Pathways to Prevent E-Cigarette Use: Examining the Effectiveness of the truth Antivaping Campaign

Objective: Mass media campaigns have been designed to counter a rise in e-cigarette use among young people. No studies to date have established pathways from campaign exposure to e-cigarette use behaviors. This study examines the mechanisms through which exposure to the truth® campaign may prevent the progression of e-cigarette use among youth and young adults. Method: Data included four waves of the truth longitudinal cohort, a probability-based, nationally representative survey: Wave 1: September 2020-March 2021; Wave 2: July-October 2021; Wave 3: January-May 2022; and Wave 4: October 2022-January 2023. The sample (N = 4,744) was aged 15-24 years and nicotine naive at Wave 1. Latent growth structural equation modeling techniques examined the pathway from cumulative frequency of ad exposure (CFE) to the e-cigarette use progression via campaign-targeted attitudes. Results: The direct effect from CFE to e-cigarette use progression was not significant. The overall indirect pathway shows that CFE was significantly associated with lower progression of e-cigarette use (β = −.01, p < .0001). CFE had a significant positive association with each campaign-targeted attitude, and each attitude was significantly associated with stronger perceived norms against e-cigarette use. Stronger perceived norms were significantly associated with a slower progression to e-cigarette use (β = −.21, p < .0001). Conclusions: Awareness of the truth antivaping campaign follows a pathway of targeted attitudes and perceptions of acceptability, then to slowed progression toward initiation of e-cigarette use. Antivaping campaigns should focus on shifting perceptions of acceptability to reduce e-cigarette use among young people. Objetivo: Se han diseñado campañas en los medios de comunicación para contrarrestar el aumento del uso de cigarrillos electrónicos entre los jóvenes. Hasta la fecha, ningún estudio ha establecido vías desde la exposición a la campaña hasta los comportamientos de uso de cigarrillos electrónicos. Este estudio examina los mecanismos a través de los cuales la campaña de exposición a la iniciativa truth® puede prevenir la progresión del uso de cigarrillos electrónicos entre jóvenes y adultos jóvenes. Métodos: Los datos incluyeron cuatro rondas de la Cohorte Longitudinal de Truth (TLC, por sus siglas en inglés), una encuesta representativa a nivel nacional basada en probabilidades: Ronda 1: septiembre de 2020 a marzo de 2021; Ola 2: julio a octubre de 2021; Ola 3: enero