Anti-Vaping Messages for Reducing Nicotine Use in Young Adults

Recruiting in Palo Alto (17 mi)

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Georgia

Disqualifiers: Neurological, Psychiatric, Medical disorders, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

180 young adult vapers who are not current smokers will participate in a baseline functional magnetic resonance imaging (fMRI) experiment, prospectively linked to a 1-year randomized controlled trial. Baseline fMRI tasks will probe critical neurocognitive markers with high potential to account for individual differences in nicotine use prognosis and responsiveness to anti-vaping public service announcements (PSAs). Participants will be assigned randomly to a survey-only control condition, or one of two intervention orders, Regular PSA then Flavor PSA, and Flavor PSA then Regular PSA (n=60 each) in a 1-year counterbalanced crossover design. Every week intervention groups will receive anti-vaping PSAs either do not specifically address harms associated with vaping flavors (regular PSAs) or PSAs with a theme focusing on the harms of flavored vape products (flavor PSAs). Participants of the intervention groups will switch PSA exposure condition after 6 months. Their evaluations of the PSAs will be assessed with brief weekly online surveys. The links to the weekly online surveys will be sent via e-mail and text which allow them to access the surveys using any device with an internet browser. During the survey, the PSA of that week will first be displayed to PSA groups (n=120), followed by a query to provide message evaluation. Afterward, the survey questions will also assess their e-cigarette, cigarette, other tobacco use, and nicotine dependence, during the past week. The control group (n=60) will complete the surveys without viewing PSAs. In-person assessments at 3, 6, 9, and 12 months will biochemically confirm nicotine exposure.

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 evidence supports the effectiveness of anti-vaping messages as a treatment for reducing nicotine use in young adults?

Research shows that anti-vaping messages can increase young adults' awareness of the risks and harms of vaping, leading to higher perceptions of addiction and harm, and lower intentions to vape. These messages have been found to be effective in changing attitudes and increasing knowledge about vaping, which can help reduce nicotine use. ^{1 2 3 4 5}

Is exposure to anti-vaping messages safe for young adults?

The research does not provide specific safety data for exposure to anti-vaping messages, but it does not indicate any harmful effects from viewing these messages. The studies focus on the effectiveness of the messages in changing perceptions and intentions related to vaping. ^{1 4 6 7 8}

How do anti-vaping messages differ from other treatments for reducing nicotine use in young adults?

Anti-vaping messages are unique because they focus on changing perceptions and attitudes towards vaping through targeted communication, rather than using medication or behavioral therapy. These messages aim to increase awareness of the risks and social implications of vaping, which can lead to reduced intentions to vape among young adults. ^{1 2 3 4 9}

Research Team

Eligibility Criteria

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

Trial Timeline

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

Treatment Details

Interventions

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

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.

Participant Groups

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+

Dr. Biao He

University of Georgia

Chief Executive Officer

PhD in Veterinary Medicine

Dr. Hank Radziewicz

University of Georgia

Chief Medical Officer

MD from Duke University, MSCR from Emory University

Findings from Research

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Identifying message themes to prevent e-cigarette use among youth and young adults. [2023]

3. Switzerland 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. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Perceived effectiveness of objective elements of vaping prevention messages among adolescents. [2023]

5. Netherlands pubmed.ncbi.nlm.nih.gov

What's in the message? An analysis of themes and features used in vaping prevention messages. [2022]

6. Switzerland 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. [2020]

7. Ireland 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. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Youth and Young Adult-targeted E-cigarette Warnings and Advertising Messages: An Experiment with Young Adults in the US. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Nicotine-related content in English language ENDS advertisements in the US: 2018-2020. [2023]