Wang Jijiang, Ayers John, Leas Eric, Gamst Anthony, Zhu Shu-Hong
Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States.
Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA, 92093-0905, United States, 1 8583001056.
J Med Internet Res. 2025 Jul 29;27:e69151. doi: 10.2196/69151.
e-Cigarette or vaping use-associated lung injury (EVALI), first reported in July 2019, caused over 2807 hospitalizations and 68 deaths by February 2020, when the outbreak subsided and the Centers for Disease Control and Prevention (CDC) stopped updating the case number. Media coverage of EVALI was extensive but not always accurate concerning the cause, which turned out to be vitamin E acetate, a compound added to certain illicit cannabis vape products. Studies have documented a significant increase in the perceived risk of vaping among the US adult population. However, research on how the EVALI outbreak influenced adolescents' knowledge of the illness and their perception of the risk of vaping products is limited, especially those that used probability sampling of the adolescent population.
This study examined knowledge of EVALI among adolescents and explored the impact of media messages on their perceptions of the condition.
Archived news reports on EVALI from an online tobacco media analysis engine, Tobacco Watcher (July 2019-March 2020), and data from the California Student Tobacco Survey, a large statewide school-based survey of 8th, 10th, and 12th graders (September 2019-March 2020; N=157,499), were analyzed. Students' awareness of EVALI and perceptions of its cause were examined in relation to their sources of information about EVALI, and their perceived risk of vaping was analyzed by their awareness of EVALI.
Of 19,661 news reports on Tobacco Watcher that discussed EVALI, 55.9% mentioned cannabis. Among the 157,499 middle and high school students participating in the statewide survey in California, 75% had heard about EVALI. The awareness level was similarly high for 8th, 10th, and 12th graders (75.7%, 74.6%, and 74.8%, respectively). Their primary source of knowledge about EVALI was media (63.1%), followed by parents (16.6%), teachers (8.1%), friends (7.7%), and peers (4.6%). Most students, 55%, believed nicotine was the cause of EVALI, while only 11% thought it was related to cannabis in vapes. Students who had heard about EVALI were more likely to rate vaping every day as extremely harmful than those who had not heard about it (67.8% vs 50.9%; P<.001).
Most adolescents were aware of EVALI and cited media as the main source of their knowledge. The effects of extensive news coverage of EVALI have reached students as young as 8th graders. Most of those who were aware of EVALI, however, incorrectly believed that nicotine in vapes was the cause of EVALI. The actual cause-vitamin E acetate found in certain cannabis vapes-appeared to have been overlooked or not effectively communicated, especially in early media reports. Media coverage of EVALI presents a case study of the critical but complicated role of modern media in communicating health information.
电子烟或雾化产品使用相关肺损伤（EVALI）于2019年7月首次报道，到2020年2月疫情平息、疾病控制与预防中心（CDC）停止更新病例数时，已导致超过2807人住院，68人死亡。媒体对EVALI的报道广泛，但关于其病因的报道并不总是准确，结果发现病因是醋酸维生素E，一种添加到某些非法大麻雾化产品中的化合物。研究表明，美国成年人群中认为雾化产品风险显著增加。然而，关于EVALI疫情如何影响青少年对该疾病的认识以及他们对雾化产品风险的认知的研究有限，尤其是那些对青少年人群采用概率抽样的研究。
本研究调查了青少年对EVALI的认识，并探讨了媒体信息对他们对该病认知的影响。
分析了来自在线烟草媒体分析引擎“烟草观察家”（2019年7月至2020年3月）关于EVALI的存档新闻报道，以及来自加利福尼亚州学生烟草调查的数据，该调查是一项针对8年级、10年级和12年级学生的大型全州范围校内调查（2019年9月至2020年3月；N = 157,499）。考察了学生对EVALI的认识及其对病因的看法与他们获取EVALI信息来源的关系，并根据他们对EVALI的认识分析了他们感知的雾化产品风险。
在“烟草观察家”上讨论EVALI的19,661篇新闻报道中，55.9%提到了大麻。在参与加利福尼亚州全州调查的157,499名中学生和高中生中，75%听说过EVALI。8年级、10年级和12年级学生的知晓率同样很高（分别为75.7%、74.6%和74.8%）。他们了解EVALI的主要信息来源是媒体（63.1%），其次是父母（16.6%）、教师（8.1%）、朋友（7.7%）和同龄人（4.6%）。大多数学生（55%）认为尼古丁是EVALI的病因，而只有11%认为它与雾化大麻有关。听说过EVALI的学生比没听说过的学生更有可能认为每天雾化极其有害（67.8%对50.9%；P <.001）。
大多数青少年知道EVALI，并将媒体作为他们知识的主要来源。EVALI广泛的新闻报道影响已波及到8年级的学生。然而，大多数知晓EVALI的人错误地认为雾化产品中的尼古丁是EVALI的病因。实际病因——某些大麻雾化产品中发现的醋酸维生素E——似乎被忽视或没有得到有效传播，尤其是在早期媒体报道中。EVALI的媒体报道展示了现代媒体在传播健康信息方面关键但复杂的作用的一个案例研究。
