E-Cigarette Health Harm Awareness and Discouragement: Implications for Health Communication

Rohde, Jacob A; Noar, Seth M.; Mendel, Jennifer; Hall, Marissa G.; Baig, Sabeeh A; Ribisl, Kurt M.; Brewer, Noel T.

doi:10.1093/ntr/ntz194

Cited by 37 publications

(31 citation statements)

References 35 publications

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“…This notion is supported by Rohde and colleagues who surveyed adult tobacco smokers and found that respiratory harm health consequence was a major reason for vaping discouragement. 12 Conversely, we observed reported increased use of alcohol. Studies have shown that young adults often indulge in drinking behavior not only for celebration but also to cope with aversive mood states, which prolongs or worsens negative affective states and further drinking.…”

Section: Discussioncontrasting

confidence: 60%

Changes in substance use among young adults during a respiratory disease pandemic

et al. 2020

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Background: News articles, commentaries, and opinion articles have suggested that ongoing social distancing measures coupled with economic challenges during COVID-19 may worsen stress, affective state, and substance use across the globe. We sought to advance our understanding of the differences between individuals who change their substance use patterns during a public health crisis and those who do not. Methods: Cross-sectional survey of young adults (18–25 years of age) assessing respondent characteristics and vaping, tobacco, alcohol, and/or marijuana use. We calculated prevalence estimates, prevalence changes, and prevalence ratios with associated 95% confidence intervals and looked for differences with the chi-square test. Results: Of the total sample, 53.2% ( n = 542/1018) young adults reported vaping or using tobacco, alcohol, and/or marijuana. Among the 542 respondents reporting use, 34.3% reported a change in their use patterns. Among respondents reporting changes in substance use patterns during the pandemic ( n = 186), 68.8% reported an increase in alcohol use, 44.0% reported a decrease in vaping product use, and 47.3% reported a decrease in tobacco product use due to COVID-19. Substance use changed significantly for respondents with increasing degree of loneliness (continuous loneliness score: prevalence ratio = 1.12, 95% confidence interval = 1.01–1.25), anxiety (prevalence ratio = 1.45, 95% confidence interval = 1.14–1.85), and depression (prevalence ratio = 1.44, 95% confidence interval = 1.13–1.82). Conclusion: Self-reported substance use among young adults was observed to change during a pandemic, and the degree of loneliness appears to impact these changes. Innovative strategies are needed to address loneliness, anxiety, depression, and substance use during global health crises that impact social contact.

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Section: Discussioncontrasting

confidence: 60%

Changes in substance use among young adults during a respiratory disease pandemic

et al. 2020

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“…Moreover, agencies could rotate among the varying topics in their communications to add novelty and prevent messages from becoming stale over time. 65 66 In contrast to the findings for smoking messages, only traditional harms (and not COVID-19 harms) were perceived as effective for vaping messages, suggesting that health agencies focus their vaping communications on traditional harms 32 rather than COVID-19 harms. The lack of effect of COVID-19 messages on PME in the vaping experiment could be due to the vaping control message being more 'active' (see figure 2), potentially reflecting that any information on vaping-even neutral information-is relatively novel for many adults.…”

Section: Discussionmentioning

confidence: 94%

“…As evidence of vaping’s harms continues to emerge, public health communications should include information about these harms in vaping messages, particularly because studies suggest vaping risk communication is effective at discouraging e-cigarette use. 32 47 The lack of differences between messages with different traditional health harms suggests that those designing vaping messages have several promising options in terms of which harms to highlight. Third, our findings suggest a general principle of simplicity for public health messages.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31] Second, only a small number of studies have examined whether particular harms may have more impact than others, so the specific harms most likely to motivate cessation remain largely unknown. [31][32][33] As research on the links between smoking, vaping and health harms (including both traditional and COVID-19 harms) develops further, forward-looking evidence on reactions to messages about particular harms can guide swift dissemination of effective messages.…”

Section: Original Researchmentioning

confidence: 99%

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Reactions to messages about smoking, vaping and COVID-19: two national experiments

et al. 2020

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IntroductionThe pace and scale of the COVID-19 pandemic, coupled with ongoing efforts by health agencies to communicate harms, have created a pressing need for data to inform messaging about smoking, vaping, and COVID-19. We examined reactions to COVID-19 and traditional health harms messages discouraging smoking and vaping.MethodsParticipants were a national convenience sample of 810 US adults recruited online in May 2020. All participated in a smoking message experiment and a vaping message experiment, presented in a random order. In each experiment, participants viewed one message formatted as a Twitter post. The experiments adopted a 3 (traditional health harms of smoking or vaping: three harms, one harm, absent) × 2 (COVID-19 harms: one harm, absent) between-subjects design. Outcomes included perceived message effectiveness (primary) and constructs from the Tobacco Warnings Model (secondary: attention, negative affect, cognitive elaboration, social interactions).ResultsSmoking messages with traditional or COVID-19 harms elicited higher perceived effectiveness for discouraging smoking than control messages without these harms (all p <0.001). However, including both traditional and COVID-19 harms in smoking messages had no benefit beyond including either alone. Smoking messages affected Tobacco Warnings Model constructs and did not elicit more reactance than control messages. Smoking messages also elicited higher perceived effectiveness for discouraging vaping. Including traditional harms in messages about vaping elicited higher perceived effectiveness for discouraging vaping (p <0.05), but including COVID-19 harms did not.ConclusionsMessages linking smoking with COVID-19 may hold promise for discouraging smoking and may have the added benefit of also discouraging vaping.

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“…Despite this mounting scientific evidence, public awareness of health harms from e-cigarettes remains low [ 17 ], which may increase misconceptions about the risk of using these devices [ 18 ]. For instance, a recent study reported that only about 16% of the participants were aware of e-liquid toxicity [ 19 ]. Tobacco and e-cigarette industries aggressively promote e-cigarettes as healthy or less harmful than combustible cigarettes [ 20 ], and this marketing contributes to low perceived risks of e-cigarettes [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

An experimental study of messages communicating potential harms of electronic cigarettes

2020

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There has been an upsurge of e-cigarette use in the United States in recent years. While ecigarettes may contain lower levels of toxic chemicals than combusted cigarettes, they still pose serious health hazards, including increased risk for heart and respiratory disease. Despite these risks, public awareness of the health harms of e-cigarettes remains low. Thus, it is important to educate the public about the potential harms of e-cigarettes. This study took themes commonly found in antismoking messages and used them to develop messages about harms of e-cigarettes. A national sample of 2801 current smokers and nonsmokers (aged 18+ years) were randomized to view one of four e-cigarette messages (harmful effect of chemicals, uncertainty about ingredients, distrust of big tobacco, or cost of vaping) or a control message (bottled water ad). Participants' reactions to the messages and behavioral intentions were assessed immediately following the exposure. MANOVA examined effects of the messages on blocks of the outcome variables and univariate analyses estimated adjusted means for each experimental condition for each outcome. The message about harmful chemicals was perceived as the most informative and effective and elicited the highest levels of negative emotions (Ps<0.05). However, on measures of actual effectiveness, the other messages performed equally well. Specifically, messages with different themes (harmful chemicals, uncertainty about ingredients, anti-industry, or financial cost) increased perceived risk of e-cigarettes, support for e-cigarette control, and lowered self-exempting beliefs and intentions to use e-cigarettes (Ps<0.05). Themes commonly used in anti-smoking messages may be effective in educating the public about the potential harm of e-cigarettes. The observed differential effects of the messages suggest the need to use multiple themes in a public education campaign about e-cigarettes.

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E-Cigarette Health Harm Awareness and Discouragement: Implications for Health Communication

Cited by 37 publications

References 35 publications

Changes in substance use among young adults during a respiratory disease pandemic

Changes in substance use among young adults during a respiratory disease pandemic

Reactions to messages about smoking, vaping and COVID-19: two national experiments

An experimental study of messages communicating potential harms of electronic cigarettes

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