2019 was a turning point in youth vaping, as aggressive public health campaigns and extensive news coverage of e-cigarette or vaping product use-associated lung injury (EVALI) effectively curbed teen use.
RT’s Three Key Takeaways:
- Media Influence: A combination of public health advertising and widespread news coverage regarding vaping-related lung injuries significantly shifted adolescent vaping behavior.
- Increased Quit Attempts: The percentage of youth vapers attempting to quit nearly doubled between 2017 and 2020, rising from 28.8% to 53.2%.
- EVALI Awareness: News coverage of e-cigarette or vaping product use-associated lung injury (EVALI) was uniquely effective in reducing the likelihood that teens who had never vaped would start the habit.
Anti-vaping advertisements and news coverage of EVALI lung-injuries were primary drivers in reversing the trend of youth vaping in the US, according to a study published in BMC Public Health.
Youth vaping in the US surged from 8.1% in 2017 to a peak of 20% in 2019 before beginning a sustained decline, reaching 5.9% by 2024. The study from Researchers from the University of California San Diego Herbert Wertheim School of Public Health and Human Longevity Science identified 2019 as a turning point, coinciding with a convergence of aggressive public health campaigns and extensive news coverage of e-cigarette or vaping product use-associated lung injury (EVALI).
“A convergence of media forces — aggressive public health campaigns and frightening news reports about people being hospitalized with severe lung injuries — appears to have shaken adolescents out of complacency and motivated many of them to quit,” said Shu-Hong Zhu, PhD, Herbert Wertheim School of Public Health professor and senior author of the study, in a news release.
Impact of Public Health Messaging
By 2019, major media forces converged to influence adolescent behavior. These included anti-vaping advertising from the Food and Drug Administration (FDA), the Truth Initiative, and state-led campaigns such as California’s Tobacco Control Program. Simultaneously, news organizations published nearly 20,000 articles regarding the EVALI outbreak between July 2019 and March 2020. EVALI was linked to more than 2,800 hospitalizations and 68 deaths.
The study analyzed data from more than 260,000 students across two cycles of the California Student Tobacco Survey. Researchers compared behaviors from the 2017–18 cycle, conducted before national campaigns launched, to the 2019–20 cycle, which took place during peak EVALI coverage.
The results showed that among current vapers, the proportion who attempted to quit in the past year rose from 28.8% in 2017–18 to 53.2% in 2019–20. Intentions to quit also increased from 56.9% to 79.1%. Furthermore, susceptibility to future vaping among students who had never vaped dropped from 30.3% to 25.7%.
EVALI Awareness vs Paid Advertising
The research indicated that while both advertising and EVALI awareness predicted higher odds of quit attempts, EVALI awareness was uniquely associated with lower susceptibility to future vaping among never-vapers. This effect was not found with anti-vaping advertising, despite national ad campaigns exceeding $100 million in annual expenditures.
Because the cause of the EVALI outbreak was not initially identified, early news reports framed the crisis around vaping broadly. While the outbreak was eventually linked to black market THC products, most teens aware of EVALI believed nicotine was responsible.
“Quit attempt rates on a population level almost never change this dramatically from one period to the next,” said Jijiang Wang, PhD, a postdoctoral researcher at the Herbert Wertheim School of Public Health and first author of the study, in a news release. “When they do, it tells us something important about what is possible when the media environment shifts.”
