April 2-4, 2020 • Hyatt Regency • Lexington, KY
Intersectionality and Interdisciplinarity in Health Communication Research
Abstract: Identifying Promising Campaign Themes to Prevent Initiation and Continued Use of Flavored E-cigarettes among Young Adult Vapers
◆ Jiaying Liu, University of Georgia
◆ Jessica Fabbricatore, University of Georgia
◆ Erin Jones, University of Georgia
◆ Lawrence Sweet, University of Georgia
E-cigarettes are now the most commonly used tobacco product among young adults (YAs).1,2 E-cigarette products are often flavored, more palatable and often perceived as safe.3–6 E-cigarette flavors induce nicotine abuse liability through enhanced pleasurable sensory qualities and reward values, leading to vaping persistence and measures of nicotine use progression among YAs;7,8 those more prone to addiction finding ENDS flavoring more appealing.9 It is crucial to develop effective media campaigns to address misperceptions related to e-cigarette flavors. The current study employed a well-validated, theory-based and systematic approach10–12 to provide empirical evidence that informs selection of promising themes addressing issues relevant to e-cigarette flavors targeting YAs.
Given that there exists no established, comprehensive evidence to guide theme selection specifically related to e-cigarette flavors, this investigation started with reviewing of existing scholarship, including the 2016 Surgeon General’s Report (SGR) on e-cigarette use among youth and young adults, the 2019 Society for Research on Nicotine and Tobacco (SRNT) abstracts, and a comprehensive search in the Web of Science database (with search keywords “e-cig and flavor” and “flavor and addiction” in the abstracts, resulting a final N = 286 relevant articles). Two coders searched through the literature for information specifically related to flavored e-cigarette vaping. In total, 356 statements related to beliefs or perceptions of e-cigarette flavors were initially extracted (e.g., “If I use flavored e-cigarette products, the vapor of flavored e-liquids can produce asthmatic symptoms in others”). After further combining similar beliefs and categorizing beliefs into larger themes that represent the same underlying construct, we performed principle component analyses to confirm that the sets of individual belief statements intended to measure each of the themes load with other statements in their predicted themes. These procedures resulted in a total of 149 individual beliefs across 18 themes, including “abuse liability,” “addiction,” “chemicals,” “comparative harms with cigarettes,” “concern for youth,” “cost,” “expert opinion,” “harm perceptions,” “health consequences,” “scientific uncertainty,” “manipulation of tobacco industry,” “nicotine,” “packaging,” “device safety concerns,” “second-hand flavored vapor,” “social perceptions (flavored vaping),” “social perceptions (not vaping flavors),” and “other tobacco initiation”.
To understand how promising each of the beliefs/themes in preventing YA vapers to not initiate or continue to use flavored e-cigarettes, we recruited a total of N = 719 YAs from a large southeastern university, among which 399 reported past-30-day vaping and were used in our sample for analysis. Following prior practices, we used intention to not use flavored e-cigarettes in the next six months as the focal outcome measure, and potential percentage to gain as the evaluation criterion (which represents the estimated additional proportion of the population who would hold the target intention, if 100% of the population endorse the target belief/ theme and the target belief/theme exerts its optimal influence) 11,12 to examine the relative promise of each individual belief statement and theme category. Results indicate strong support for “social perceptions (not vaping flavors),” “health consequences,” “chemicals,” “addiction,” and “second-hand flavored vapor” being the most promising media campaign themes perceived by YA current vapers.