Anti-Vaping Messages for Reducing Nicotine Use in Young Adults

Overseen By Jiaying Liu, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Georgia

Disqualifiers: Neurological, Psychiatric, Medical disorders, others

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

Compensation: Varies

Number of Visits: 6

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to examine how different anti-vaping messages affect young adult vapers who do not currently smoke cigarettes. Researchers seek to understand how these messages influence brain activity, using brain scans, and whether this alters vaping habits over a year. Participants will be divided into groups to receive either general anti-vaping messages, messages focusing on the harms of flavored vapes, or no messages, with some switching message types halfway through. The trial is ideal for young adults who have vaped at least three times in the last month but have not smoked cigarettes during that time. As an unphased trial, it offers a unique opportunity to contribute to important research on vaping behaviors and brain responses.

Will I have to stop taking my current medications?

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

What prior data suggests that these anti-vaping messages are safe for young adults?

Research shows that anti-vaping public service announcements (PSAs) are generally well-received by young adults. These announcements aim to discourage vaping and inform young people about the risks of using e-cigarettes. Studies have found that these messages can effectively increase awareness about the health risks of vaping without causing major negative reactions.

For example, the campaign "The Real Cost" targets youth and highlights the potential harms of e-cigarettes. It successfully educated middle and high school students about the dangers, without any reported negative effects. Additionally, research has found that young adults often share social media messages about the harms of vaping, indicating that the content is engaging and not upsetting to the audience.

Overall, exposure to anti-vaping messages appears safe, with no significant safety concerns reported in the available studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores new ways to curb nicotine use among young adults through targeted messaging. Traditional approaches to reducing vaping often involve counseling, nicotine replacement therapies, or medications. However, this study tests the impact of exposure to anti-vaping messages delivered via emails and texts, focusing first on either general negative consequences or specific harms of flavored e-cigarettes. By comparing the effectiveness of different messaging sequences, researchers hope to discover a more effective strategy for reducing vaping rates. This approach is particularly innovative because it leverages digital communication to directly influence behavior, potentially offering a scalable and personalized intervention.

What evidence suggests that this trial's anti-vaping messages could be effective for reducing nicotine use in young adults?

Studies have shown that anti-vaping public service announcements (PSAs) can lead people to view e-cigarettes more negatively and perceive them as more harmful. Research indicates that these messages can reduce vaping and smoking among young people. In this trial, participants will encounter different sequences of anti-vaping messages. One group will receive regular PSAs followed by flavor-specific PSAs, while another group will receive flavor-specific PSAs followed by regular PSAs. A previous study found that a text message program helped teenagers quit vaping, suggesting that targeted messages can be effective. A review of several studies also supports the idea that health messages can help prevent and stop e-cigarette use in both young people and young adults. Overall, the evidence suggests that exposure to anti-vaping messages can be a useful tool in reducing nicotine use. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for young adult vapers who haven't smoked cigarettes in the past month, have used e-cigarettes on at least 3 days in that time, and can safely undergo MRI scans. It's not for those with recent cigarette use, major health disorders, or MRI contraindications.

Inclusion Criteria

Used e-cigarettes or other vaping devices at least 3 days during the past 30 days

Magnetic resonance imaging (MRI) compatible and safe

Did not smoke a cigarette, even one or two puffs, during the past 30 days

Exclusion Criteria

History of a major neurological, psychiatric, or medical disorder

Used e-cigarettes or other vaping devices for less than 3 days during the past 30 days

Any use of cigarettes during the past 30 days

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (virtual)

Baseline fMRI

Participants undergo a baseline fMRI scan to assess neurocognitive markers

1 day

1 visit (in-person)

Intervention

Participants receive weekly anti-vaping PSAs and complete online surveys

12 months

Weekly online surveys

In-person Assessments

Participants complete in-person assessments to biochemically confirm nicotine exposure

12 months

4 visits (in-person at 3, 6, 9, and 12 months)

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Exposure to Anti-Vaping Messages (flavor-specific themes then generic themes)
• Exposure to Anti-Vaping Messages (generic themes then flavor-specific themes)
• Exposure to Anti-Vaping Messages (no message exposure)

Trial Overview The study tests how anti-vaping messages affect young vapers' brains and behavior over a year. Participants will see regular or flavor-specific anti-vaping PSAs while their brain activity is monitored using fMRI. They'll switch message types after 6 months.

How Is the Trial Designed?

Group I: No message exposure (control condition) Experimental Treatment 1 Intervention

Participants will not be receiving any PSA exposure over the 12 months.

Group II: Message exposure (sequence: regular PSAs then flavor PSAs) Experimental Treatment 1 Intervention

Participants randomly assigned to this arm will receive weekly emails and text messages of regular PSAs (i.e., focused in general on the negative consequences of vaping) for the first 6 months of the study, and will then receive weekly emails and text messages of flavor PSAs (i.e., focused specifically on harms and negative consequences associated with vaping flavored e-cigarette products) for the second 6 months of the study.

Group III: Message exposure (sequence: flavor PSAs then regular PSAs) Experimental Treatment 1 Intervention

Participants randomly assigned to this arm will receive weekly emails and text messages of flavor PSAs (i.e., focused specifically on harms and negative consequences associated with vaping flavored e-cigarette products) for the first 6 months of the study, and will then receive weekly emails and text messages of regular PSAs (i.e., focused in general on the negative consequences of vaping) for the second 6 months of the study.

Who Is Running the Clinical Trial?

University of Georgia

Lead Sponsor

Trials

109

Recruited

43,500+

Published Research Related to This Trial

A comprehensive analysis identified 220 vaping prevention messages aimed at youth, with the most common themes focusing on nicotine addiction (32%), harmful chemicals (30%), and health effects (24%).

The study highlights that while many messages effectively use imagery and emphasize the risks of vaping, further research is necessary to evaluate how well these messages actually prevent vaping among young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What's in the message? An analysis of themes and features used in vaping prevention messages. Kresovich, A., Sanzo, N., Brothers, W., et al.[2022]

In a study involving 876 young adults, different warning themes on e-cigarette ads (like nicotine addiction and harmful chemicals) did not significantly change perceptions of harm or intentions to use e-cigarettes, indicating that the current warning system may not effectively deter use.

Warnings emphasizing the impact of nicotine on brain development and the presence of harmful chemicals were perceived as more effective in discouraging youth initiation compared to the standard addiction warning, suggesting that the content of warnings could be crucial in shaping public perception.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults' E-Cigarette Perceptions and Use Intentions. Wackowski, OA., Sontag, JM., Hammond, D., et al.[2020]

Anti-vaping public service announcements (PSAs) that include vapor portrayals effectively reduce intentions to vape and smoke among young adult smokers, with significant decreases in the desire to purchase electronic nicotine delivery systems (ENDS) and traditional cigarettes.

The study found that anti-vaping PSAs without vapor also led to lower vaping urges and intentions to purchase ENDS, indicating that both types of PSAs can be beneficial without causing unintended increases in smoking or vaping urges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of exposure to anti-vaping public service announcements among current smokers and dual users of cigarettes and electronic nicotine delivery systems. Tan, ASL., Rees, VW., Rodgers, J., et al.[2019]

A study involving 1,564 participants aged 15 to 24 identified key messaging themes for a national anti-vape campaign, focusing on attitudes that differentiate between various groups of vape users.

The identified themes, such as social acceptability of vaping and perceived risk of harm, will help tailor effective messages to reduce e-cigarette use among youth, addressing the challenge of selecting impactful communication strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying message themes to prevent e-cigarette use among youth and young adults. Rath, JM., Romberg, AR., Perks, SN., et al.[2023]

A study involving 1501 adolescents found that vaping prevention ads emphasizing addiction, harmful chemicals, and negative health effects were more effective in discouraging vaping, especially when using graphic images and warning symbols.

Conversely, ads that included themes about flavors or used first-person language were less effective and could even increase the appeal of vaping among youth, suggesting that messaging should focus on the dangers rather than appealing to youth culture.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceived effectiveness of objective elements of vaping prevention messages among adolescents. Boynton, MH., Sanzo, N., Brothers, W., et al.[2023]

Youth-focused vaping warnings significantly increased negative feelings and harm beliefs about e-cigarettes compared to no warnings, suggesting that targeted messaging can effectively raise awareness of risks among young adults aged 18-25.

While implicit advertising strategies generated more positive feelings than explicit messages, they did not significantly affect risk perceptions or willingness to vape, indicating that emotional responses may not directly translate to behavioral intentions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Youth and Young Adult-targeted E-cigarette Warnings and Advertising Messages: An Experiment with Young Adults in the US. Kalaji, M., Mathios, AD., Skurka, C., et al.[2022]

A meta-analysis of 12 studies involving 6,622 participants found that vaping prevention messages significantly increased adolescents' and young adults' perceptions of the risks and harms associated with vaping, including addiction and health risks.

Exposure to these messages also resulted in greater knowledge about vaping and lower intentions to vape, indicating that these prevention strategies are effective in discouraging vaping among young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies. Ma, H., Kieu, TK., Ribisl, KM., et al.[2023]

Out of 2966 unique electronic nicotine delivery system (ENDS) advertisements analyzed from 2018-2020, only 33% included any nicotine-related content, indicating a lack of standard communication about nicotine levels to consumers.

There was significant variation in how nicotine strength was presented across different manufacturers and media outlets, with ads for Logic e-cigarettes showing the highest nicotine content (62%) compared to JUUL (13%) and Vapor4Life (19%), which could lead to confusion for consumers regarding nicotine exposure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nicotine-related content in English language ENDS advertisements in the US: 2018-2020. Kennedy, RD., Moran, M., Czaplicki, L., et al.[2023]

In a study involving 569 young adults aged 18-24, eight vaping prevention messages were tested, but overall, these messages did not significantly change beliefs, harm perceptions, or vaping behaviors after one month.

However, participants who perceived the messages as more effective showed a lower intention to try cigarettes in the following year, suggesting that while the messages may not have impacted vaping directly, they could influence broader tobacco-related intentions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Vaping Prevention Messages on Electronic Vapor Product Beliefs, Perceived Harms, and Behavioral Intentions among Young Adults: A Randomized Controlled Trial. Villanti, AC., Wackowski, OA., LePine, SE., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10077926/

Testing the Effects of Adolescent-Targeted Anti-vaping ... Exposure to the PSA resulted in overall more negative expectancies about e-cigarettes, as well as increased perceived harmfulness and reduced ...

2. jamanetwork.com jamanetwork.com/journals/jama/fullarticle/2822082

A Vaping Cessation Text Message Program for Adolescent ... This study demonstrated the effectiveness of a tailored, interactive text message intervention for vaping cessation among adolescents.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6825509/

Effects of Exposure to Anti-Vaping Public Service ... From the overall picture of the findings in this study, anti-vaping PSAs reduced both vaping and smoking-related outcomes among smokers, ...

4. tandfonline.com tandfonline.com/doi/full/10.1080/10410236.2024.2352284

Health Messaging Strategies for Vaping Prevention and ... This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults.

5. fda.gov fda.gov/tobacco-products/real-cost-campaign/real-cost-e-cigarette-prevention-campaign

The Real Cost E-Cigarette Prevention Campaign The latest outcome evaluation data collected between August and December 2023 show that approximately 67 percent of youth were aware of at least ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S2352853221000675

What's in the message? An analysis of themes and ... Vaping prevention messages for youth have commonly focused on addiction and health risks of vaping, and they vary on a series of text and image features.

7. jahonline.org jahonline.org/article/S1054-139X(25)00159-4/fulltext

Sharing Antivaping Social Media Messages Social media posts with novel health harms discourage vaping, educate young adults, and are likely to be shared with other young adults.