 1.76; 95% CI = 1.67, 1.85) and fruit/candy descriptor features (MM = 1.56; 95% CI = 1.41, 1.70); entry time was the shortest for the social media account (MM = 0.35; 95% CI = 0.26, 0.46), personal item (MM = 0.36; 95% CI = 0.17, 0.56) and human model features (MM = 0.40; 95% CI = 0.08, 0.72). Two use status groups had comparable dwell and entry times, except for the product descriptor feature. Longer dwell time for the product package feature increased positive product perceptions among both use status groups [regression coefficient (β) = 0.44 and 2.61]. Longer dwell time for fruit/candy descriptor (β = 1.80) and price promotion features (β = 4.04) increased positive product perceptions among those who smoke. CONCLUSIONS US young adults appear to be particularly visually engaged by disposable e-cigarette marketing that uses social media account features (account profile pictures, information about the products marketed and relevant hashtags) and features enhancing the products' personal relatability. Disposable product packages, fruit/candy descriptors and price promotions may increase the influence of social media marketing among various use status groups.
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Affiliation(s)
- Julia Chen-Sankey
- Rutgers University, Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Caitlin Weiger
- Rutgers University, Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
| | - Kathryn La Capria
- Rutgers University, Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
| | - Julia Vassey
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michelle Jeong
- Rutgers University, Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Lilianna Phan
- Dornsife School of Public Health and College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Jennifer B Unger
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jon-Patrick Allem
- Rutgers University, Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Robert Wood Johnson Medical School, Division of General Internal Medicine, Rutgers University, New Brunswick, NJ, USA
| | - Carla J Berg
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute of Minority Health and Health Disparities, Bethesda, MD, USA
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Chen-Sankey J, Elhabashy M, Schroth KR. Does Brand Choice Matter: Associations Between Usual E-Cigarette Brands and E-Cigarette Use Patterns Among U.S. Youth, 2021. Health Promot Pract 2024; 25:460-467. [PMID: 37978824 PMCID: PMC11062808 DOI: 10.1177/15248399231210511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND To inform youth about e-cigarette use prevention, it is important to understand whether using e-cigarette products from certain brands is associated with youth's differential e-cigarette use patterns and willingness to quit e-cigarettes. METHODS Data for this study come from the 2021 U.S. National Youth Tobacco Survey (NYTS). The sample was current (past-30-day) e-cigarette users (unweighted n = 1,436). We examined the associations between users' usual e-cigarette brands (Puff, Vuse, Smoke, JUUL, and others) and e-cigarette use patterns (use frequency, use with nicotine, use with flavors) and willingness to quit, controlling for covariates. RESULTS In 2021, 25.6%, 9.7%, 8.1%, and 6.5% of users reported Puff, Vuse, Smok, and JUUL as their usual brands, respectively. Having Smok as a usual brand increased the odds of frequent e-cigarette use compared with other brands. Using Puff, Vuse, and Smok increased the odds of using e-cigarettes with nicotine. Using Puff and Smok increased the odds of using e-cigarettes with any flavors and fruit flavors, and using Smok and JUUL increased the odds of using mint flavors. Finally, using Vuse reduced the odds of having a willingness to quit e-cigarettes. CONCLUSION Puff products, which are likely to be used infrequently and with fruit flavors, were the most endorsed usual brand by youth users. Vuse and Smok brand users demonstrated problematic use patterns, including high-frequency use of nicotine and reduced willingness to quit. The high prevalence of using flavors, especially banned flavors (e.g., mint for JUUL products), suggests the need for tightened restrictions on youth's access to flavored e-cigarettes.
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Affiliation(s)
- Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ 08854
| | - Maryam Elhabashy
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901
| | - Kevin R.J. Schroth
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ 08854
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La Capria K, Uriarte C, Elhabashy M, Menkevich M, Maxton O, Awadalla J, Tan ASL, Moran MB, Chen-Sankey J. Exploring the Influence of E-cigarette Ad Features on Perceived Product Appeal and Use Interest Among Young Adults of Varying Tobacco-Use Behaviors. Nicotine Tob Res 2024; 26:361-369. [PMID: 37594249 PMCID: PMC10882433 DOI: 10.1093/ntr/ntad150] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/05/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Exposure to certain features in commercial e-cigarette ads may influence e-cigarette use perceptions. This study explored the reactions toward common features in e-cigarette ads among young adults of various tobacco-use behaviors. AIMS AND METHODS We used data from in-depth interviews with U.S. young adults (ages 18-29) who do not use tobacco (n = 26) and who currently smoke cigarettes (n = 26). Participants viewed 30 print e-cigarette ads that included multiple features (eg, fruit flavors, price promotions, smoker-targeted messages) before discussing their perceived influence of memorable ad features. We used reflective thematic analysis to analyze interview data. RESULTS Participants from both groups generally noticed fruit and multiple flavors displayed in the ads, which were seen as appealing and were reported to generate product-use interest because of bright colors, sensory appeal, and a variety of flavor options. Participants who smoke perceived price promotions and positive experience testimonials to be appealing, and some reported this generated use interest. Participants from both groups perceived smoker-targeted messages to be unconvincing, and reported this dampened ad and product appeal and use interest. Participants who do not use tobacco perceived nicotine warnings to be unappealing, resulting in reduced perceived appeal of other attractive features (eg, fruit flavors) appearing in the same ads. CONCLUSIONS Marketing features appearing in e-cigarette ads may be perceived by young adults of various tobacco-use behaviors in both similar and different ways. Communication and policy strategies that account for these differential perceptions towards various marketing features are needed to reduce the negative impact of e-cigarette marketing. IMPLICATIONS This study revealed evidence related to young adults' reactions to and perceived influence of commonly used marketing features (eg, fruit flavors, nicotine warnings, price promotions, smoker-targeted messages) in commercial e-cigarette ads. The results highlight the similar and differential perceived appeal and use interest of e-cigarette products promoted with various marketing features among young adults of different tobacco-use behaviors. The results have implications for informing the design of communication strategies and policies related to e-cigarette marketing aimed at promoting complete product switching among young adults who smoke while simultaneously deterring e-cigarette use interest among those who do not use tobacco.
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Affiliation(s)
- Kathryn La Capria
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Caitlin Uriarte
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Maryam Elhabashy
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Madison Menkevich
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
| | - Olivia Maxton
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
| | - Josephine Awadalla
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Meghan B Moran
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ, USA
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Gaiha SM, Lempert LK, McKelvey K, Halpern-Felsher B. E-cigarette devices, brands, and flavors attract youth: Informing FDA's policies and priorities to close critical gaps. Addict Behav 2022; 126:107179. [PMID: 34861522 PMCID: PMC8712419 DOI: 10.1016/j.addbeh.2021.107179] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Identify e-cigarette devices, brands, and flavor types used by adolescents and young adults soon after the enactment of flavor restrictions, youth access laws, FDA's enforcement prioritization against some flavored pod/cartridge-based e-cigarettes, and during COVID-19 pandemic-related school closures. METHODS National cross-sectional online survey (N = 4,351) in May 2020 assessed popularity, ever- and past-30-day use of e-cigarette device types (pod/cartridge-based, disposables, others), brands, flavor types and flavor-enhancers, by age group (under age 21 and 21 and over). RESULTS While pod/cartridge-based e-cigarettes had the highest ever-use (82.7% <21; 69.8% ≥21) and were most often-used (41.9% <21; 41.4% ≥21), most past 30-day-users (50.8% <21; 61.9% ≥21) and 7-day-users (36.0% <21; 56.7% ≥21) used disposables. Mint/menthol was the most-used flavor type (pod/cartridge-based: 48.2% <21, 48.1% ≥21; disposables: 51.6% <21, 56.4% ≥21), followed by fruit (pod/cartridge-based: 37.4% <21, 35.5%≥ 21; disposables: 51.6% >21, 46.2% ≥ 21), and sweet/dessert/candy flavor types (pod/cartridge-based: 24.4% <21, 24.7% ≥21; disposables: 29.7% <21, 33.8% ≥21). Participants reported using add-on e-cigarette flavor-enhancers (pod/cartridge-based: 24.6%; disposables: 31.3%). CONCLUSION Soon after FDA's January 2020 announcement of prioritized enforcement against flavored pod/cartridge-based e-cigarettes and during the pandemic lockdown, adolescents' and young adults' past 30-day use included mostly flavored disposables rather than pod/cartridge-based e-cigarettes, mint/menthol flavors, and some used add-on flavor enhancers. To reduce youth use, comprehensive regulation of e-cigarette devices and flavors should be enacted and enforced at federal, state, and local levels.
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Affiliation(s)
- Shivani Mathur Gaiha
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA
| | - Lauren Kass Lempert
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA; Center for Tobacco Control Research and Education, University of California, San Francisco, USA
| | - Karma McKelvey
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA
| | - Bonnie Halpern-Felsher
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA.
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Rutherford BN, Sun T, Lim CCW, Chung J, Cheng B, Davidson L, Tisdale C, Leung J, Stjepanović D, Connor JP, Chan GCK. Changes in Viewer Engagement and Accessibility of Popular Vaping Videos on TikTok: A 12-Month Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031141. [PMID: 35162170 PMCID: PMC8834819 DOI: 10.3390/ijerph19031141] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
AIM There are concerns regarding what young people are exposed to on TikTok due to trending content promoting e-cigarette use through humour, marketing and lifestyle acceptability. Using baseline data from November 2020, we aimed to examine how much content from a sample of popular vaping videos remained accessible at 9- and 12-month follow-ups. We aimed to monitor changes in viewer engagement (using metadata) before and after the U.S. Congressional Hearing on youth protection measures on social media in October 2021. METHODS Hashtag-based keywords were used to collect the most viewed publicly available e-cigarette related videos on TikTok (N = 802) from inception to November 2020 to form a baseline. Researchers conducted a longitudinal descriptive study using this data, with 9- and 12-month follow-ups to measure changes in viewer engagement (using metadata) and content availability. FINDINGS Of the 802 videos from the baseline, 562 remained at the 9-month follow-up and 511 remained at the 12-month follow-up. At the 12-month follow-up, the majority of vaping-related hashtags were removed by TikTok after the Congressional Hearing. Between the baseline and 9-month follow up, views increased by 1.4% and likes increased by 4.4%. At 12-month follow-up, views had increased by 1.7% and likes by 4.2% compared to baseline data. Whilst 291 videos were no longer publicly accessible at 12-month follow-up, 39 of these were made inaccessible by the content creators. The most viewed and most liked vaping videos at baseline were still publicly available. CONCLUSIONS Whilst the depiction type and thematic distribution of removed videos suggest that TikTok may be removing a small proportion of content that promotes the use of e-cigarettes, metadata of remaining videos indicate an increase in viewer engagement. TikTok's removal of explicit substance-related hashtags from the platform could be a step towards preventing adolescents from being exposed to harmful behaviours and substances online. However, the platform should consider enforcing effective age restrictions on content that promotes substance use in a positive light.
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Affiliation(s)
- Brienna N. Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
- Correspondence:
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Carmen C. W. Lim
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Brandon Cheng
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Lily Davidson
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Calvert Tisdale
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington 2033, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Jason P. Connor
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- Discipline of Psychiatry, The University of Queensland, Herston 4006, Australia
| | - Gary C. K. Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
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Hong T, Wu J, Wijaya D, Xuan Z, Fetterman JL. JUUL the heartbreaker: Twitter analysis of cardiovascular health perceptions of vaping. Tob Induc Dis 2021; 19:01. [PMID: 33437228 PMCID: PMC7791365 DOI: 10.18332/tid/130961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/13/2020] [Accepted: 11/27/2020] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The public most frequently associates tobacco use solely with pulmonary health risks, despite heart disease being the leading cause of death in smokers. The health perceptions of e-cigarettes, especially cardiovascular health, have not been well studied. We aimed to evaluate the prevalence and health perceptions of tweets related to cardiovascular, pulmonary, and brain health – three organ systems for which tobacco use is a major disease risk factor. METHODS We examined the cardiovascular, pulmonary, and brain health perceptions of vaping and JUUL on Twitter, followed by a content analysis of tweets pertaining to the cardiovascular risks. A Twitter firehose API scraped about 6.2 million publicly available tweets from 2015–2019 that contained vaping-related terms, and a separate dataset of about 1.9 million tweets that contained the term JUUL. A quantitative content analysis (n=2145) of tweets was subsequently conducted to assess the health perceptions of vaping and JUUL. Two trained coders independently assessed the posts and Twitter profiles to determine age (<18 or ≥18 years), sex, race, sentiment towards JUUL, and vaping-related topics. RESULTS The majority of tweets containing vaping or JUUL-related terms did not also contain cardiovascular, pulmonary, or brain health terms (97.99% and 96.67%, respectively). Multiple linear regression analysis showed that youth (<18 years), females, non-White individuals, mention of a flavor, and mention of cardiovascular health harm words were associated with more positive sentiments towards JUUL. Pearson’s chi-squared analyses indicated that youth were more likely to mention a JUUL flavor. Females and youth were more likely to reference cardiovascular terms with humor. CONCLUSIONS The cardiovascular health risks of vaping are not fully recognized by the public. Vulnerable populations such as youth and females reference JUUL with cardiovascular-related words that downplay the severity of tobacco as a major risk factor for cardiovascular disease.
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Affiliation(s)
- Traci Hong
- College of Communication, Boston University, Boston, United States
| | - Jiaxi Wu
- College of Communication, Boston University, Boston, United States
| | - Derry Wijaya
- Department of Computer Science, Boston University, Boston, United States
| | - Ziming Xuan
- School of Public Health, Boston University, Boston, United States
| | - Jessica L Fetterman
- Evans Department of Medicine, Boston University School of Medicine, Boston, United States.,Whitaker Cardiovascular Institute, Boston University, Boston, United States
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