E-Cig Use
Conditions
Brief summary
While conventional cigarette use continues to decline among youth and young adults, e-cigarette (EC) use is on the rise. The use of ECs during young adulthood, particularly 18 years of age, is especially alarming because it is not only a critical period in development but also a time when tobacco use is established. Additionally, the tobacco industry targets individuals of this age with the hope that they will one day progress to using combustible cigarettes. Advertising may be one of the reasons leading young people to use ECs, and the Food and Drug Administration (FDA) now has the authority to regulate EC advertisement features. The goal of the study is to determine which EC ad features most strongly influence young adults' attitudes, susceptibility, and intentions to use ECs. Fifteen ads from the most popular EC brands that employ a brand, product descriptions, and modeling features were selected. Young adults who are susceptible to EC use will come into the lab and view these ads. During exposure, they will be assessed for real-time visual attention using eye-tracking, orienting responses using heart rate, and arousal using skin conductance as well as pre- and post-ad self-report measures of attitudes, susceptibility, and behavioral intentions. These factors will help determine the most high impact features, which will be associated with the greatest visual attention, orienting responses, and arousal levels and changes in attitudes. Findings from this study will provide public health officials important and urgently needed information as to what advertising features are contributing to the sharp rise in the use of ECs among young adults.
Interventions
OTHERViewing e-cigarette ads
All participants will see the same e-cigarette ads presented in a random order.
Sponsors
National Institute on Drug Abuse (NIDA)
University of Massachusetts, Worcester
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 26 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-26 years old, * Fluent in English, * Biochemically confirmed abstinence combusted tobacco or marijuana (eCO: exhaled carbon monoxide \<6 parts per million) at time of visit * Reporting never trying an e-cigarette, not even a puff OR reporting having used an e-cigarette in the past but has not used in the past 30 days * Susceptibility to EC use, will be determined using the Susceptibility to Use Tobacco Products questionnaire
Exclusion criteria
* Younger than 18 years or older than 26 years * Not fluent in English * Not confirmed abstinent of combusted tobacco or marijuana * Use of an e-cigarette * Not susceptible to e-cigarette use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Attention to Specific ad Feature | Change from the first second of viewing to each subsequent second of the intervention (10 seconds per ad), averaged for each participant. | Heart rate was measured to assess the cognitive resources allocated to the message. Using three sensors applied to participants' fingers, electrocardiogram (ECG) signals were recorded with a Shimmer 3 EXG module, while viewing the advertisements and were sampled at 512 Hz. Heart change scores were computed using beats per minute (BPM) and subtracting the first second of the stimuli (participant had seen a black screen just prior) from scores for each second of message exposure for each participant. Then, scores were averaged across each advertisement. Lesser values indicated greater deceleration in heart rate, signaling more cognitive resources allocated to the message. |
| Arousal | The average amplitude of skin conductance peaks over the 10 second viewing window for each ad brand. | Skin conductance or galvanic skin response was measured using three sensors applied to participants' fingers. Skin conductance measured if there was an emotional response and the intensity of the emotional response. A peak is a biological indicator that something happened, and the participant had an emotional response to it. The amplitude of each peak for each participant was measured and averaged per ad. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Motivations to Avoid E-cigarettes | Immediately after viewing each ad | Self-report Please rate on a scale from 0 (not at all) to 10 (very much). How important is it to avoid e-cigarettes in the future? How confident are in avoiding e-cigarettes in the future? How ready are you to avoid e-cigarettes in the future? How committed are you to avoid e-cigarettes in the future? Scores were averaged for each ad for each participant. Then, an overall average was taken among all participants for each ad. Higher values indicate greater motivation to avoid e-cigarettes. |
Countries
United States
Participant flow
Pre-assignment details
All enrolled participants were assigned to the one arm of the study.
Participants by arm
| Arm | Count |
|---|---|
| E-Cigarette Ads All individuals in the study will see the same e-cigarette advertisements presented in a random order.
Viewing e-cigarette ads: All participants will see the same e-cigarette ads presented in a random order. | 62 |
| Total | 62 |
Baseline characteristics
| Characteristic | E-Cigarette Ads |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 62 Participants |
| Age, Continuous | 22.5 years STANDARD_DEVIATION 2.31 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 14 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants |
| Race (NIH/OMB) More than one race | 5 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 38 Participants |
| Region of Enrollment United States | 62 participants |
| Sex: Female, Male Female | 49 Participants |
| Sex: Female, Male Male | 13 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 62 |
| other Total, other adverse events | 0 / 62 |
| serious Total, serious adverse events | 0 / 62 |
Outcome results
Primary
Arousal
Skin conductance or galvanic skin response was measured using three sensors applied to participants' fingers. Skin conductance measured if there was an emotional response and the intensity of the emotional response. A peak is a biological indicator that something happened, and the participant had an emotional response to it. The amplitude of each peak for each participant was measured and averaged per ad.
Time frame: The average amplitude of skin conductance peaks over the 10 second viewing window for each ad brand.
Population: All individuals in the study saw the same e-cigarette advertisements.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| E-Cigarette Ads | Arousal | Blu ads | 0.094441599 microSiemens | Standard Deviation 0.039786446 |
| E-Cigarette Ads | Arousal | Juul ads | 0.080156704 microSiemens | Standard Deviation 0.014821968 |
| E-Cigarette Ads | Arousal | MarkTen ads | 0.107337121 microSiemens | Standard Deviation 0.047972698 |
Primary
Attention to Specific ad Feature
Heart rate was measured to assess the cognitive resources allocated to the message. Using three sensors applied to participants' fingers, electrocardiogram (ECG) signals were recorded with a Shimmer 3 EXG module, while viewing the advertisements and were sampled at 512 Hz. Heart change scores were computed using beats per minute (BPM) and subtracting the first second of the stimuli (participant had seen a black screen just prior) from scores for each second of message exposure for each participant. Then, scores were averaged across each advertisement. Lesser values indicated greater deceleration in heart rate, signaling more cognitive resources allocated to the message.
Time frame: Change from the first second of viewing to each subsequent second of the intervention (10 seconds per ad), averaged for each participant.
Population: All individuals in the study saw the same advertisements.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| E-Cigarette Ads | Attention to Specific ad Feature | Blu ads | -1.7062 Beats per minute | Standard Deviation 1.318833535 |
| E-Cigarette Ads | Attention to Specific ad Feature | Juul ads | -0.9676 Beats per minute | Standard Deviation 0.918885902 |
| E-Cigarette Ads | Attention to Specific ad Feature | MarkTen ads | -1.8238 Beats per minute | Standard Deviation 1.209606837 |
Primary
Attention to Specific ad Feature
Visual attention was assessed using an eye-tracker connected to the base of the computer screen. For each message, four areas of interest (AOI) were identified: 1) brand, 2) descriptor, 3) modeling, and 4) warning. All four AOIs were summed for a total number of milliseconds that a participant viewed the AOIs.
Time frame: Duration of seconds spent on all areas of interest during 10 second viewing window for each ad brand
Population: All individuals in the study saw the same e-cigarette advertisements.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| E-Cigarette Ads | Attention to Specific ad Feature | Blu ads | 5464.656 milliseconds | Standard Deviation 557.5287713 |
| E-Cigarette Ads | Attention to Specific ad Feature | Juul ads | 5963.704 milliseconds | Standard Deviation 676.8965371 |
| E-Cigarette Ads | Attention to Specific ad Feature | MarkTen ads | 5107.014 milliseconds | Standard Deviation 394.2662056 |
Secondary
Motivations to Avoid E-cigarettes
Self-report Please rate on a scale from 0 (not at all) to 10 (very much). How important is it to avoid e-cigarettes in the future? How confident are in avoiding e-cigarettes in the future? How ready are you to avoid e-cigarettes in the future? How committed are you to avoid e-cigarettes in the future? Scores were averaged for each ad for each participant. Then, an overall average was taken among all participants for each ad. Higher values indicate greater motivation to avoid e-cigarettes.
Time frame: Immediately after viewing each ad
Population: All individuals in the study saw the same e-cigarette advertisements.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| E-Cigarette Ads | Motivations to Avoid E-cigarettes | Blu ads | 8.618 score on a scale | Standard Deviation 0.027748874 |
| E-Cigarette Ads | Motivations to Avoid E-cigarettes | Juul ads | 8.62 score on a scale | Standard Deviation 0.051961524 |
| E-Cigarette Ads | Motivations to Avoid E-cigarettes | MarkTen ads | 8.61 score on a scale | Standard Deviation 0 |