Relevant Vapes are discreet, cheap, and come in a range of fruit flavours. A few studies have found that using them may lead to high nicotine levels and increased exposure to chemicals associated with respiratory disease.
Evidence from a few cross-sectional and interventional studies was difficult to synthesise on inflammation biomarkers and on lung function (fEV1/FENO). This is because of different study designs, outcomes measures and comparison groups.
Messages
Twenty-seven objective features were coded across five categories (message themes, imagery, text features, message perspective, and other). Six messages (3%) were Internet memes, and eighty-nine percent of the 220 eligible messages included an image. In addition, 80% of the messages included bright/vivid colors.
Themes that were most frequently present included nicotine addiction, chemicals, and health effects. The latter theme can be challenging to develop given the limited body of evidence on vaping’s impact on health, but lessons from the recent mislabeled e-cigarette and vapor product contaminant outbreak in the US may prove useful for future work.
Health effects messages must be accurate and provide information on both absolute harms and relative harms compared to smoking. Additionally, it is important to highlight the differences in cardiovascular risk based on factors such as device type and nicotine concentration and liquid composition. Finally, the inclusion of a source is critical for establishing credibility for health risks messages, especially when targeting adolescents.
Targeting
State and local health departments, along with national public health organizations, have created anti-vaping ads geared to teens. One study found that ads that clearly communicated health harms, compared vaping to cigarette smoking, or were personal and relevant to teens were most impactful. Ads that were neutral or less personally relevant were significantly less effective.
Further research is needed to evaluate the effectiveness of messaging aimed at reducing teen vaping. Specifically, studies with longer follow up periods are needed to assess whether changes in spirometry measures, which have been associated with an increased risk of respiratory diseases, occur in vapers as well as non-vapers.
Studies that explore how adolescents perceive the portrayal of vaping on social media platforms are also necessary to help develop counter-marketing campaigns. In addition, strategies to monitor e-cigarette marketing on social media are warranted, as well as strict regulatory action to ensure that social media companies comply with tobacco-marketing policies. Lastly, more research is needed with cancer patients and survivors to understand whether vaping can reduce exposure to carcinogens from cigarette smoke and enhance treatment outcomes or reduce the risk of recurrence.
Media Gallery
The media gallery contains hundreds of vaping prevention and cessation images, videos, GIFs, audio, e-cigarette warning labels and infographics. Practitioners can browse by topic, audience and creator to find anti-vaping messages that can be used in their campaigns.
The gallery includes a variety of content from Instagram, TikTok and YouTube. The scope of this content is alarming, with a mixture of modern advertising techniques and age-old tobacco industry tropes. It glamourises e-cigarettes with flavours such as cola ice and candy floss, features scantily dressed models and promotes ‘vape challenges’ on social platforms. It also includes e-cigarettes made to look like USB drives, ballpoint pens and phones.
Parents, students and teachers all identified TikTok, Instagram and Snapchat as the main sources of their information on vaping. It is important to educate young people about the short-term health impacts of e-cigarettes. This should include addressing e-cigarette product design, marketing and age verification practices. This can be done through improving NSW Health resources, PDHPE lessons and professional learning sessions delivered at schools.
Evaluation
We used an inductive approach to develop a coding rubric to examine elements of the messages, based on our prior work with tobacco prevention messaging. The rubric included 37 categories to examine the themes, colours, design and message perspective.
Further research is needed to examine whether the use of hashtags and memes in vaping prevention campaigns is effective. It is also important to understand why some messages are more or less effective than others.
Evidence is growing that e-cigarette vaping can negatively impact health. A number of studies have shown that e-cigarette vaping can increase platelet activation, inhibit the adhesion molecule P-selectin, and increase oxidative stress, vascular endothelial dysfunction, and vascular stiffness [17, 18].
In addition, NHS Digital data indicate that supported stop smoking services are seeing more people with problems related to nicotine vaping. MHRA also receives reports through its Yellow Card scheme about suspected adverse reactions associated with e-cigarette products containing nicotine. More research is also needed to examine the effect of the flavouring chemicals in e-cigarette aerosols and on human cells.