BACKGROUND: Despite a global decline in smoking rates, the use of newer nicotine products, such as electronic cigarettes, has risen significantly, especially among youth. Governments are increasingly interested in developing mass media campaigns to raise awareness about the harms of electronic cigarettes and regulate or prevent their market entry, aiming to protect future generations from nicotine addiction. However, effective messaging strategies to increase public understanding of harms of these products and build support for policy measures remain underexplored.
METHODS: Between 2020 and 2023, Vital Strategies conducted concept testing in Brazil, India, Mexico, Ukraine, and Vietnam to support governments interested in developing electronic cigarette prevention campaigns. This study examines perceived personal effectiveness ratings of various communication concepts tested across these five countries. A combination of quantitative (concept ratings) and qualitative (focus group discussions) methods was employed to evaluate the concepts. The groups were segmented by tobacco use status (users and non-users), gender, age, and socio-economic status (middle and high).
RESULTS: Results indicated that messages highlighting the negative health threats of electronic cigarette use, presented with a serious tone and graphic imagery depicting harm, were consistently rated as personally effective in discouraging use. Simple language was essential to address significant knowledge gaps, and comparing chemicals in electronic cigarettes to common toxins, like car exhaust or pesticides, proved effective. Statistical health risk information was impactful but required credible sourcing for message believability. The study also emphasized the importance of communicating that both electronic and traditional cigarettes are harmful to health. In Ukraine, an anti-industry approach resonated strongly, highlighting the need for tailored messaging strategies based on local contexts.
CONCLUSIONS: The findings provide valuable insights to help develop evidence-based, culturally relevant messaging for future electronic cigarette prevention campaigns, aimed at reducing use and building support for relevant policy measures.