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  • 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

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Original research
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
  1. Elizabeth C Hair1,2,3,
  2. Jennifer M Kreslake1,2,
  3. Jessica Miller Rath1,2,
  4. Lindsay Pitzer1,
  5. Morgane Bennett1,
  6. Donna Vallone1,2,3
  1. 1 Truth Initiative Schroeder Institute, Washington, DC, USA
  2. 2 Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3 School of Global Public Health, New York University, New York, NY, USA
  1. Correspondence to Dr Elizabeth C Hair, Schroeder Institute, Truth Initiative, Washington, DC 20001, USA; ehair{at}truthinitiative.org

Abstract

Objective Antismoking mass media campaigns have contributed to significant declines in combustible tobacco use among young people. This study evaluates a national anti-e-cigarette campaign to determine its association with knowledge, attitudes and beliefs in the context of increasing e-cigarette use in the USA.

Methods A national sample of respondents aged 15–24 years (n=8421) was drawn from a repeated cross-sectional online panel survey (220 participants/week) (October 2018 to December 2019). Self-reported exposure to the truth anti-e-cigarette campaign was measured according to level of ad awareness. Outcomes were subjective knowledge of campaign-targeted facts about e-cigarettes and attitudinal constructs about perceived e-cigarette harm, social unacceptability and anti-industry sentiments. Covariates included respondent demographics, current e-cigarette use and cigarette use, parental smoking, sensation seeking, mental health and growth in e-cigarette sales.

Results Ad awareness was associated with knowledge that e-cigarette users are more likely to start smoking (low OR: 1.28, 95% CI 1.14 to 1.44; high OR: 1.88, 95% CI 1.66 to 2.13) and of the nicotine content of JUUL compared with cigarettes (low OR: 1.63, 95% CI 1.45 to 1.82; high OR: 2.50, 95% CI 2.21 to 2.84). High ad awareness was associated with knowledge that the long-term health effects of JUUL use are unknown (OR: 1.88, 95% CI 1.57 to 2.28). High ad awareness was associated with significantly higher perceived product harm (OR: 1.35, 95% CI 1.18 to 1.54), social unacceptability (OR: 1.32, 95% CI 1.15 to 1.53) and anti-industry attitudes (OR: 1.40, 95% CI 1.21 to 1.62), compared with respondents with no awareness.

Conclusions Young people with awareness of anti-e-cigarette ads demonstrate higher levels of campaign-targeted knowledge, attitudes and beliefs. Future campaign evaluation priorities include measuring the campaign effects on e-cigarette use behaviours.

  • electronic nicotine delivery devices
  • denormalisation
  • social marketing

Data availability statement

Data are available upon reasonable request. Study data are archived on a secure server maintained by Truth Initiative. A data sharing agreement is required for use of all data. Investigators seeking access to data used in the study should make a written request to Truth Initiative authors and submit a detailed research plan including the purpose of the proposed research, required variables, duration of the analysis phase, IRB approval with FWA information and investigator training in human subjects. Approved investigators may access data sets via an analytic portal owned and administered by Truth Initiative.

https://doi.org/10.1136/tobaccocontrol-2020-056047

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    Data availability statement

    Data are available upon reasonable request. Study data are archived on a secure server maintained by Truth Initiative. A data sharing agreement is required for use of all data. Investigators seeking access to data used in the study should make a written request to Truth Initiative authors and submit a detailed research plan including the purpose of the proposed research, required variables, duration of the analysis phase, IRB approval with FWA information and investigator training in human subjects. Approved investigators may access data sets via an analytic portal owned and administered by Truth Initiative.

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    Footnotes

    • Twitter @ehairphd

    • Contributors ECH and DV conceptualised and designed the study. JMR oversaw data collection. LP conducted the analyses under the guidance of ECH. JMK and MB composed the manuscript with significant written contributions by JMR, LP and DV. ECH provided final review of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.