Impact of Vaping Prevention Advertisements on US Adolescents: A Randomized Clinical Trial.
Tuesday, October 25, 2022
Posted by: Natalia Gromov
Noar
SM, Gottfredson NC, Kieu T, et al.
Impact of Vaping
Prevention Advertisements on US Adolescents: A Randomized Clinical Trial.
JAMA Netw Open.
2022;5(10):e2236370. Published 2022 Oct 3.
doi:10.1001/jamanetworkopen.2022.36370
Importance. Understanding
whether prevention advertisements reduce susceptibility to vaping is important
owing to concerning levels of adolescent vaping.
Objective. To
examine whether vaping prevention advertisements from the US Food and Drug
Administration (FDA) national Real Cost campaign lead to lower susceptibility
to vaping among adolescents.
Design, setting, and
participants. For this 3-group randomized clinical trial
with parallel assignment, participants were US adolescents aged 13 to 17 years
who were susceptible to vaping or current e-cigarette users, recruited from
online panels. Adolescents were randomized to 1 of 2 Real Cost vaping
prevention trial groups (health harms- or addiction-themed advertisements) or
to a control group (investigator-created neutral videos about vaping).
Adolescents completed 4 weekly online surveys at visits 1 to 4 over a 3-week
period. Data were analyzed from December 1, 2021, to August 25, 2022.
Interventions. Adolescents
saw 3 randomly ordered 30-second video advertisements online at each of 3
weekly study visits (visits 1, 2, and 3).
Main outcomes and
measures. The primary trial outcome was susceptibility to
vaping. Surveys also assessed susceptibility to smoking cigarettes to examine
any spillover effects of vaping prevention advertisements on smoking outcomes.
Both susceptibility measures had 3 items and ranged from 1 (indicating not
susceptible) to 4 (indicating highly susceptible). The primary analyses
compared Real Cost groups (combined) with the control group, while exploratory
analyses compared the Real Cost groups with each other.
Results. Participants
were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years),
including 504 randomized to the Real Cost health harms group, 506 randomized to
the Real Cost addiction group, and 504 randomized to the control group.
Adolescents in the Real Cost groups (combined) had lower susceptibility to
vaping at visit 4 than those in the control group (b = -0.21; 95% CI, -0.32 to
-0.10). The Real Cost groups did not differ from one another on susceptibility
to vaping (visit 4: b = -0.05; 95% CI, -0.17 to 0.07). Adolescents in the Real
Cost groups (combined) also had lower susceptibility to smoking cigarettes than
those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). For both vaping
and smoking, Real Cost groups had less positive attitudes (vaping: b = -0.27;
95% CI, -0.40 to -0.14; smoking: b = -0.23; 95% CI, -0.39 to -0.08) compared
with the control group.
Conclusions and
relevance. These findings suggest that vaping prevention
advertisements from the FDA Real Cost campaign led to lower adolescent
susceptibility to vaping and had beneficial spillover effects on cigarette
smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco
use.
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