Evans William Douglas, Ichimiya Megumi, Bingenheimer Jeffrey B, Cantrell Jennifer, D'Esterre Alexander P, Pincus Olivia, Yu Linda Q, Hair Elizabeth C
Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Department of Social and Behavioral Sciences, School of Public Health, New York University, New York, NY, United States.
J Med Internet Res. 2025 Mar 31;27:e72002. doi: 10.2196/72002.
Electronic cigarette (e-cigarette) use is a major public health problem and young adults aged 18-24 years are at high risk. Furthermore, oral nicotine products (ONPs) are growing in popularity in this population. Poly-use is widespread. New methodologies for rigorous online studies using social media have been conducted and shown to reduce nicotine use.
We report on the design and baseline evaluation of a large-scale social media-based randomized controlled trial to evaluate the effects of antivaping social media on young adult vaping and determinants of use.
Using the Virtual Lab social media platform, participants were recruited using an artificial intelligence chatbot and social media advertising, completed a baseline survey, and were randomized to 1 of 4 study arms. The design was to achieve specific numbers of impressions per arm over 3 survey time points. We recruited 8437 participants, stratified by vaper (n=5026) and nonvaper (n=3321) status. Questionnaire data were collected using the Qualtrics survey platform. Future analyses will examine the effects of social media content on vaping at the endline. Our data analysis describes the 2 cohort samples, examines balance across the 4 study arms on baseline variables in each of the cohorts, and evaluates the internal consistency of several multi-indicator measures of psychosocial constructs.
Among vapers, almost three-fourths were current vapers, >40% were current smokers (using in the past 30 days), and >48% were current poly-users (using e-cigarettes and ≥1 other tobacco products). Substantial numbers of current vapers also currently use some other product, including cigars (n=1520, 30.2%), hookah (n=794, 15.8%), smokeless devices (n=462, 9.2%), and ONPs (n=578, 11.5%). The average age of participants was 21.2 (SD 2) years. Just less than 45% of participants were non-Hispanic White (n=3728, 44.7%), just less than 47% (n=3913, 46.9%) of the sample was male, more than 44% (n=3704, 44.4%) reported completing high school, and 79.3% reported meeting basic needs or better. There were no significant differences between arms and strata by any of these demographics. We calculated scale scores for depression and covariates related to nicotine use and found high alphas. Finally, participants who reported having seen antitobacco brand advertising were more likely to have higher levels of these variables and scales than participants who reported not having seen the advertisements. These results will be examined in future studies.
Social media can be used as a platform at scale for longitudinal randomized controlled trials over extended periods, which extends previous research on short-term trials. Interventions delivered by social media can be used with large samples to evaluate social media health behavior change interventions. Future studies based on this research will evaluate the intervention and dose-response effects of social media exposure on vaping behavior and determinants.
ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668.
电子烟的使用是一个重大的公共卫生问题，18至24岁的年轻人面临的风险很高。此外，口服尼古丁产品（ONP）在这一人群中越来越受欢迎。多种产品同时使用的情况很普遍。已经开展了使用社交媒体进行严格在线研究的新方法，并显示这些方法可减少尼古丁的使用。
我们报告一项基于社交媒体的大规模随机对照试验的设计和基线评估，以评估反电子烟社交媒体对年轻成年人电子烟使用及使用决定因素的影响。
使用虚拟实验室社交媒体平台，通过人工智能聊天机器人和社交媒体广告招募参与者，参与者完成基线调查后，被随机分配到4个研究组中的一组。该设计旨在在3个调查时间点上每组达到特定的曝光量。我们招募了8437名参与者，按电子烟使用者（n = 5026）和非使用者（n = 3321）的状态进行分层。问卷数据通过Qualtrics调查平台收集。未来的分析将在研究结束时检查社交媒体内容对电子烟使用的影响。我们的数据分析描述了这两个队列样本，检查了每个队列中4个研究组在基线变量上的平衡性，并评估了心理社会结构的几种多指标测量方法的内部一致性。
在电子烟使用者中，近四分之三是当前使用者，超过40%是当前吸烟者（在过去30天内使用过），超过48%是当前的多种产品使用者（使用电子烟和至少1种其他烟草产品）。相当数量的当前电子烟使用者目前还使用其他一些产品，包括雪茄（n = 1520，30.2%）、水烟（n = 794，15.8%）、无烟设备（n = 462，9.2%）和口服尼古丁产品（n = 578，11.5%）。参与者的平均年龄为21.2（标准差2）岁。不到45%的参与者是非西班牙裔白人（n = 3728，44.7%），样本中不到47%（n = 3913，46.9%）是男性，超过44%（n = 3704，44.4%）报告完成了高中学业，79.3%报告基本需求得到满足或更好。在这些人口统计学特征方面，各研究组和分层之间没有显著差异。我们计算了与尼古丁使用相关的抑郁和协变量的量表分数，发现信度系数较高。最后，报告看过反烟草品牌广告的参与者比报告没看过广告的参与者更有可能在这些变量和量表上得分更高。这些结果将在未来的研究中进行检验。
社交媒体可作为一个大规模的平台，用于长期的纵向随机对照试验，这扩展了以往关于短期试验的研究。通过社交媒体进行的干预可用于大样本，以评估社交媒体对健康行为改变的干预效果。基于本研究的未来研究将评估社交媒体曝光对电子烟使用行为及决定因素的干预和剂量反应效应。
ClinicalTrials.gov NCT04867668；https://clinicaltrials.gov/study/NCT04867668
