Digital Media Campaign for Tobacco Use Prevention

(DMCC Trial)

No longer recruiting at 1 trial location

Overseen By Madeline Martin, MPH

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: George Washington University

Disqualifiers: Not in age range, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how digital ads about the dangers of smoking and vaping can influence young people. Researchers aim to determine if different levels of exposure to these messages can change attitudes and behaviors toward tobacco use. Participants will either see varying amounts of these ads or none at all to compare the effects. Young adults aged 18-24 who are part of the Ipsos/Knowledge Panel are ideal candidates for this study. As an unphased trial, this study offers a unique opportunity to contribute to important research on public health messaging.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this digital intervention is safe for youth and young adults?

Research has shown that digital ads against vaping and smoking help young people develop healthier attitudes. For instance, the truth campaign found that these ads made young people less likely to try or continue using e-cigarettes. This indicates that young people not only see these messages but also change their behavior as a result.

The ads are designed to educate about the dangers and health risks of vaping and smoking. Importantly, viewing these digital messages carries no direct physical risks or side effects, as they are purely informational. Participants can feel confident that involvement in this campaign is unlikely to impact their health.

In summary, the campaign aims to change attitudes and behaviors without affecting the physical health of participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using digital advertising for tobacco use prevention because it's a fresh approach compared to traditional methods like counseling and nicotine replacement therapies. These digital interventions can reach a much larger audience quickly and cost-effectively, utilizing platforms where young people spend a lot of time, like social media. The adaptability of digital content allows for tailored messaging that can be more engaging and relevant to different audiences, potentially making it more impactful in reducing tobacco use among teens and young adults.

What evidence suggests that this digital intervention is effective for tobacco use prevention?

Research shows that digital ads against vaping and smoking can effectively change young people's attitudes and behaviors. One study found that ads aimed at preventing smoking also helped reduce vaping among youth. Another study showed that mass media campaigns could lower cigarette use. Research on The Real Cost campaign found it positively influenced how teenagers think about vaping. Reviews from the past decade confirm that these campaigns can affect tobacco use in both adults and young people. In this trial, participants will receive varying levels of exposure to digital anti-vaping and anti-smoking messages, or no exposure as a control. These findings suggest that digital ads may help reduce tobacco use among young people. ^{2 3 6 7 8}

Are You a Good Fit for This Trial?

This trial is for young adults aged 18-24 who are part of the Ipsos/Knowledge Panel. It's designed to evaluate if digital ads can influence anti-tobacco attitudes and behaviors. People outside this age group or not in the panel cannot participate.

Exclusion Criteria

Those who do not meet inclusion criteria

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Online Randomized Study

Conduct a 6-month controlled, online, randomized study to compare the effects of varying levels of digital media exposure on tobacco-related knowledge, attitudes, beliefs, and behavioral outcomes.

6 months

Field-based Randomized Trial

Evaluate a truth digital campaign to confirm the relationship between digital media exposure, message awareness, and tobacco-related outcomes.

36 months

Follow-up

Participants are monitored for changes in tobacco-related knowledge, attitudes, beliefs, and behaviors after the intervention.

4-6 months

What Are the Treatments Tested in This Trial?

Interventions

• Anti-vaping and anti-smoking digital advertising

Trial Overview The study tests the impact of different levels of exposure to anti-vaping and anti-smoking digital advertising on youth and young adult attitudes, beliefs, or actions against tobacco use through online experiments and field evaluations.

How Is the Trial Designed?

Group I: Digital intervention Experimental Treatment 1 Intervention

Participants will be randomized to receive variable levels of exposure (including no exposure control) of digital anti-vaping and anti-smoking messages. We will evaluate the effects of experimental condition and exposure on outcomes (tobacco product use).

Group II: Control Active Control 1 Intervention

No exposure control condition

Anti-vaping and anti-smoking digital advertising is already approved in United States, European Union for the following indications:

Approved in United States as Anti-vaping campaigns for:

• Prevention of vaping and smoking behavior among youth and young adults

Approved in European Union as Anti-smoking digital advertising for:

• Prevention of smoking behavior among youth and young adults

Who Is Running the Clinical Trial?

George Washington University

Lead Sponsor

Trials

263

Recruited

476,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Published Research Related to This Trial

This review analyzed 17 tobacco control campaigns evaluated across 51 articles and various reports, highlighting the diversity of metrics used to assess campaign effectiveness, which complicates comparisons between campaigns.

Only 7 out of the 17 campaigns measured how well different media platforms contributed to their success, indicating a need for standardized metrics to better evaluate the impact of digital media in public health campaigns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns. Chan, L., O'Hara, B., Phongsavan, P., et al.[2021]

E-cigarette advertising expenditures in the USA decreased from $133 million in 2014 to $48 million in 2017, but then surged to $110 million in 2018, indicating a volatile advertising landscape.

Altria was the leading spender on e-cigarette advertising from 2014 to 2018, with significant expenditures, particularly in 2018 when JUUL Labs also made a notable impact with over $73 million spent in that year.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

E-cigarette advertising expenditures in the USA, 2014-2018. Ali, FRM., Marynak, KL., Kim, Y., et al.[2021]

Exposure to emotional and graphic antismoking advertisements significantly increases the likelihood of quit attempts among adult smokers, as shown in a study of 8,780 smokers in New York State from 2003 to 2010.

Advertisements that do not evoke strong negative emotions or use graphic images do not have any effect on smokers' attempts to quit, highlighting the importance of impactful messaging in antismoking campaigns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promotion of smoking cessation with emotional and/or graphic antismoking advertising. Farrelly, MC., Duke, JC., Davis, KC., et al.[2022]

A systematic review identified 9 key websites that archive anti-tobacco media content, which can be valuable resources for researchers and practitioners in tobacco prevention and control efforts.

While all identified websites contained anti-tobacco content, 56% also included pro-tobacco material, highlighting the need for more focused archives on vaping media as youth vaping rates rise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Review of Web-Based Tobacco Control Media Archives for Researchers and Practitioners. Kresovich, A., Noar, SM., Gvino, E., et al.[2023]

In a study involving 1400 US adult smokers and recent quitters, both types of comparative risk messages about e-cigarettes effectively reduced intentions to smoke traditional cigarettes and increased the likelihood of switching to e-cigarettes, suggesting a potential for harm reduction.

Messages that included more negative antismoking elements not only enhanced self-efficacy to quit smoking but also did not promote dual use of e-cigarettes and traditional cigarettes, indicating they may be particularly effective for encouraging smokers to transition to lower-risk products.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Testing messages about comparative risk of electronic cigarettes and combusted cigarettes. Yang, B., Owusu, D., Popova, L.[2020]

A digital media campaign promoting the California Smokers' Helpline to healthcare professionals generated over 2.7 million impressions and significantly increased online orders for promotional materials by nearly 40% over three years.

The campaign's success was attributed to a well-defined strategy that allowed for systematic development and implementation, highlighting the importance of learning from past experiences to improve future digital media efforts in smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maximizing the Impact of Digital Media Campaigns to Promote Smoking Cessation: A Case Study of the California Tobacco Control Program and the California Smokers' Helpline. Lee, YO., Momin, B., Hansen, H., et al.[2020]

Tobacco control campaigns have been shown to effectively influence both adult and youth tobacco use behaviors, demonstrating high cost-effectiveness and positive impacts on social norms and policy support.

Future research should focus on adapting to the changing media landscape and ensuring equitable campaign effects in high smoking prevalence communities, including understanding the best media mix and message strategies to promote quitting and prevent e-cigarette use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimising tobacco control campaigns within a changing media landscape and among priority populations. Durkin, SJ., Brennan, E., Wakefield, MA.[2023]

Newly developed warning messages about the health risks of e-cigarettes, particularly those focusing on toxic metals exposure, were found to be significantly more effective in discouraging vaping than the current FDA-required warning, based on a study involving 1629 US adults.

The study also revealed that using images depicting internal harm or individuals suffering from vaping-related issues was more effective in discouraging e-cigarette use compared to images of hazards, suggesting that visual representations of harm can enhance the impact of warning messages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimising messages and images for e-cigarette warnings. Lazard, AJ., Ebrahimi Kalan, M., Nicolla, S., et al.[2023]

Only about 12% of healthcare providers in New York State were aware of the NYSDOH's media campaign aimed at promoting tobacco dependence treatment, but those who were aware showed significantly increased beliefs in the effectiveness of nicotine patches and gum for helping patients quit smoking.

The study suggests that while awareness of the campaign positively influenced providers' beliefs about treatment effectiveness, it did not significantly change their clinical behavior, indicating a need for improved campaign delivery to enhance awareness and impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of a media campaign promoting health care provider tobacco dependence treatment. Hayes, KA., Brown, EM., Nonnemaker, J., et al.[2023]

In a study of 13,165 middle and high school students, exposure to The Real Cost anti-tobacco campaign was linked to lower odds of using other tobacco products and dual/poly tobacco use, suggesting the campaign's effectiveness in reducing certain tobacco behaviors.

Conversely, increased exposure to pro-tobacco advertising was associated with higher odds of exclusive E-cigarette use and dual/poly use, highlighting the influence of advertising on youth tobacco consumption.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Associations Between Exposure to The Real Cost Campaign, Pro-Tobacco Advertisements, and Tobacco Use Among Youth in the U.S. Stevens, EM., Hébert, ET., Keller-Hamilton, B., et al.[2023]

This scoping review aims to analyze online promotions and discussions about electronic cigarettes from 2007 to 2017, focusing on claims related to health benefits, smoking cessation, and pricing, to understand the messaging surrounding these products.

The review will follow a systematic methodology to ensure comprehensive data collection and will highlight the need for regulatory and health policy discussions regarding the marketing of electronic cigarettes as a safer alternative to traditional smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The messages presented in online electronic cigarette promotions and discussions: a scoping review protocol. McCausland, K., Maycock, B., Jancey, J.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9910139/

The Impact of The Real Cost Vaping and Smoking Ads ... This experiment found evidence of beneficial spillover effects of smoking prevention ads on vaping outcomes and found no detrimental effects.

2. tobaccocontrol.bmj.com tobaccocontrol.bmj.com/content/34/1/59

Reducing e-cigarette use among youth and young adults Background Mass media campaigns have been shown to be effective in reducing cigarette use. However, evidence is limited for whether campaigns can shift ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0306460320306031

Evaluating the actual and perceived effectiveness of E- ... We examined the impact of ads from the The Real Cost vaping prevention media campaign on what adolescents think and believe about vaping.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5623370/

Effect of e-cigarette advertisements and antismoking ... It will determine whether viewing an e-cigarette advertisement increases positive attitudes towards tobacco smoking in smokers, vapers and non-smokers, and ...

5. tobaccocontrol.bmj.com tobaccocontrol.bmj.com/content/31/2/284

Optimising tobacco control campaigns within a changing ... Reviews published over the past decade confirm tobacco control campaigns can be effective for influencing adult and youth tobacco use behaviours.

6. fda.gov fda.gov/tobacco-products/public-health-education-campaigns/real-cost-campaign

The Real Cost Campaign The e-cigarette and cigarette prevention campaigns focus on educating youth about the negative health effects and risks of vaping and smoking.

7. truthinitiative.org truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-facts-stats-and-regulations

E-cigarettes: Facts, stats and regulations In 2021, more than 75% of middle and high school students reported exposure to marketing or advertising of any nicotine or tobacco product — including e- ...

8. cdc.gov cdc.gov/tobacco/e-cigarettes/youth.html

E-Cigarette Use Among Youth | Smoking and Tobacco Use No tobacco products, including e-cigarettes, are safe, especially for children, teens, and young adults. Learn more about e-cigarette use among ...