Hussman School of Journalism and Media, University of North Carolina, Chapel Hill.
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.
JAMA Netw Open. 2022 Oct 3;5(10):e2236370. doi: 10.1001/jamanetworkopen.2022.36370.
Understanding whether prevention advertisements reduce susceptibility to vaping is important owing to concerning levels of adolescent vaping.
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.
Adolescents saw 3 randomly ordered 30-second video advertisements online at each of 3 weekly study visits (visits 1, 2, and 3).
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.
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.
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.
ClinicalTrials.gov Identifier: NCT04836455.
了解预防吸电子烟广告是否会降低青少年对吸电子烟的易感性，这一点很重要，因为青少年吸电子烟的现象令人担忧。
研究美国食品和药物管理局（FDA）全国“真实成本”运动的吸电子烟预防广告是否会降低青少年对吸电子烟的易感性。
设计、地点和参与者：这是一项 3 组随机临床试验，采用平行分组，参与者为年龄在 13 至 17 岁之间、易受吸电子烟影响或目前使用电子烟的美国青少年，他们是从在线小组招募的。青少年被随机分配到 2 个 Real Cost 吸电子烟预防试验组（健康危害或成瘾主题广告）或对照组（研究人员制作的关于吸电子烟的中立视频）之一。青少年在 3 周的时间内，在第 1 到 4 次就诊期间每周完成 4 次在线调查。数据分析于 2021 年 12 月 1 日至 2022 年 8 月 25 日进行。
青少年在每周的 3 次研究访问（访问 1、2 和 3）中，每次随机观看 3 个 30 秒的视频广告。
主要试验结果是吸电子烟的易感性。调查还评估了对吸烟的易感性，以研究吸电子烟预防广告对吸烟结果的任何溢出效应。这两个易感性测量都有 3 个项目，范围从 1（表示不易感）到 4（表示高度易感）。主要分析比较了 Real Cost 组（合并）与对照组，而探索性分析比较了 Real Cost 组之间的差异。
共有 1514 名青少年（1140 名[75.3%]为男性；平均[SD]年龄为 15.22[1.18]岁）参与了研究，包括 504 名被随机分配到 Real Cost 健康危害组、506 名被随机分配到 Real Cost 成瘾组和 504 名被随机分配到对照组。与对照组相比，Real Cost 组（合并）在第 4 次就诊时对吸电子烟的易感性较低（b=-0.21；95%置信区间，-0.32 至 -0.10）。Real Cost 组之间在吸电子烟的易感性上没有差异（第 4 次就诊：b=-0.05；95%置信区间，-0.17 至 0.07）。与对照组相比，Real Cost 组（合并）对吸烟的易感性也较低（b=-0.21；95%置信区间，-0.32 至 -0.10）。对于吸电子烟和吸烟，Real Cost 组的态度比对照组更消极（吸电子烟：b=-0.27；95%置信区间，-0.40 至 -0.14；吸烟：b=-0.23；95%置信区间，-0.39 至 -0.08）。
这些发现表明，美国食品和药物管理局“真实成本”运动的吸电子烟预防广告降低了青少年对吸电子烟的易感性，并对吸烟结果产生了有益的溢出效应。烟草预防运动有助于减少青少年的烟草使用。
美国国立卫生研究院临床试验注册处：NCT04836455。
