United States: Evaluation of a first awareness campaign on the risks of vaping

The American organization Truth Initiative has been able to verify that the methods used in awareness campaigns on the dangers of smoking are also effective in changing the perceptions of young people and young adults about the risks associated with e-cigarettes.

As smoking prevalence declined in the United States during the 2010s, the sharp rise in vaping among adolescents and young adults in 2017 and 2018 alerted health stakeholders. The Truth Initiative therefore decided to produce several videos to raise awareness of the risks of vaping and distributed them primarily on social networks used by adolescents and young adults (Snapchat, Instagram, YouTube and TikTok), from October 2018 to December 2019. This awareness campaign was modeled on the communication strategy of the e-cigarette manufacturer JUUL (one-third of which is owned by Altria)[1], at the time leader in this market, to promote its products to young people and young adults on the same social networks.

Exposure to prevention messages changes perceptions

An online impact assessment of this awareness campaign was conducted with 8,421 young people aged 15 to 24 during the broadcast period. It showed that the more individuals were exposed to these awareness videos, the more their perceptions and attitudes towards e-cigarettes had changed.2]. Participants most exposed to these videos had significantly better integrated information on the dangers and issues of e-cigarettes than participants with the least exposure. They were more likely to recognize that young vapers are four times more likely to become tobacco smokers than other young people, that the nicotine concentrations in JUUL e-liquid refills were equivalent to the content of 20 cigarettes and that the long-term effects of using e-cigarettes like JUUL remained unknown to this day. These participants most exposed to awareness videos were also more likely to perceive the risks associated with e-cigarettes, to consider vaping as socially unacceptable and to develop anti-industry opinions.

This study thus showed that the effectiveness of prevention campaigns, already proven in the area of smoked tobacco when information is provided that can change public perceptions, could also be transposed to e-cigarettes. Further longitudinal studies would be necessary to assess the impact of these campaigns on behaviors in the medium and long term.

Battles on the field of communication

The financial power of the tobacco industry allows it to allocate significant budgets to promote its products by all available means. Since tobacco advertising is banned in most Western countries, manufacturers seize every opportunity available to them and do not hesitate to break the laws to achieve their goals. Since advertising for electronic cigarettes has been banned from traditional media (press, TV, radio), their communication strategies have focused on the Internet and its social networks. By flooding these networks with advertising targeting young people and paying influencers, the tobacco industry is perpetuating and adapting its old strategies, proven on tobacco products, to capture younger audiences and influence their perceptions. As part of social responsibility, manufacturers are, for example, funding summer camps to mark the minds of children as young as 8.3].

It is therefore in this area of representations that action is needed, in order to provide as many people as possible with information that allows for a critical look at tobacco products, with a view to denormalizing all of these products that induce strong addictions. However, budgets for prevention and awareness campaigns cannot reach the levels deployed by manufacturers, but prevention messages can be relayed by many other stakeholders, whether they are caregivers, educators, parents or members of the entourage.

MF