Pathway from Exposure to an E-Cigarette Prevention Social Media Campaign to Increased Quitting Intentions: A Randomized Trial Among Young Adult E-Cigarette Users

In 2022, 26-31% of young adults reported using e-cigarettes in the previous 30 days. Research supports the effectiveness of mass media health campaigns in changing targeted attitudes and behaviors regarding nicotine use. However, the effect of social media campaigns and the pathway through which they change attitudes and behaviors require more research. This randomized controlled experiment examines the pathway through which exposure to an e-cigarette prevention social media campaign influences intentions to quit e-cigarettes among young adults who currently use e-cigarettes. Participants (<i>n</i> = 160) aged 18 to 24 years old were recruited through Virtual Lab in Facebook and Instagram. Structural equation modeling (SEM) was used to examine the pathway from campaign exposure, to changes in targeted attitudes, and finally to intentions to quit e-cigarettes in the next year. Ad exposure was significantly associated with stronger anti-industry attitudes, independence from e-cigarettes, and risk perceptions. These campaign-targeted attitudes were significantly associated with greater intentions to quit e-cigarettes (anti-industry attitudes (OR = 1.43), independence (OR = 1.50), and risk perception (OR = 1.71)). The findings suggest that exposure to an e-cigarette prevention social media campaign can affect targeted attitudes, which in turn improve intentions to quit. Future research should examine behavior changes and compare the effects between those currently using e-cigarettes and those not using them.