Cigarette Smoking Behavior
Conditions
Brief summary
Project RESIST is an R01 study funded by NCI focused on determining the effects of using culturally tailored inoculation approaches to increase resilience to tobacco marketing influences among young adult sexual minority women ages 18-30 and incorporates critical stakeholder inputs that support later adoption and implementation. The study team is utilizing formative research to design and pre-test anti-smoking messages and two national longitudinal online survey experiments.
Detailed description
This study will recruit 3000 young adult sexual minority women (SMW), ages 18-30 years, current smokers (n = 1500) and not current smokers (n = 1500). The study will determine the effects of varying the dose (single vs. multiple), and latency (immediate vs. delayed) of showing participants inoculation anti-smoking messages on smoking and quitting intentions. The study team hypothesize that the multiple exposures (vs. single), and delayed exposure (vs. immediate) will be associated with increased resistance to marketing, reduced smoking intention, and increased quitting intention. The study team will further explore the mechanisms of inoculation effects through emotions, beliefs, and attitudes towards tobacco companies. Participants will be asked to complete a baseline survey and then will receive an anti-smoking message in varying dosages based on the condition they are assigned with a control group receiving no message. Participants will then see a pro-smoking or threat message immediately, one week, or one month late, depending on the condition they were assigned.
Interventions
Anti-smoking messages will be administered online via a Qualtrics survey.
Sponsors
National Cancer Institute (NCI)
Harvard School of Public Health (HSPH)
Stanford University
Dana-Farber Cancer Institute
Fenway Community Health
Abramson Cancer Center at Penn Medicine
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Ages 18-30 * Woman * Identifies as a sexual minority (any sexual orientation other than heterosexual) * Lives in the United States * Able to take surveys in English
Exclusion criteria
* Under 18 or older than 30 * Men * Heterosexual * Lives outside the United States * Unable to take the survey in English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intention to Quit Smoking at Follow-up | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | We used a 4-item scale on intention to quit smoking at baseline and at follow-up (immediate, one-week and one-month) among current smokers only: 1. I will make an effort to quit smoking in the next 30 days; 2. I intend to quit smoking in the next 30 days; 3. I expect to quit smoking in the next 30 days; 4. How likely is it that you will quit smoking in the next 30 days. Responses ranged on 7-point Likert-like scales. Responses were summed to create a scale for intention to quit (range from 4-28), higher scores indicate higher intention to quit. |
| Intention to Purchase Cigarettes | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | The Juster scale was used to measure intention to purchase cigarettes at baseline and at one-month follow-up. Participants were asked, How likely are you to purchase cigarettes in the next 6 months? Responses ranged from 0=No chance, almost no chance (1 in 100) to 10=Certain, practically certain (99 in 100). Higher values reflect higher intention to purchase. |
| Susceptibility to Smoke Cigarettes | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | Susceptibility to smoke cigarettes were measured using four-items: 1. Have you ever been curious about smoking a cigarette? 2. Do you think you will smoke a cigarette in the next year? 3. Do you think that you will try a cigarette soon? 4. If one of your best friends were to offer you a cigarette, would you smoke it? Responses ranged on 4-point Likert-like scales. Responses were summed to create a scale for susceptibility to smoke cigarettes (range from 0-12). This was only measured among participants who did not currently smoke. Higher scores indicate increased susceptibility to smoke cigarettes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Receptivity to Marketing | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | Receptivity to marketing was measured using 2 items: 1. Tobacco companies should have the same rights to advertise as other companies. 2. Are you open to using or wearing something with a tobacco company logo or picture on it? Response options range from 1 (strongly agree) to 5 (strongly disagree) The scale is a sum of the responses to these items, the scale ranges from 2 to 10, with lower scores indicating greater receptivity to marketing. |
| Tobacco Industry Attitudes | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | Tobacco industry attitudes were measured using 3 items: 1. I would like to see cigarette companies go out of business. 2. I would not work for a cigarette company. 3. How much do you like cigarette companies. Response options for items 1 and 2 were from 1 (Strongly agree) to 5 (Strongly disagree). Response options for item 3 were from 1 (Dislike strongly) to 5 (Like strongly). Response options were summed across these 3 items to create the tobacco industry attitudes scale. Values range from 3 to 15, with lower scores indicating stronger anti-industry sentiment. |
| Tobacco Industry Beliefs | Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions | Industry beliefs were measured using 4 items: Cigarette companies lie. Cigarette companies target teens to replace smokers who die. Cigarette companies deny that cigarettes cause cancer and other harmful diseases. Cigarette companies deny that cigarettes are addictive. Response options were from 1 (Strongly agree) to 5 (Strongly disagree). Responses were summed across these 4 items to create the tobacco industry beliefs scale. Values ranges from 4 to 20, with lower scores indicating stronger anti-industry sentiment. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Currently Smoking, No Message Condition Participants will receive no anti-smoking messages. They will receive the threat message during the baseline survey. Outcomes will be measured before and immediately after seeing the threat message, and at 1 month. | 210 |
| Currently Smoking, Single Message Immediate Participants will receive a single anti-smoking message followed by the threat message during the baseline survey. Outcomes will be measured before seeing the anti-smoking message and threat message, immediately after seeing the threat message, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 103 |
| Currently Smoking, Single Message 1 Week Delay Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one week later in a separate survey. Outcomes will be measured before seeing the anti-smoking message at baseline, immediately after seeing the threat message at 1 week, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 113 |
| Currently Smoking, Single Message 1 Month Delay Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one month later in a separate survey. Outcomes will be measured before seeing the anti-smoking message at baseline, and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 107 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one month later. Participants will also receive repeated exposures of a single anti-smoking message at 1, 2, and 3 weeks in separate surveys. Outcomes will be measured before seeing the anti-smoking message at baseline and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 110 |
| Currently Smoking, Three Messages Immediate Participants will receive three anti-smoking messages, followed by the threat message during the baseline survey. Outcomes will be measured before seeing the anti-smoking messages and threat message, immediately after seeing the threat message, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 107 |
| Currently Smoking, Three Messages 1 Week Delay Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one week later in a separate survey. Outcomes will be measured before seeing the anti-smoking messages at baseline, immediately after seeing the threat message at 1 week, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 112 |
| Currently Smoking, Three Messages 1 Month Delay Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one month later in a separate survey. Outcomes will be measured before seeing the anti-smoking messages at baseline, and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 106 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one month later. Participants will also receive repeated exposures of three anti-smoking messages at 1, 2, and 3 weeks in separate surveys. Outcomes will be measured before seeing the anti-smoking messages at baseline and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 107 |
| Not Currently Smoking, No Message Condition Participants will receive no anti-smoking messages. They will receive the threat message during the baseline survey. Outcomes will be measured before and immediately after seeing the threat message, and at 1 month. | 305 |
| Not Currently Smoking, Single Message Immediate Participants will receive a single anti-smoking message followed by the threat message during the baseline survey. Outcomes will be measured before seeing the anti-smoking message and threat message, immediately after seeing the threat message, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 155 |
| Not Currently Smoking, Single Message 1 Week Delay Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one week later in a separate survey. Outcomes will be measured before seeing the anti-smoking message at baseline, immediately after seeing the threat message at 1 week, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 146 |
| Not Currently Smoking, Single Message 1 Month Delay Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one month later in a separate survey. Outcomes will be measured before seeing the anti-smoking message at baseline, and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 150 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure Participants will receive a single anti-smoking message during the baseline survey, followed by the threat message one month later. Participants will also receive repeated exposures of a single anti-smoking message at 1, 2, and 3 weeks in separate surveys. Outcomes will be measured before seeing the anti-smoking message at baseline and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 156 |
| Not Currently Smoking, Three Messages Immediate Participants will receive three anti-smoking messages, followed by the threat message during the baseline survey. Outcomes will be measured before seeing the anti-smoking messages and threat message, immediately after seeing the threat message, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 146 |
| Not Currently Smoking, Three Messages 1 Week Delay Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one week later in a separate survey. Outcomes will be measured before seeing the anti-smoking messages at baseline, immediately after seeing the threat message at 1 week, and at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 154 |
| Not Currently Smoking, Three Messages 1 Month Delay Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one month later in a separate survey. Outcomes will be measured before seeing the anti-smoking messages at baseline, and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 150 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure Participants will receive three anti-smoking messages during the baseline survey, followed by the threat message one month later. Participants will also receive repeated exposures of three anti-smoking messages at 1, 2, and 3 weeks in separate surveys. Outcomes will be measured before seeing the anti-smoking messages at baseline and immediately after seeing the threat message at 1 month.
Culturally Tailored Anti-Smoking Messages: Anti-smoking messages will be administered online via a Qualtrics survey. | 154 |
| Total | 2,591 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 | FG008 | FG009 | FG010 | FG011 | FG012 | FG013 | FG014 | FG015 | FG016 | FG017 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 0 | 0 | 38 | 41 | 46 | 0 | 31 | 45 | 42 | 0 | 0 | 37 | 53 | 49 | 0 | 36 | 58 | 53 |
Baseline characteristics
| Characteristic | Not Currently Smoking, Single Message 1 Week Delay | Not Currently Smoking, Single Message 1 Month Delay | Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Not Currently Smoking, Three Messages Immediate | Not Currently Smoking, Three Messages 1 Week Delay | Not Currently Smoking, Three Messages 1 Month Delay | Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Total | Currently Smoking, Single Message Immediate | Currently Smoking, Single Message 1 Week Delay | Currently Smoking, Single Message 1 Month Delay | Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Currently Smoking, Three Messages Immediate | Currently Smoking, Three Messages 1 Week Delay | Currently Smoking, Three Messages 1 Month Delay | Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Not Currently Smoking, No Message Condition | Not Currently Smoking, Single Message Immediate | Currently Smoking, No Message Condition |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | 24.36 years STANDARD_DEVIATION 3.23 | 24.75 years STANDARD_DEVIATION 3.53 | 24.29 years STANDARD_DEVIATION 3.18 | 23.95 years STANDARD_DEVIATION 3.33 | 24.97 years STANDARD_DEVIATION 3.2 | 24.27 years STANDARD_DEVIATION 3.26 | 24.05 years STANDARD_DEVIATION 3.16 | 24.38 years STANDARD_DEVIATION 3.29 | 24.37 years STANDARD_DEVIATION 3.19 | 24.45 years STANDARD_DEVIATION 3.08 | 23.96 years STANDARD_DEVIATION 3.2 | 24.32 years STANDARD_DEVIATION 3.3 | 24.70 years STANDARD_DEVIATION 3.52 | 24.81 years STANDARD_DEVIATION 3.26 | 24.41 years STANDARD_DEVIATION 3.46 | 24.52 years STANDARD_DEVIATION 3.45 | 24.11 years STANDARD_DEVIATION 3.22 | 24.75 years STANDARD_DEVIATION 3.4 | 24.25 years STANDARD_DEVIATION 3.35 |
| Baseline Intention to Quit Scale | — | — | — | — | — | — | — | 13.61 units on a scale STANDARD_DEVIATION 7.96 | 13.02 units on a scale STANDARD_DEVIATION 7.8 | 13.47 units on a scale STANDARD_DEVIATION 8.65 | 14.33 units on a scale STANDARD_DEVIATION 8.37 | 13.22 units on a scale STANDARD_DEVIATION 8.08 | 13.57 units on a scale STANDARD_DEVIATION 7.2 | 13.91 units on a scale STANDARD_DEVIATION 7.3 | 13.06 units on a scale STANDARD_DEVIATION 7.88 | 13.94 units on a scale STANDARD_DEVIATION 7.77 | — | — | 13.78 units on a scale STANDARD_DEVIATION 8.31 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 22 Participants | 21 Participants | 20 Participants | 19 Participants | 22 Participants | 21 Participants | 18 Participants | 391 Participants | 18 Participants | 19 Participants | 19 Participants | 20 Participants | 19 Participants | 22 Participants | 18 Participants | 16 Participants | 43 Participants | 21 Participants | 33 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 124 Participants | 129 Participants | 136 Participants | 127 Participants | 132 Participants | 129 Participants | 136 Participants | 2200 Participants | 85 Participants | 94 Participants | 88 Participants | 90 Participants | 88 Participants | 90 Participants | 88 Participants | 91 Participants | 262 Participants | 134 Participants | 177 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Intention to Purchase Cigarettes at Baseline | 0.39 units on a scale STANDARD_DEVIATION 1.13 | 0.28 units on a scale STANDARD_DEVIATION 0.84 | 0.38 units on a scale STANDARD_DEVIATION 0.99 | 0.48 units on a scale STANDARD_DEVIATION 1.47 | 0.33 units on a scale STANDARD_DEVIATION 1.02 | 0.38 units on a scale STANDARD_DEVIATION 1.17 | 0.45 units on a scale STANDARD_DEVIATION 1.25 | 3.04 units on a scale STANDARD_DEVIATION 3.97 | 7.04 units on a scale STANDARD_DEVIATION 3.3 | 6.58 units on a scale STANDARD_DEVIATION 3.68 | 6.51 units on a scale STANDARD_DEVIATION 3.47 | 6.99 units on a scale STANDARD_DEVIATION 3.43 | 6.81 units on a scale STANDARD_DEVIATION 3.3 | 6.96 units on a scale STANDARD_DEVIATION 3.11 | 7.39 units on a scale STANDARD_DEVIATION 3.22 | 6.64 units on a scale STANDARD_DEVIATION 3.58 | 0.29 units on a scale STANDARD_DEVIATION 0.98 | 0.22 units on a scale STANDARD_DEVIATION 0.67 | 6.76 units on a scale STANDARD_DEVIATION 3.53 |
| Race (NIH/OMB) American Indian or Alaska Native | 3 Participants | 2 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 24 Participants | 2 Participants | 2 Participants | 4 Participants | 1 Participants | 0 Participants | 2 Participants | 0 Participants | 2 Participants | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 8 Participants | 11 Participants | 11 Participants | 9 Participants | 10 Participants | 10 Participants | 11 Participants | 129 Participants | 4 Participants | 4 Participants | 2 Participants | 3 Participants | 2 Participants | 3 Participants | 1 Participants | 3 Participants | 21 Participants | 10 Participants | 6 Participants |
| Race (NIH/OMB) Black or African American | 12 Participants | 13 Participants | 10 Participants | 11 Participants | 14 Participants | 9 Participants | 11 Participants | 281 Participants | 15 Participants | 17 Participants | 13 Participants | 12 Participants | 19 Participants | 19 Participants | 20 Participants | 18 Participants | 20 Participants | 10 Participants | 38 Participants |
| Race (NIH/OMB) More than one race | 13 Participants | 13 Participants | 15 Participants | 17 Participants | 19 Participants | 20 Participants | 17 Participants | 297 Participants | 15 Participants | 7 Participants | 9 Participants | 18 Participants | 13 Participants | 18 Participants | 10 Participants | 13 Participants | 43 Participants | 16 Participants | 21 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 3 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 0 Participants | 1 Participants | 1 Participants | 2 Participants | 0 Participants | 2 Participants | 14 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 2 Participants | 0 Participants | 1 Participants | 2 Participants | 2 Participants |
| Race (NIH/OMB) White | 109 Participants | 111 Participants | 118 Participants | 108 Participants | 109 Participants | 111 Participants | 112 Participants | 1843 Participants | 67 Participants | 82 Participants | 79 Participants | 76 Participants | 73 Participants | 70 Participants | 72 Participants | 71 Participants | 219 Participants | 115 Participants | 141 Participants |
| Sex/Gender, Customized Female | 136 Participants | 142 Participants | 149 Participants | 138 Participants | 140 Participants | 146 Participants | 149 Participants | 2467 Participants | 99 Participants | 110 Participants | 101 Participants | 104 Participants | 104 Participants | 108 Participants | 102 Participants | 98 Participants | 291 Participants | 146 Participants | 204 Participants |
| Sex/Gender, Customized Male | 10 Participants | 7 Participants | 6 Participants | 8 Participants | 14 Participants | 4 Participants | 5 Participants | 117 Participants | 4 Participants | 3 Participants | 6 Participants | 5 Participants | 3 Participants | 3 Participants | 3 Participants | 7 Participants | 14 Participants | 9 Participants | 6 Participants |
| Sex/Gender, Customized Unknown | 0 Participants | 1 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 7 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 1 Participants | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 0 Participants |
| Susceptibility to smoke cigarettes at baseline | 3.01 units on a scale STANDARD_DEVIATION 2.84 | 2.93 units on a scale STANDARD_DEVIATION 2.66 | 3.04 units on a scale STANDARD_DEVIATION 2.77 | 3.00 units on a scale STANDARD_DEVIATION 2.9 | 3.11 units on a scale STANDARD_DEVIATION 2.88 | 2.92 units on a scale STANDARD_DEVIATION 2.81 | 2.89 units on a scale STANDARD_DEVIATION 295 | 3.00 units on a scale STANDARD_DEVIATION 2.76 | — | — | — | — | — | — | — | — | 3.19 units on a scale STANDARD_DEVIATION 2.71 | 2.77 units on a scale STANDARD_DEVIATION 2.4 | — |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk | EG010 affected / at risk | EG011 affected / at risk | EG012 affected / at risk | EG013 affected / at risk | EG014 affected / at risk | EG015 affected / at risk | EG016 affected / at risk | EG017 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 210 | 0 / 103 | 0 / 113 | 0 / 107 | 0 / 110 | 0 / 107 | 0 / 112 | 0 / 106 | 0 / 107 | 0 / 305 | 0 / 155 | 0 / 146 | 0 / 150 | 0 / 156 | 0 / 146 | 0 / 154 | 0 / 150 | 0 / 154 |
| other Total, other adverse events | 0 / 210 | 0 / 103 | 0 / 113 | 0 / 107 | 0 / 110 | 0 / 107 | 0 / 112 | 0 / 106 | 0 / 107 | 0 / 305 | 0 / 155 | 0 / 146 | 0 / 150 | 0 / 156 | 0 / 146 | 0 / 154 | 0 / 150 | 0 / 154 |
| serious Total, serious adverse events | 0 / 210 | 0 / 103 | 0 / 113 | 0 / 107 | 0 / 110 | 0 / 107 | 0 / 112 | 0 / 106 | 0 / 107 | 0 / 305 | 0 / 155 | 0 / 146 | 0 / 150 | 0 / 156 | 0 / 146 | 0 / 154 | 0 / 150 | 0 / 154 |
Outcome results
Primary
Intention to Purchase Cigarettes
The Juster scale was used to measure intention to purchase cigarettes at baseline and at one-month follow-up. Participants were asked, How likely are you to purchase cigarettes in the next 6 months? Responses ranged from 0=No chance, almost no chance (1 in 100) to 10=Certain, practically certain (99 in 100). Higher values reflect higher intention to purchase.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
Population: Participants in the no-message condition and immediate conditions were not asked post-test intention to purchase.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Currently Smoking, Single Message 1 Week Delay | Intention to Purchase Cigarettes | 5.5 units on a scale | Standard Deviation 3.8 |
| Currently Smoking, Single Message 1 Month Delay | Intention to Purchase Cigarettes | 5.7 units on a scale | Standard Deviation 3.7 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Intention to Purchase Cigarettes | 4.2 units on a scale | Standard Deviation 3.8 |
| Currently Smoking, Three Messages 1 Week Delay | Intention to Purchase Cigarettes | 5.9 units on a scale | Standard Deviation 3.3 |
| Currently Smoking, Three Messages 1 Month Delay | Intention to Purchase Cigarettes | 5.7 units on a scale | Standard Deviation 3.5 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Intention to Purchase Cigarettes | 3.9 units on a scale | Standard Deviation 3.4 |
| Not Currently Smoking, Single Message 1 Week Delay | Intention to Purchase Cigarettes | 0.4 units on a scale | Standard Deviation 1.4 |
| Not Currently Smoking, Single Message 1 Month Delay | Intention to Purchase Cigarettes | 0.2 units on a scale | Standard Deviation 0.5 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Intention to Purchase Cigarettes | 0.4 units on a scale | Standard Deviation 1.2 |
| Not Currently Smoking, Three Messages 1 Week Delay | Intention to Purchase Cigarettes | 0.2 units on a scale | Standard Deviation 0.5 |
| Not Currently Smoking, Three Messages 1 Month Delay | Intention to Purchase Cigarettes | 0.3 units on a scale | Standard Deviation 1.1 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Intention to Purchase Cigarettes | 0.4 units on a scale | Standard Deviation 1.3 |
Primary
Intention to Quit Smoking at Follow-up
We used a 4-item scale on intention to quit smoking at baseline and at follow-up (immediate, one-week and one-month) among current smokers only: 1. I will make an effort to quit smoking in the next 30 days; 2. I intend to quit smoking in the next 30 days; 3. I expect to quit smoking in the next 30 days; 4. How likely is it that you will quit smoking in the next 30 days. Responses ranged on 7-point Likert-like scales. Responses were summed to create a scale for intention to quit (range from 4-28), higher scores indicate higher intention to quit.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
Population: Participants who were currently not smoking were not asked intentions to quit questions~Participants in the no-message and immediate conditions were not asked post-test intentions to quit.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Currently Smoking, Single Message 1 Week Delay | Intention to Quit Smoking at Follow-up | 11.8 units on a scale | Standard Deviation 8.5 |
| Currently Smoking, Single Message 1 Month Delay | Intention to Quit Smoking at Follow-up | 11.0 units on a scale | Standard Deviation 9 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Intention to Quit Smoking at Follow-up | 14.4 units on a scale | Standard Deviation 8.1 |
| Currently Smoking, Three Messages 1 Week Delay | Intention to Quit Smoking at Follow-up | 9.9 units on a scale | Standard Deviation 7.8 |
| Currently Smoking, Three Messages 1 Month Delay | Intention to Quit Smoking at Follow-up | 11.1 units on a scale | Standard Deviation 8.4 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Intention to Quit Smoking at Follow-up | 14.4 units on a scale | Standard Deviation 7.9 |
Primary
Susceptibility to Smoke Cigarettes
Susceptibility to smoke cigarettes were measured using four-items: 1. Have you ever been curious about smoking a cigarette? 2. Do you think you will smoke a cigarette in the next year? 3. Do you think that you will try a cigarette soon? 4. If one of your best friends were to offer you a cigarette, would you smoke it? Responses ranged on 4-point Likert-like scales. Responses were summed to create a scale for susceptibility to smoke cigarettes (range from 0-12). This was only measured among participants who did not currently smoke. Higher scores indicate increased susceptibility to smoke cigarettes.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
Population: This was only measured among participants who did not currently smoke.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Not Currently Smoking, No Message Condition | Susceptibility to Smoke Cigarettes | 3.0 units on a scale | Standard Deviation 2.6 |
| Not Currently Smoking, Single Message Immediate | Susceptibility to Smoke Cigarettes | 2.7 units on a scale | Standard Deviation 2.4 |
| Not Currently Smoking, Single Message 1 Week Delay | Susceptibility to Smoke Cigarettes | 2.2 units on a scale | Standard Deviation 2.7 |
| Not Currently Smoking, Single Message 1 Month Delay | Susceptibility to Smoke Cigarettes | 2.8 units on a scale | Standard Deviation 2.5 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Susceptibility to Smoke Cigarettes | 2.5 units on a scale | Standard Deviation 2.7 |
| Not Currently Smoking, Three Messages Immediate | Susceptibility to Smoke Cigarettes | 3.0 units on a scale | Standard Deviation 2.9 |
| Not Currently Smoking, Three Messages 1 Week Delay | Susceptibility to Smoke Cigarettes | 1.9 units on a scale | Standard Deviation 2.8 |
| Not Currently Smoking, Three Messages 1 Month Delay | Susceptibility to Smoke Cigarettes | 2.6 units on a scale | Standard Deviation 2.6 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Susceptibility to Smoke Cigarettes | 2.8 units on a scale | Standard Deviation 3 |
Secondary
Receptivity to Marketing
Receptivity to marketing was measured using 2 items: 1. Tobacco companies should have the same rights to advertise as other companies. 2. Are you open to using or wearing something with a tobacco company logo or picture on it? Response options range from 1 (strongly agree) to 5 (strongly disagree) The scale is a sum of the responses to these items, the scale ranges from 2 to 10, with lower scores indicating greater receptivity to marketing.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Currently Smoking, No Message Condition | Receptivity to Marketing | 6.3 units on a scale | Standard Deviation 2.5 |
| Currently Smoking, Single Message Immediate | Receptivity to Marketing | 6.1 units on a scale | Standard Deviation 2.6 |
| Currently Smoking, Single Message 1 Week Delay | Receptivity to Marketing | 6.4 units on a scale | Standard Deviation 2.5 |
| Currently Smoking, Single Message 1 Month Delay | Receptivity to Marketing | 6.6 units on a scale | Standard Deviation 2.5 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Receptivity to Marketing | 6.8 units on a scale | Standard Deviation 2.4 |
| Currently Smoking, Three Messages Immediate | Receptivity to Marketing | 6.5 units on a scale | Standard Deviation 2.5 |
| Currently Smoking, Three Messages 1 Week Delay | Receptivity to Marketing | 6.7 units on a scale | Standard Deviation 2.6 |
| Currently Smoking, Three Messages 1 Month Delay | Receptivity to Marketing | 6.3 units on a scale | Standard Deviation 2.6 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Receptivity to Marketing | 7.2 units on a scale | Standard Deviation 2.5 |
| Not Currently Smoking, No Message Condition | Receptivity to Marketing | 8.3 units on a scale | Standard Deviation 1.7 |
| Not Currently Smoking, Single Message Immediate | Receptivity to Marketing | 8.5 units on a scale | Standard Deviation 1.5 |
| Not Currently Smoking, Single Message 1 Week Delay | Receptivity to Marketing | 8.4 units on a scale | Standard Deviation 1.5 |
| Not Currently Smoking, Single Message 1 Month Delay | Receptivity to Marketing | 8.4 units on a scale | Standard Deviation 1.6 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Receptivity to Marketing | 8.4 units on a scale | Standard Deviation 1.4 |
| Not Currently Smoking, Three Messages Immediate | Receptivity to Marketing | 8.6 units on a scale | Standard Deviation 1.4 |
| Not Currently Smoking, Three Messages 1 Week Delay | Receptivity to Marketing | 8.3 units on a scale | Standard Deviation 1.6 |
| Not Currently Smoking, Three Messages 1 Month Delay | Receptivity to Marketing | 8.2 units on a scale | Standard Deviation 1.7 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Receptivity to Marketing | 8.4 units on a scale | Standard Deviation 1.4 |
Secondary
Tobacco Industry Attitudes
Tobacco industry attitudes were measured using 3 items: 1. I would like to see cigarette companies go out of business. 2. I would not work for a cigarette company. 3. How much do you like cigarette companies. Response options for items 1 and 2 were from 1 (Strongly agree) to 5 (Strongly disagree). Response options for item 3 were from 1 (Dislike strongly) to 5 (Like strongly). Response options were summed across these 3 items to create the tobacco industry attitudes scale. Values range from 3 to 15, with lower scores indicating stronger anti-industry sentiment.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Currently Smoking, No Message Condition | Tobacco Industry Attitudes | 8.1 units on a scale | Standard Deviation 3.4 |
| Currently Smoking, Single Message Immediate | Tobacco Industry Attitudes | 8.2 units on a scale | Standard Deviation 3.4 |
| Currently Smoking, Single Message 1 Week Delay | Tobacco Industry Attitudes | 7.8 units on a scale | Standard Deviation 3.4 |
| Currently Smoking, Single Message 1 Month Delay | Tobacco Industry Attitudes | 7.6 units on a scale | Standard Deviation 3.5 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Tobacco Industry Attitudes | 7.1 units on a scale | Standard Deviation 2.8 |
| Currently Smoking, Three Messages Immediate | Tobacco Industry Attitudes | 7.4 units on a scale | Standard Deviation 3.5 |
| Currently Smoking, Three Messages 1 Week Delay | Tobacco Industry Attitudes | 8.0 units on a scale | Standard Deviation 3.3 |
| Currently Smoking, Three Messages 1 Month Delay | Tobacco Industry Attitudes | 7.8 units on a scale | Standard Deviation 3.3 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Tobacco Industry Attitudes | 6.7 units on a scale | Standard Deviation 3.2 |
| Not Currently Smoking, No Message Condition | Tobacco Industry Attitudes | 5.0 units on a scale | Standard Deviation 2.2 |
| Not Currently Smoking, Single Message Immediate | Tobacco Industry Attitudes | 4.8 units on a scale | Standard Deviation 1.8 |
| Not Currently Smoking, Single Message 1 Week Delay | Tobacco Industry Attitudes | 4.5 units on a scale | Standard Deviation 1.8 |
| Not Currently Smoking, Single Message 1 Month Delay | Tobacco Industry Attitudes | 4.7 units on a scale | Standard Deviation 1.8 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Tobacco Industry Attitudes | 4.6 units on a scale | Standard Deviation 2 |
| Not Currently Smoking, Three Messages Immediate | Tobacco Industry Attitudes | 4.8 units on a scale | Standard Deviation 2.1 |
| Not Currently Smoking, Three Messages 1 Week Delay | Tobacco Industry Attitudes | 4.9 units on a scale | Standard Deviation 2.2 |
| Not Currently Smoking, Three Messages 1 Month Delay | Tobacco Industry Attitudes | 4.8 units on a scale | Standard Deviation 2.1 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Tobacco Industry Attitudes | 4.6 units on a scale | Standard Deviation 2 |
Secondary
Tobacco Industry Beliefs
Industry beliefs were measured using 4 items: Cigarette companies lie. Cigarette companies target teens to replace smokers who die. Cigarette companies deny that cigarettes cause cancer and other harmful diseases. Cigarette companies deny that cigarettes are addictive. Response options were from 1 (Strongly agree) to 5 (Strongly disagree). Responses were summed across these 4 items to create the tobacco industry beliefs scale. Values ranges from 4 to 20, with lower scores indicating stronger anti-industry sentiment.
Time frame: Day [0] reported for No-message, single-message immediate, & 3-messages immediate conditions; Week [1] reported for Single-message & 3-messages 1-week delay conditions; Month [1] reported for Single-message & 3-messages 1-month delay conditions
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Currently Smoking, No Message Condition | Tobacco Industry Beliefs | 11.7 units on a scale | Standard Deviation 4.5 |
| Currently Smoking, Single Message Immediate | Tobacco Industry Beliefs | 11.7 units on a scale | Standard Deviation 4.9 |
| Currently Smoking, Single Message 1 Week Delay | Tobacco Industry Beliefs | 10.9 units on a scale | Standard Deviation 4.4 |
| Currently Smoking, Single Message 1 Month Delay | Tobacco Industry Beliefs | 11.1 units on a scale | Standard Deviation 4.7 |
| Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Tobacco Industry Beliefs | 10.4 units on a scale | Standard Deviation 4.3 |
| Currently Smoking, Three Messages Immediate | Tobacco Industry Beliefs | 11.0 units on a scale | Standard Deviation 4.2 |
| Currently Smoking, Three Messages 1 Week Delay | Tobacco Industry Beliefs | 11.4 units on a scale | Standard Deviation 4 |
| Currently Smoking, Three Messages 1 Month Delay | Tobacco Industry Beliefs | 10.5 units on a scale | Standard Deviation 4.5 |
| Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Tobacco Industry Beliefs | 10.5 units on a scale | Standard Deviation 4.4 |
| Not Currently Smoking, No Message Condition | Tobacco Industry Beliefs | 8.9 units on a scale | Standard Deviation 3.7 |
| Not Currently Smoking, Single Message Immediate | Tobacco Industry Beliefs | 8.3 units on a scale | Standard Deviation 3.5 |
| Not Currently Smoking, Single Message 1 Week Delay | Tobacco Industry Beliefs | 8.9 units on a scale | Standard Deviation 3.5 |
| Not Currently Smoking, Single Message 1 Month Delay | Tobacco Industry Beliefs | 8.9 units on a scale | Standard Deviation 3.2 |
| Not Currently Smoking, Single Message 1 Month Delay, Repeated Exposure | Tobacco Industry Beliefs | 8.7 units on a scale | Standard Deviation 3.4 |
| Not Currently Smoking, Three Messages Immediate | Tobacco Industry Beliefs | 8.5 units on a scale | Standard Deviation 3.4 |
| Not Currently Smoking, Three Messages 1 Week Delay | Tobacco Industry Beliefs | 8.9 units on a scale | Standard Deviation 3.3 |
| Not Currently Smoking, Three Messages 1 Month Delay | Tobacco Industry Beliefs | 9.2 units on a scale | Standard Deviation 3.6 |
| Not Currently Smoking, Three Messages 1 Month Delay Repeat Exposure | Tobacco Industry Beliefs | 8.8 units on a scale | Standard Deviation 3.3 |