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Impact of Vaping Prevention Advertisements

Impact of The Real Cost Vaping Prevention Advertisements on Adolescents

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04836455
Enrollment
1565
Registered
2021-04-08
Start date
2021-07-03
Completion date
2021-11-03
Last updated
2024-04-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Vaping

Brief summary

The purpose of this randomized controlled trial is to determine whether exposure to vaping prevention advertisements (ads) reduce susceptibility to vaping among adolescents. Previous studies have been informative, but they have tended to be one-time experimental studies that do not replicate the repeated exposures to ads that people have in the real world. This study addresses this issue by repeatedly exposing participants to vaping prevention ads over time. Participants will be adolescents aged 13-17 who currently vape or who are susceptible to vaping. Participants will be randomly assigned to ad stimuli. They will be assigned to one of two The Real Cost trial arms-health harms or addiction-or to a control trial arm (probability of assignment is 1/3 for all trial arms). Participants in the study will take 4 online surveys over a 3-week period, once per week (At week 0, 1, 2, and 3). All participants will view randomized ad stimuli based on their trial arm and answer surveys items at each session.

Detailed description

Tobacco prevention mass media campaigns are a key tool for reducing tobacco use among adolescents. While vaping has increased greatly among adolescents, there has been a dearth of research on effective communication strategies to reduce vaping. This study will test the impact of advertisements from the Food and Drug Administration's The Real Cost campaign on reducing susceptibility to vaping in a randomized controlled trial, illuminating whether such ads are effective as well as what themes are most effective (i.e., health harms, addiction). The investigators focus on adolescents (ages 13-17) who currently vape or are at risk of vaping. Setting: The trial will be a longitudinal online study with 4 surveys over a 3 week period - 1 survey per week. Recruitment: Adolescent participants will be recruited through Qualtrics, an online survey panel platform. Interested prospective participants will complete a screening questionnaire to determine their eligibility. If eligible, Qualtrics will invite them to enroll in the trial. Informed Consent: Qualtrics will obtain parental consent online for adolescents who are eligible and interested in participating. After parental consent, adolescents will provide online assent prior to taking the survey. Randomization: After providing informed assent, Qualtrics survey software will randomly assign participants to one of the three trial arms. Participants will have an equal chance of being randomized to any of the 3 trial arms. Assessment: Participants in the study will take 4 surveys over a 3-week period. This will allow for multiple exposures to campaign ads. At week 0, randomize participants will be randomized to 1 of 2 FDA The Real Cost vaping prevention ad trial arms (health harms or addiction) or to a control arm (investigator created neutral ads about vaping). In each condition, participants will view 3 ads at each session, in a random order, corresponding to the theme they were assigned. At the first session (week 0), each participant will complete measures of vaping and smoking behavior, and will then view the ads that correspond to their trial arm. They will complete measures assessing message reactions after viewing each ad, followed by measures of susceptibility to vaping, vaping and smoking beliefs, and finally questions assessing demographics. For week 1 and 2 assessments, participants will complete measures of susceptibility to vaping, vaping and smoking beliefs, and vaping and smoking behavior. They will then view the same 3 ads from their trial arm and complete the message reactions measures. For the week 3 assessment, participants will only complete measures of susceptibility to vaping, vaping and smoking beliefs, and vaping and smoking behavior. Each survey will take approximately 15 minutes.

Interventions

BEHAVIORALThe FDA's The REal Cost vaping prevention ads - Health harms theme

Three vaping prevention video ads from the FDA's The Real Cost prevention campaign about the health harms of vaping will be shown to participants at weeks 0, 1, and 2. Ads will be shown in a random order.

BEHAVIORALThe FDA's The Real Cost vaping prevention ads - Addiction theme

Three vaping prevention video ads from the FDA's The Real Cost prevention campaign about vaping addiction will be shown to participants at week 0, 1, and 2. Ads will be shown in a random order.

BEHAVIORALNeutral vaping ads

Three neutral (i.e., purely informational and without graphics) vaping video ads developed by the Investigators will be shown to participants at weeks 0, 1, and 2. Ads will be shown in a random order.

Sponsors

National Institutes of Health (NIH)
CollaboratorNIH
Food and Drug Administration (FDA)
CollaboratorFED
National Cancer Institute (NCI)
CollaboratorNIH
UNC Lineberger Comprehensive Cancer Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
13 Years to 17 Years
Healthy volunteers
Yes

Inclusion criteria

* Between ages 13-17 years old * Be able to read and speak English * Be able to take an online survey in English * Be susceptible to vaping

Exclusion criteria

* None

Design outcomes

Primary

MeasureTime frameDescription
Mean Susceptibility to Vaping ScoreWeek 3The 3-item Susceptibility to Vaping Scale assesses the extent to which adolescents are open to vaping, using a 1 to 4 response option scale. Here, 1 indicates the lowest susceptibility to vaping, and 4 represents the highest, with higher values indicating a greater susceptibility to vaping - essentially, a worse outcome. The overall scale score is determined by averaging the scores of the three items, summing these scores and dividing by 3. This method results in a score range from a minimum of 1 to a maximum of 4.

Secondary

MeasureTime frameDescription
Mean Social Interactions ScoreWeek 3The 3-item Mean Social Interactions Scale assesses the extent to which a participant has discussed the addictiveness or harmfulness of vaping with others in the past 7 days. Response options range from 1 (0 times) to 6 (11 or more times). The overall scale score is calculated by averaging the three items, resulting in a score range from a minimum of 1 to a maximum of 6. Higher scores indicate more frequent social interactions, which are considered a better outcome.
Mean Vaping Addiction Risk Beliefs ScoreWeek 3The 3-item Vaping Addiction Risk Beliefs Scale assesses the extent to which participants believe that vaping will lead to addiction. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with a score range from 1 to 5. Higher scores indicate stronger beliefs in the risk of addiction due to vaping, which is considered a better outcome.
Mean Vaping Attitudes ScoreWeek 3The 3-item Vaping Attitudes Scale assesses a participant's attitude towards vaping (e.g., good/bad). Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with scores ranging from 1 to 5. Higher scores indicate a more positive attitude toward vaping, which is considered a less desirable outcome (i.e., worse outcome).
Number of Days Participants Vape (E-cigarette Use)Week 3Participants will be asked to report the number of days they vaped over the past 21 days. We chose to retain the continuous measure of the number of days spent vaping rather than dichotomizing this outcome, due to the substantial variability observed in the number of days e-cigarettes were used. A higher value indicates more days that participants vaped, which is considered a less desirable outcome (i.e., worse outcome).
Mean Smoking Health Harm Risk Belief ScoreWeek 3The 1-item Mean Smoking Health Harm Risk Belief Measure assesses the extent to which a participant believes that smoking will lead to health harms. Response options range from 1 to 5, with higher scores indicating stronger beliefs in the health risks associated with smoking, which is considered a desirable outcome (i.e., better outcome).
Mean Smoking Addiction Risk Belief ScoreWeek 3The 1-item mean smoking health harm risk belief measure assesses the extent to which a participant believes that smoking will lead to health harms. Response options are on a 1 to 5 scale, with higher scores representing a stronger health harm beliefs about smoking, which is a desirable outcome (i.e., better outcome).
Mean Smoking Attitude ScoreWeek 3The 1-item mean smoking attitude measure assesses a participant's attitude toward smoking (i.e., good/bad). Response options are on a 1 to 5 scale, with higher scores representing a more positive attitude toward smoking, which is considered as less desirable outcome (i.e., worse outcome).
Mean Susceptibility to Smoking CigarettesWeek 3The 3-item Mean Susceptibility to Smoking Cigarettes Scale assesses a participant's susceptibility to smoking cigarettes. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with possible scores ranging from 1 to 5. Higher scores indicate a stronger susceptibility to smoking, which is considered a less desirable outcome (i.e., worse outcome).
Number of Days That Participants Who Smoke CigarettesWeek 3Participants will be asked to report the number of days they smoked cigarettes over the past 21 days. We chose to retain the continuous measure of the number of days smoking rather than dichotomizing this outcome, due to the substantial variability observed in the number of days cigarettes were used. A higher value indicates more days that participants smoked cigarettes, which is considered a less desirable outcome (i.e., worse outcome).
Mean Attention ScoreWeek 2The 1-item mean attention measure assesses the extent to which a participant reports that an advertisement captures their attention. Response options range from 1 to 5, with higher scores indicating stronger attention, which is considered a better outcome.
Mean Negative Affect ScoreWeek 2The 3-item Negative Affect Scale assesses the extent to which an advertisement elicits negative emotions from the participant, such as fear or disgust. Response options range from 1 to 5. The overall scale score is calculated by averaging the scores of the three items, resulting in a minimum possible score of 1 and a maximum of 5. Higher scores indicate stronger negative emotions. In the context of this assessment, higher negative emotions are considered a more effective (better) outcome.
Mean Cognitive Elaboration ScoreWeek 3The 3-item Mean Cognitive Elaboration Scale assesses the extent to which participants have thought about the addictiveness or harmfulness of vaping over the past 7 days. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with scores ranging from a minimum of 1 to a maximum of 5. Higher scores indicate greater cognitive elaboration, suggesting a more effective engagement with the content (a better outcome).
Mean Vaping Health Harm Risk Beliefs ScoreWeek 3The 3-item Vaping Health Harm Risk Beliefs Scale assesses the extent to which participants believe that vaping will lead to health harms. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with possible scores ranging from a minimum of 1 to a maximum of 5. Higher scores indicate stronger beliefs in the health risks associated with vaping, which is considered a better outcome.

Other

MeasureTime frameDescription
Mean Perceived Message Effectiveness Score (FDA Scale)Week 2The 6-item FDA Mean Perceived Message Effectiveness Scale evaluates a participant's overall impressions of an advertisement. Responses are provided on a scale from 1 to 5. The overall scale score is calculated by averaging these six items, resulting in a possible range of 1 to 5. Higher scores indicate that participants found the advertisements to be more informative (i.e., better outcome).
Mean Avoidance ScoreWeek 2The 3-item Avoidance Scale measures the degree to which a participant wishes to avoid engaging with an advertisement. Responses are provided on a scale from 1 to 5. The overall score is calculated by summing the scores of the three items and then dividing by 3, resulting in a possible range of 1 to 5. Higher scores indicate greater avoidance, which is considered a less desirable outcome (i.e., worse outcome).
Mean Vaping Social Enhancement Beliefs ScoreWeek 3The 3-item Mean Vaping Social Enhancement Beliefs Scale measures participants' perceptions of the social benefits of vaping, such as fitting in better with friends. Responses are on a 1 to 5 scale, with overall scores calculated by averaging the three items. Scores range from 1 to 5, where higher scores indicate a stronger belief in the social benefits of vaping, a less desirable outcome (i.e., worse outcome).
Mean Vaping Affect Regulation Beliefs ScoreWeek 3The 3-item Mean Vaping Affect Regulation Beliefs Scale evaluates participants' beliefs about the experiential benefits of vaping, such as feeling good. Responses are recorded on a 1 to 5 scale. The overall score, which also ranges from 1 to 5, is calculated by averaging the three items. Higher scores indicate that participants expect more significant emotional or affective benefits from vaping, which is considered a less desirable outcome (i.e., worse outcome).
Mean Vaping Injunctive Norms ScoreWeek 3The 3-item Mean Vaping Injunctive Norms Scale measures participants' perceptions of others' approval or disapproval of their vaping behavior, using a response scale from 1 to 5. Overall scores, which range from 1 to 5, are calculated by averaging the three items. Higher scores indicate stronger perceived disapproval of vaping, which is considered a desirable outcome (i.e., better outcome).
Mean Vaping Refusal Self-efficacyWeek 3The 3-item Mean Vaping Refusal Self-Efficacy Scale measures a participant's confidence in their ability to refuse vaping in social situations, with response options ranging from 1 to 5. The overall score, also ranging from 1 to 5, is calculated by averaging the three items. Higher scores indicate stronger self-efficacy beliefs in refusing vaping, which is considered a desirable outcome (i.e., better outcome).
Mean Perceived Message Effectiveness Score (UNC Youth Scale)Week 2The 3-item UNC Youth Mean Perceived Message Effectiveness Scale assesses a participant's judgment of an advertisement's impact on their vaping beliefs and behaviors. Response options range from 1 to 5. The overall score is calculated by averaging the three items, with possible scores ranging from 1 to 5. Higher scores indicate that participants perceive the advertisements as more effective (i.e., better outcome).
Mean Reactance ScoreWeek 2The 1-item reactance measure evaluates the degree to which an ad annoys participants, using a response scale from 1 to 5. Higher scores indicate greater reactance to the ad, representing a less favorable outcome.

Countries

United States

Participant flow

Participants by arm

ArmCount
The Real Cost Vaping Prevention Ads - Health Effects Theme
The FDA's The REal Cost vaping prevention ads - Health harms theme: Three vaping prevention video ads from the FDA's The Real Cost prevention campaign about the health harms of vaping will be shown to participants at weeks 0, 1, and 2. Ads will be shown in a random order.
504
The Real Cost Vaping Prevention Ads - Addiction Theme
The FDA's The Real Cost vaping prevention ads - Addiction theme: Three vaping prevention video ads from the FDA's The Real Cost prevention campaign about vaping addiction will be shown to participants at week 0, 1, and 2. Ads will be shown in a random order.
506
Neutral Vaping Ads
Neutral vaping ads: Three neutral (i.e., purely informational and without graphics) vaping video ads developed by the Investigators will be shown to participants at weeks 0, 1, and 2. Ads will be shown in a random order.
504
Pilot Trial Group
This group consists of participants who took part in the pilot phase of the trial prior to its full launch. The purpose of this phase was to pilot test the clinical trial processes and procedures. Participants were recruited separately and not a part of the actual clinical trial.
51
Total1,565

Baseline characteristics

CharacteristicThe Real Cost Vaping Prevention Ads - Health Effects ThemeTotalPilot Trial GroupNeutral Vaping AdsThe Real Cost Vaping Prevention Ads - Addiction Theme
Age, Continuous15.21 years
STANDARD_DEVIATION 1.17
15.22 years
STANDARD_DEVIATION 1.18
15.55 years
STANDARD_DEVIATION 1.3
15.28 years
STANDARD_DEVIATION 1.18
15.18 years
STANDARD_DEVIATION 1.19
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants1 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
5 Participants14 Participants0 Participants6 Participants3 Participants
Race (NIH/OMB)
Black or African American
137 Participants384 Participants13 Participants118 Participants116 Participants
Race (NIH/OMB)
More than one race
12 Participants33 Participants0 Participants8 Participants13 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
2 Participants4 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants10 Participants0 Participants3 Participants5 Participants
Race (NIH/OMB)
White
345 Participants1119 Participants38 Participants369 Participants367 Participants
Sex: Female, Male
Female
126 Participants380 Participants22 Participants110 Participants122 Participants
Sex: Female, Male
Male
372 Participants1169 Participants29 Participants393 Participants375 Participants
Susceptibility to vaping2.31 units on a scale
STANDARD_DEVIATION 0.98
2.50 units on a scale
STANDARD_DEVIATION 0.97
2.16 units on a scale
STANDARD_DEVIATION 0.97
2.75 units on a scale
STANDARD_DEVIATION 0.94
2.45 units on a scale
STANDARD_DEVIATION 0.94

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 5040 / 5060 / 5040 / 51
other
Total, other adverse events
0 / 5040 / 5060 / 5040 / 51
serious
Total, serious adverse events
0 / 5040 / 5060 / 5040 / 51

Outcome results

Primary

Mean Susceptibility to Vaping Score

The 3-item Susceptibility to Vaping Scale assesses the extent to which adolescents are open to vaping, using a 1 to 4 response option scale. Here, 1 indicates the lowest susceptibility to vaping, and 4 represents the highest, with higher values indicating a greater susceptibility to vaping - essentially, a worse outcome. The overall scale score is determined by averaging the scores of the three items, summing these scores and dividing by 3. This method results in a score range from a minimum of 1 to a maximum of 4.

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Susceptibility to Vaping Score2.16 score on a scaleStandard Deviation 1.04
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Susceptibility to Vaping Score2.21 score on a scaleStandard Deviation 1.01
Neutral Vaping AdsMean Susceptibility to Vaping Score2.36 score on a scaleStandard Deviation 1.07
Secondary

Mean Attention Score

The 1-item mean attention measure assesses the extent to which a participant reports that an advertisement captures their attention. Response options range from 1 to 5, with higher scores indicating stronger attention, which is considered a better outcome.

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Attention Score4.49 score on a scaleStandard Deviation 0.79
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Attention Score4.49 score on a scaleStandard Deviation 0.77
Neutral Vaping AdsMean Attention Score4.10 score on a scaleStandard Deviation 1.11
Secondary

Mean Cognitive Elaboration Score

The 3-item Mean Cognitive Elaboration Scale assesses the extent to which participants have thought about the addictiveness or harmfulness of vaping over the past 7 days. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with scores ranging from a minimum of 1 to a maximum of 5. Higher scores indicate greater cognitive elaboration, suggesting a more effective engagement with the content (a better outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Cognitive Elaboration Score3.59 score on a scaleStandard Deviation 1.2
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Cognitive Elaboration Score3.57 score on a scaleStandard Deviation 1.21
Neutral Vaping AdsMean Cognitive Elaboration Score3.43 score on a scaleStandard Deviation 1.28
Secondary

Mean Negative Affect Score

The 3-item Negative Affect Scale assesses the extent to which an advertisement elicits negative emotions from the participant, such as fear or disgust. Response options range from 1 to 5. The overall scale score is calculated by averaging the scores of the three items, resulting in a minimum possible score of 1 and a maximum of 5. Higher scores indicate stronger negative emotions. In the context of this assessment, higher negative emotions are considered a more effective (better) outcome.

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Negative Affect Score3.42 score on a scaleStandard Deviation 1.13
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Negative Affect Score3.19 score on a scaleStandard Deviation 1.19
Neutral Vaping AdsMean Negative Affect Score2.68 score on a scaleStandard Deviation 1.33
Secondary

Mean Smoking Addiction Risk Belief Score

The 1-item mean smoking health harm risk belief measure assesses the extent to which a participant believes that smoking will lead to health harms. Response options are on a 1 to 5 scale, with higher scores representing a stronger health harm beliefs about smoking, which is a desirable outcome (i.e., better outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Smoking Addiction Risk Belief Score3.79 score on a scaleStandard Deviation 1.33
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Smoking Addiction Risk Belief Score3.82 score on a scaleStandard Deviation 1.33
Neutral Vaping AdsMean Smoking Addiction Risk Belief Score3.76 score on a scaleStandard Deviation 1.37
Secondary

Mean Smoking Attitude Score

The 1-item mean smoking attitude measure assesses a participant's attitude toward smoking (i.e., good/bad). Response options are on a 1 to 5 scale, with higher scores representing a more positive attitude toward smoking, which is considered as less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Smoking Attitude Score2.13 score on a scaleStandard Deviation 1.38
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Smoking Attitude Score2.16 score on a scaleStandard Deviation 1.42
Neutral Vaping AdsMean Smoking Attitude Score2.35 score on a scaleStandard Deviation 1.46
Secondary

Mean Smoking Health Harm Risk Belief Score

The 1-item Mean Smoking Health Harm Risk Belief Measure assesses the extent to which a participant believes that smoking will lead to health harms. Response options range from 1 to 5, with higher scores indicating stronger beliefs in the health risks associated with smoking, which is considered a desirable outcome (i.e., better outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Smoking Health Harm Risk Belief Score4.02 score on a scaleStandard Deviation 1.22
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Smoking Health Harm Risk Belief Score3.98 score on a scaleStandard Deviation 1.28
Neutral Vaping AdsMean Smoking Health Harm Risk Belief Score3.83 score on a scaleStandard Deviation 1.29
Secondary

Mean Social Interactions Score

The 3-item Mean Social Interactions Scale assesses the extent to which a participant has discussed the addictiveness or harmfulness of vaping with others in the past 7 days. Response options range from 1 (0 times) to 6 (11 or more times). The overall scale score is calculated by averaging the three items, resulting in a score range from a minimum of 1 to a maximum of 6. Higher scores indicate more frequent social interactions, which are considered a better outcome.

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Social Interactions Score3.33 score on a scaleStandard Deviation 1.39
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Social Interactions Score3.20 score on a scaleStandard Deviation 1.36
Neutral Vaping AdsMean Social Interactions Score3.19 score on a scaleStandard Deviation 1.45
Secondary

Mean Susceptibility to Smoking Cigarettes

The 3-item Mean Susceptibility to Smoking Cigarettes Scale assesses a participant's susceptibility to smoking cigarettes. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with possible scores ranging from 1 to 5. Higher scores indicate a stronger susceptibility to smoking, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Susceptibility to Smoking Cigarettes2.02 score on a scaleStandard Deviation 1.02
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Susceptibility to Smoking Cigarettes2.05 score on a scaleStandard Deviation 1.02
Neutral Vaping AdsMean Susceptibility to Smoking Cigarettes2.21 score on a scaleStandard Deviation 1.05
Secondary

Mean Vaping Addiction Risk Beliefs Score

The 3-item Vaping Addiction Risk Beliefs Scale assesses the extent to which participants believe that vaping will lead to addiction. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with a score range from 1 to 5. Higher scores indicate stronger beliefs in the risk of addiction due to vaping, which is considered a better outcome.

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Addiction Risk Beliefs Score3.77 score on a scaleStandard Deviation 1.18
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Addiction Risk Beliefs Score3.78 score on a scaleStandard Deviation 1.13
Neutral Vaping AdsMean Vaping Addiction Risk Beliefs Score3.58 score on a scaleStandard Deviation 1.28
Secondary

Mean Vaping Attitudes Score

The 3-item Vaping Attitudes Scale assesses a participant's attitude towards vaping (e.g., good/bad). Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with scores ranging from 1 to 5. Higher scores indicate a more positive attitude toward vaping, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Attitudes Score2.35 score on a scaleStandard Deviation 1.29
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Attitudes Score2.37 score on a scaleStandard Deviation 1.25
Neutral Vaping AdsMean Vaping Attitudes Score2.60 score on a scaleStandard Deviation 1.33
Secondary

Mean Vaping Health Harm Risk Beliefs Score

The 3-item Vaping Health Harm Risk Beliefs Scale assesses the extent to which participants believe that vaping will lead to health harms. Response options range from 1 to 5. The overall scale score is calculated by averaging the three items, with possible scores ranging from a minimum of 1 to a maximum of 5. Higher scores indicate stronger beliefs in the health risks associated with vaping, which is considered a better outcome.

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Health Harm Risk Beliefs Score4.09 score on a scaleStandard Deviation 1.08
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Health Harm Risk Beliefs Score4.09 score on a scaleStandard Deviation 1.03
Neutral Vaping AdsMean Vaping Health Harm Risk Beliefs Score3.85 score on a scaleStandard Deviation 1.18
Secondary

Number of Days Participants Vape (E-cigarette Use)

Participants will be asked to report the number of days they vaped over the past 21 days. We chose to retain the continuous measure of the number of days spent vaping rather than dichotomizing this outcome, due to the substantial variability observed in the number of days e-cigarettes were used. A higher value indicates more days that participants vaped, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeNumber of Days Participants Vape (E-cigarette Use)1.86 daysStandard Deviation 2.08
The Real Cost Vaping Prevention Ads - Addiction ThemeNumber of Days Participants Vape (E-cigarette Use)1.98 daysStandard Deviation 2.19
Neutral Vaping AdsNumber of Days Participants Vape (E-cigarette Use)2.14 daysStandard Deviation 2.11
Secondary

Number of Days That Participants Who Smoke Cigarettes

Participants will be asked to report the number of days they smoked cigarettes over the past 21 days. We chose to retain the continuous measure of the number of days smoking rather than dichotomizing this outcome, due to the substantial variability observed in the number of days cigarettes were used. A higher value indicates more days that participants smoked cigarettes, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeNumber of Days That Participants Who Smoke Cigarettes1.61 daysStandard Deviation 1.94
The Real Cost Vaping Prevention Ads - Addiction ThemeNumber of Days That Participants Who Smoke Cigarettes1.63 daysStandard Deviation 2
Neutral Vaping AdsNumber of Days That Participants Who Smoke Cigarettes1.8 daysStandard Deviation 1.96
Other Pre-specified

Mean Avoidance Score

The 3-item Avoidance Scale measures the degree to which a participant wishes to avoid engaging with an advertisement. Responses are provided on a scale from 1 to 5. The overall score is calculated by summing the scores of the three items and then dividing by 3, resulting in a possible range of 1 to 5. Higher scores indicate greater avoidance, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Avoidance Score2.74 score on a scaleStandard Deviation 1.31
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Avoidance Score2.57 score on a scaleStandard Deviation 1.3
Neutral Vaping AdsMean Avoidance Score2.58 score on a scaleStandard Deviation 1.3
Other Pre-specified

Mean Perceived Message Effectiveness Score (FDA Scale)

The 6-item FDA Mean Perceived Message Effectiveness Scale evaluates a participant's overall impressions of an advertisement. Responses are provided on a scale from 1 to 5. The overall scale score is calculated by averaging these six items, resulting in a possible range of 1 to 5. Higher scores indicate that participants found the advertisements to be more informative (i.e., better outcome).

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Perceived Message Effectiveness Score (FDA Scale)4.38 score on a scaleStandard Deviation 0.63
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Perceived Message Effectiveness Score (FDA Scale)4.35 score on a scaleStandard Deviation 0.63
Neutral Vaping AdsMean Perceived Message Effectiveness Score (FDA Scale)4.10 score on a scaleStandard Deviation 0.86
Other Pre-specified

Mean Perceived Message Effectiveness Score (UNC Youth Scale)

The 3-item UNC Youth Mean Perceived Message Effectiveness Scale assesses a participant's judgment of an advertisement's impact on their vaping beliefs and behaviors. Response options range from 1 to 5. The overall score is calculated by averaging the three items, with possible scores ranging from 1 to 5. Higher scores indicate that participants perceive the advertisements as more effective (i.e., better outcome).

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Perceived Message Effectiveness Score (UNC Youth Scale)4.18 score on a scaleStandard Deviation 0.82
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Perceived Message Effectiveness Score (UNC Youth Scale)4.14 score on a scaleStandard Deviation 0.86
Neutral Vaping AdsMean Perceived Message Effectiveness Score (UNC Youth Scale)3.32 score on a scaleStandard Deviation 1.36
Other Pre-specified

Mean Reactance Score

The 1-item reactance measure evaluates the degree to which an ad annoys participants, using a response scale from 1 to 5. Higher scores indicate greater reactance to the ad, representing a less favorable outcome.

Time frame: Week 2

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Reactance Score2.39 score on a scaleStandard Deviation 1.53
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Reactance Score2.28 score on a scaleStandard Deviation 1.48
Neutral Vaping AdsMean Reactance Score2.25 score on a scaleStandard Deviation 1.46
Other Pre-specified

Mean Vaping Affect Regulation Beliefs Score

The 3-item Mean Vaping Affect Regulation Beliefs Scale evaluates participants' beliefs about the experiential benefits of vaping, such as feeling good. Responses are recorded on a 1 to 5 scale. The overall score, which also ranges from 1 to 5, is calculated by averaging the three items. Higher scores indicate that participants expect more significant emotional or affective benefits from vaping, which is considered a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Affect Regulation Beliefs Score3.24 score on a scaleStandard Deviation 1.28
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Affect Regulation Beliefs Score3.28 score on a scaleStandard Deviation 1.3
Neutral Vaping AdsMean Vaping Affect Regulation Beliefs Score3.46 score on a scaleStandard Deviation 1.27
Other Pre-specified

Mean Vaping Injunctive Norms Score

The 3-item Mean Vaping Injunctive Norms Scale measures participants' perceptions of others' approval or disapproval of their vaping behavior, using a response scale from 1 to 5. Overall scores, which range from 1 to 5, are calculated by averaging the three items. Higher scores indicate stronger perceived disapproval of vaping, which is considered a desirable outcome (i.e., better outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Injunctive Norms Score4.27 score on a scaleStandard Deviation 0.86
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Injunctive Norms Score4.26 score on a scaleStandard Deviation 0.9
Neutral Vaping AdsMean Vaping Injunctive Norms Score4.18 score on a scaleStandard Deviation 0.93
Other Pre-specified

Mean Vaping Refusal Self-efficacy

The 3-item Mean Vaping Refusal Self-Efficacy Scale measures a participant's confidence in their ability to refuse vaping in social situations, with response options ranging from 1 to 5. The overall score, also ranging from 1 to 5, is calculated by averaging the three items. Higher scores indicate stronger self-efficacy beliefs in refusing vaping, which is considered a desirable outcome (i.e., better outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Refusal Self-efficacy3.50 units on a scaleStandard Deviation 1.06
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Refusal Self-efficacy3.53 units on a scaleStandard Deviation 1.02
Neutral Vaping AdsMean Vaping Refusal Self-efficacy3.51 units on a scaleStandard Deviation 1.12
Other Pre-specified

Mean Vaping Social Enhancement Beliefs Score

The 3-item Mean Vaping Social Enhancement Beliefs Scale measures participants' perceptions of the social benefits of vaping, such as fitting in better with friends. Responses are on a 1 to 5 scale, with overall scores calculated by averaging the three items. Scores range from 1 to 5, where higher scores indicate a stronger belief in the social benefits of vaping, a less desirable outcome (i.e., worse outcome).

Time frame: Week 3

ArmMeasureValue (MEAN)Dispersion
The Real Cost Vaping Prevention Ads - Health Effects ThemeMean Vaping Social Enhancement Beliefs Score2.84 score on a scaleStandard Deviation 1.29
The Real Cost Vaping Prevention Ads - Addiction ThemeMean Vaping Social Enhancement Beliefs Score2.93 score on a scaleStandard Deviation 1.3
Neutral Vaping AdsMean Vaping Social Enhancement Beliefs Score3.09 score on a scaleStandard Deviation 1.31

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026