Reducing e-cigarette use among youth and young adults: evidence of the truth campaign’s impact

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.

[1]  K. A. Cullen,et al.  Tobacco Product Use Among Middle and High School Students — United States, 2022 , 2022, MMWR. Morbidity and mortality weekly report.

[2]  K. A. Cullen,et al.  Notes from the Field: E-Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021 , 2021, MMWR. Morbidity and mortality weekly report.

[3]  D. Vallone,et al.  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 , 2021, Tobacco Control.

[4]  Timothy R. Rice,et al.  Systematic review of electronic cigarette use (vaping) and mental health comorbidity among adolescents and young adults. , 2020, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[5]  R. McIntyre,et al.  Impact of COVID-19 pandemic on mental health in the general population: A systematic review , 2020, Journal of Affective Disorders.

[6]  D. Vallone,et al.  Association between e-cigarette use and future combustible cigarette use: Evidence from a prospective cohort of youth and young adults, 2017-2019. , 2020, Addictive behaviors.

[7]  Ezra Golberstein,et al.  Coronavirus Disease 2019 (COVID-19) and Mental Health for Children and Adolescents. , 2020, JAMA pediatrics.

[8]  D. Vallone,et al.  Using Aggregate Temporal Variation in Ad Awareness to Assess the Effects of the truth® Campaign on Youth and Young Adult Smoking Behavior , 2020, Journal of health communication.

[9]  C. Delnevo,et al.  Rapid proliferation of illegal pod-mod disposable e-cigarettes , 2020, Tobacco Control.

[10]  E. Benjamin,et al.  Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017 , 2019, JAMA network open.

[11]  J. Nonnemaker,et al.  Impact of The Real Cost Media Campaign on Youth Smoking Initiation. , 2019, American journal of preventive medicine.

[12]  Brian A. King,et al.  Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018. , 2019, Drug and alcohol dependence.

[13]  Jill M Williams,et al.  Nicotine absorption during electronic cigarette use among regular users , 2019, PloS one.

[14]  N. Saliba,et al.  Characteristics and toxicant emissions of JUUL electronic cigarettes , 2019, Tobacco Control.

[15]  Jennifer Cantrell,et al.  Estimating the Pathways of an Antitobacco Campaign. , 2018, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[16]  Jennifer Cantrell,et al.  Evidence of the Impact of the truth FinishIt Campaign , 2018, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[17]  Jennifer Cantrell,et al.  Validity of a Subjective Financial Situation Measure to Assess Socioeconomic Status in US Young Adults , 2017, Journal of public health management and practice : JPHMP.

[18]  Vinu Ilakkuvan,et al.  Social Media Use and Access to Digital Technology in US Young Adults in 2016 , 2017, Journal of medical Internet research.

[19]  C. Kahler,et al.  Bi-directional associations of electronic and combustible cigarette use onset patterns with depressive symptoms in adolescents. , 2017, Preventive medicine.

[20]  J. Nonnemaker,et al.  Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths — United States, 2014–2016 , 2017, MMWR. Morbidity and mortality weekly report.

[21]  Megan E. Patrick,et al.  Monitoring the Future national survey results on drug use, 1975-2017: Overview, key findings on adolescent drug use , 2016 .

[22]  Xiaoquan Zhao,et al.  Youth's Awareness of and Reactions to The Real Cost National Tobacco Public Education Campaign , 2015, PloS one.

[23]  J. Nonnemaker,et al.  A cost-effectiveness analysis of the first federally funded antismoking campaign. , 2015, American journal of preventive medicine.

[24]  L. Johnston,et al.  Monitoring the Future national survey results on drug use, 1975-2019: Overview, key findings on adolescent drug use , 2014 .

[25]  T. Pechacek,et al.  Effect of the first federally funded US antismoking national media campaign , 2013, The Lancet.

[26]  Brian A. King,et al.  Tobacco Product Use Among Middle and High School Students — United States, 2011 and 2012 , 2013, MMWR. Morbidity and mortality weekly report.

[27]  Branalyn K. Williams National Center For Chronic Disease Prevention and Health Promotion regions , 2013 .

[28]  Robert C Hornik,et al.  Use of mass media campaigns to change health behaviour , 2010, The Lancet.

[29]  Phillip E. Pfeifer,et al.  Marketing Metrics: The Definitive Guide to Measuring Marketing Performance , 2010 .

[30]  J. Nonnemaker,et al.  The Influence of the National truth campaign on smoking initiation. , 2009, American journal of preventive medicine.

[31]  G. Pugliese,et al.  Severe Streptococcus pyogenes Infections, United Kingdom, 2003–2004 , 2008, Emerging infectious diseases.

[32]  Patrick M. O'Malley,et al.  Monitoring the Future: National Survey Results on Drug Use, 1975-2006. Volume II: College Students & Adults Ages 19-25. NIH Publication No. 07-6206. , 2007 .

[33]  C S Bergeman,et al.  Psychological resilience, positive emotions, and successful adaptation to stress in later life. , 2006, Journal of personality and social psychology.

[34]  K. Davis,et al.  Evidence of a dose-response relationship between "truth" antismoking ads and youth smoking prevalence. , 2005, American journal of public health.

[35]  G. Giovino,et al.  Effects of Anti-Smoking Advertising on Youth Smoking: A Review , 2003, Journal of health communication.

[36]  R. Hoyle,et al.  Reliability and validity of a brief measure of sensation seeking , 2002 .

[37]  Anthony S. Bryk,et al.  Hierarchical Linear Models: Applications and Data Analysis Methods , 1992 .

[38]  R. Heidel,et al.  Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. , 1989 .

[39]  Sylvia S. Burwell E-Cigarette Use Among Youth and Young Adults : A Report of the Surgeon General , 2016 .

[40]  Public Health,et al.  Ten great public health achievements--United States, 2001-2010. , 2011, MMWR. Morbidity and mortality weekly report.

[41]  Ten great public health achievements--United States, 1900-1999. , 1999, MMWR. Morbidity and mortality weekly report.

[42]  Prabhat Jha,et al.  What About Chronic Disease? , 1955, American journal of public health and the nation's health.

[43]  M. Sherif,et al.  The psychology of attitudes. , 1946, Psychological review.