SCIENCE OF VAPING PREVENTION

3 Recommendations from the latest research
Practical tips synthesized from the most recent research studies in the field
#1

Show youth the effects of vaping, instead of only listing ingredients. Recent studies suggest that vape ingredients (like chemicals) can be the basis of effective messages, but it's most important to help youth understand what those chemicals will do to their bodies and minds.1-2

#2

Consider focusing on the respiratory, chemical and cardiovascular harms of vaping in your communications. A recent study found that tobacco users were more discouraged from vaping by these harms, and least discouraged by nicotine addiction.3

#3

Implement pricing policies on all tobacco products in your community. Policies that raise the price of commercial tobacco products, including e-cigarettes, are highly effective in: 1) reducing tobacco initiation, 2) reducing consumption among continuing users, and 3) promoting cessation.4

Vaping Epidemic By the Numbers

1 in 5
high school students
currently vape1
50%
of all youth who vape
want to quit2
$1.3 billion
USD in annual e-cigarette
retail sales in 2017 6
3.6 million
youth in the U.S. vape1
15,000+
e-cigarette flavors are on the
on the market4
$110+ million
USD spent on advertising by e-cigarette companies in 20184

HEALTH EFFECTS OF VAPING

Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control. A recent CDC study found that 99% of the e-cigarettes sold in in the United States contained nicotine.5
Nearly all habitual tobacco use begins during youth and young adulthood. Among adults who are daily smokers, nearly 90% first used of cigarettes by 18 years of age.5
E-cigarettes contain harmful chemicals (like formaldehyde and acrolein), and we don’t yet know the long-term effects of these chemicals.6
There may be increased cough and wheeze in adolescents who use e-cigarettes, and an association with e-cigarette use and increased asthma issues.5,6
Exhaled aerosol from e-cigarettes can expose users and bystanders to harmful compounds and ultrafine particles which can be inhaled deeply into the lungs.5
Exposure to e-liquids (from drinking, eye contact, or dermal contact) can result in adverse health effects including but not limited to: seizures, anoxic brain injury, vomiting, and lactic acidosis.6
Youth largely know that e-cigarettes have nicotine and are addictive, but they don’t understand the harmful consequences of addiction. Youth want more information on why e-cigarettes are bad, and want to see specific facts.7

Q & A WITH THE EXPERTS

Innovative and groundbreaking research findings from experts in the field of vaping prevention and control.
Olivia Wackowski, PhD, MPH
Associate Professor
Department of Health Behavior, Society, and Policy
Rutgers School of Public Health

Use statements that are grounded in scientific evidence. It’s important for practitioners and researchers to maintain credibility when talking about e-cigarettes.8-10 Try to craft clear messages without being misleading or over the top with your language.11,12 In particular, be cautious about saying e-cigarettes “cause” certain health issues if it hasn’t been established in the scientific evidence. If needed, be open about what we know about e-cigarettes, and where the research is still growing. For a good starting place, refer to the list of established e-cigarette harms above.

Remember that e-cigarette products and trends are constantly changing. When creating new messages for your community, review existing research, but also consider doing new message testing to ensure your communications are timely and relevant to your audience. Doing research with your audience is vital – especially when it concerns what young people are seeing, discussing, being exposed to, or currently think is cool or trendy.9,13

Stay away from the message that e-cigarettes “are not a safe alternative to combustible cigarettes.”11 This message can have two major weaknesses: 1) it’s not effective because it is a vague statement, and 2) it can be perceived as misleading because consumers think you’re saying that e-cigarettes are the same or just as harmful as cigarettes.11,14

Joseph Capella, PhD
Gerard R. Miller Professor
Annenberg School for Communication
UPenn Leonard Davis Institute of Health Economics

Avoid showing vaping behavior in your communications. In anti-smoking messages, the presence of smoking or smoking paraphernalia may undermine the message because it sparks cravings for smokers.15-18 This lesson can be applied to anti-vaping communications if vaping behavior is directly or indirectly depicted. There is some research to suggest that vaping cues in advertisements can cue cigarette cravings in former smokers,19,20 and exposure to pro-vaping advertisements may increase vaping among youth.21

Use narratives and testimonials to make your messages more powerful. Vaping messaging may be most powerful when it uses narratives and testimonials from individuals who currently or previously vaped.22-24 These stories are especially effective when personal harm, experience with quitting, or the overall journey is shared. These messages have been proven to engage the viewer and change their intentions to smoke.

Manage comment sections on social media and online platforms. Studies show that comment threads distract and detract from public health messaging.25 If allowed, comments should be curated, and the most virulent or uncivil messages removed to protect the intent of the messaging. However, comments can only be controlled on an institutional website or social media platform, and this control is lost when the communications are shared elsewhere.

TIPS FOR HEALTH COMMUNICATION

Health communication – when done effectively – can create lasting public health improvements by preventing tobacco use initiation and increasing cessation.

Want to communicate about a vaping-related issue that is impacting your community? Below is a road map of best practices to help you:


Step 1. Develop a plan.

A plan will inform how you roll out your communications campaign, and should include:
  • WHO you want to target (i.e. your audience)
  • WHAT evidence you are using to build your campaign, as well as the goals or desired impact of your campaign
  • WHEN you plan to roll-out and evaluate your campaign
  • WHERE you will reach your audience (i.e. your communication strategies or channels for sending your messages)
  • HOW you will evaluate if the campaign is working
  • The budget you have for your campaign

Step 2. Understand your audience.

  • Researching the people you want to reach will help you to better understand how to communicate effectively with them. It is critical to take some time to talk with members of your audience directly to understand their experience and perceptions of the health problem before you begin crafting your messages. Their answers and feedback may surprise you.
  • Use already-existing population-level data like census information or health department data to understand your audience’s health issue.
  • Narrow your target audience as much as possible so you can target your strategies and messaging for a more successful campaign.
  • Representation is essential. Make sure your team represents the audience you’re trying to reach, that you are culturally competent, and are including members of your target audience in the development process.

Step 3. Develop and pre-test your messages.

  • Messages should be hard-hitting and should be targeted to your specific target audience.
  • Try developing a mix of messages for your campaign. This will help make sure you reach as many members of your audience as possible. The messages you choose should be based on your campaign goals, your audience’s preferences, and your budget.
  • Test your ads with your audience. After you create your message ideas, use focus groups, surveys, or other methods to refine your messages, ensure they are well-received, seem to achieve the desired impact, and will be placed in locations where your audience will see them.
  • Your messaging should include information about additional support resources — for example, linking to state or national vaping prevention and cessation resources, or your state Quitline.
  • You may have the option to re-use ads or make new ones. Decide what works best for your budget, your campaign goals, and your audience. Make sure the reach and frequency of exposure to the ads is at an appropriate level to have an impact.

Step 4. Get ready for launch!

Review your plan, update your timeline, choose a spokesperson, problem-solve for potential questions or press that might come up, and get ready to respond to the potential opposition.

Implement your plan:

  • Develop and place paid media: TV, radio, billboards, etc. Interacting with your audience will help you decide which type of media to use and the frequency.
  • Generate earned media (media that you do not pay for) – such as writing op-eds, pitching to the news media to cover your campaign, or hosting newsworthy events that the news will want to cover.
  • Share messages on social media. Create a social media plan, pick your channels, develop messages, and start posting!
  • Develop interactive program communications. This might be a website or involve interactions between your organization and the community that build relationships with your stakeholders.

Step 5. Adjust and respond.

  • Monitor and evaluate the dissemination of your campaign and the audience response. This can include tracking where and how many ads have been disseminated, monitoring the numbers of visitors to a website over the timespan of your campaign, and evaluating the behavioral impact you’re hoping to make.
  • Make adjustments to your ad deployment where necessary. For example, you can adjust the frequency of messages or media channels to increase the impact of your campaign.

Step 6. Evaluate.

  • Evaluating all aspects of the campaign, from development to implementation, will inform how the campaign is working, help you understand longer-term impact on behavior change, and help you and your team create future campaigns.
  • Share your results with your team and stakeholders.

Finish.

  • Nice job! Your campaign is now addressing a vaping-related health issue in your community.

For more detailed information, visit the CDC’s health communication guide: https://www.cdc.gov/tobacco/stateandcommunity/bp-health-communications/pdfs/health-communications-508.pdf

REFERENCES

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  2. Wang TW, Neff LJ, Park-Lee E, Ren C, Cullen KA, King BA. E-cigarette Use Among Middle and High School Students — United States, 2020. MMWR Morbidity and Mortality Weekly Report. 2020;69(37):1310-1312. doi:10.15585/mmwr.mm6937e1
  3. Hsu G, Sun JY, Zhu SH. Evolution of electronic cigarette brands from 2013-2014 to 2016-2017: Analysis of brand websites. Journal of Medical Internet Research. 2018;20(3):e80. doi:10.2196/jmir.8550
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