American Journal of Preventive Medicine最新文献

{"title":"STRIVING FOR DIVERSITY IN POPULATION-BASED RESEARCH: STRATEGIES AND OUTCOMES IN THE RISE FOR HEALTH STUDY.","authors":"Siobhan Sutcliffe, Chloe Falke, Kyle D Rudser, Gerald McGwin, Cynthia S Fok, Cecilia Hardacker, Aimee S James, Emily S Lukacz, Julia Maki, Alayne D Markland, Ratna Pakpahan, Sara Putnam, Leslie M Rickey, Jean F Wyman, Linda Brubaker, Ariana L Smith","doi":"10.1016/j.amepre.2026.108483","DOIUrl":"https://doi.org/10.1016/j.amepre.2026.108483","url":null,"abstract":"<p><strong>Introduction: </strong>Broad demographic representation is important in population-based research to enhance generalizability. The purpose of this manuscript is to describe strategies used to promote broad representation in the RISE FOR HEALTH study (RISE), consistent with its prioritized representation goals; and to compare participants to American women to gauge the success of these strategies.</p><p><strong>Methods: </strong>RISE was a large population-based cohort study of community-dwelling women selected by probability sampling of adult female residents of 57 geographically dispersed U.S. counties. Participation entailed completing self-administered surveys and an optional in-person assessment. Diversity goals and associated strategies were to: 1) ensure representation by race, ethnicity, and age similar to the U.S. population (by stratified probability sampling from a large marketing database); 2) remove barriers to participation by preferred Spanish language speakers (cultural adaptation, linguistic translation, bilingual mailings); and 3) promote diversity more broadly (marketing-style materials, community engagement). In 2024-2025, participant characteristics were compared to those of American women, using data from two national surveys (American Community Survey, National Health and Nutrition Examination Survey).</p><p><strong>Results: </strong>3,400 participants (of 50,367 invited) completed the baseline survey from 2022-2023 and were eligible. Consistent with the stratified sampling plan, participants were similar to the U.S. population with respect to race, ethnicity, and age. In contrast, they differed by Spanish as a primary language spoken (4.4% versus 12.9% in the U.S.) and completion of a high school degree or less (13.8% versus 35.9%).</p><p><strong>Conclusions: </strong>Strategies designed to promote diversity were variably successful in RISE, offering insight for future population-based research.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108483"},"PeriodicalIF":4.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Attention to Digital Ads: How Audiences Attend to and Respond to “The Real Cost” Youth E-Cigarette Prevention Campaign Ads","authors":"Elizabeth L. Petrun Sayers PhD,&nbsp;Mihaela Johnson PhD,&nbsp;Merrybelle Guo MPH,&nbsp;Jamie Guillory PhD,&nbsp;Kim A. Hayes MPH,&nbsp;Sarah Helen Cooper MA,&nbsp;McKinley Saunders BA","doi":"10.1016/j.amepre.2025.108215","DOIUrl":"10.1016/j.amepre.2025.108215","url":null,"abstract":"<div><h3>Introduction</h3><div>This study examined visual attention to and recognition of “The Real Cost” Youth e-cigarette Prevention Campaign ads in simulated, naturalistic digital media environments.</div></div><div><h3>Methods</h3><div>In 2024, a convenience sample of 2,040 individuals aged 18–24 years in the U.S. was exposed to a campaign ad in 1 of 4 simulated digital media environments (YouTube skippable and nonskippable, Instagram Reels and Stories). Participants’ cameras captured facial coding measurements (e.g., attention), and a survey captured brand and ad recognition. Analyses included descriptive statistics and statistical testing (z-scores for categorical outcomes, independent <em>t</em>-tests for continuous outcomes) to compare outcomes for ad placements.</div></div><div><h3>Results</h3><div>Nonskippable YouTube ads captured the most attention, with participants focusing for 8.6–9.7 seconds, and 46%–54% paying attention to at least half the ad and the last 2 seconds. Instagram Stories held attention for 5–7 seconds; 25%–32% of viewers watched half the ad and the last 2 seconds. Instagram Reels and YouTube skippable ads received the least attention. Brand recognition was similar across YouTube nonskippable ads (37%–49%), Instagram Stories (45%–46%), and Instagram Reels (39%–41%), whereas fewer YouTube skippable viewers (23%–32%) recognized the brand. Ad recognition was highest for YouTube nonskippable ads (52%–73%), followed by Instagram Reels (36%–61%), Instagram Stories (32%–41%), and YouTube skippable ads (22%–48%).</div></div><div><h3>Conclusions</h3><div>Results show that some media platforms and placements can capture more of a viewer’s attention than others. Results show that attention, brand awareness, and ad awareness can increase on several digital media platforms and ad placements.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108215"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of “The Real Cost” on E-cigarette Initiation Among U.S. Youth","authors":"Anna MacMonegle MA,&nbsp;Anh Nguyen Zarndt PhD,&nbsp;Yifan Wang MPH,&nbsp;Morgane Bennett DrPH, MPH,&nbsp;Vincenzo F. Malo MSc,&nbsp;Lindsay Pitzer PhD,&nbsp;James M. Nonnemaker PhD,&nbsp;Allie Jaarsma MPP,&nbsp;Leeann N. Siegel PhD, MPH,&nbsp;Nathaniel H. Taylor MPH,&nbsp;Jennifer Duke PhD","doi":"10.1016/j.amepre.2025.02.015","DOIUrl":"10.1016/j.amepre.2025.02.015","url":null,"abstract":"<div><h3>Introduction</h3><div>E-cigarette use among U.S. youth has declined in recent years. This study examined the effect of exposure to “The Real Cost” Youth E-cigarette Prevention Campaign on e-cigarette initiation among U.S. youth aged 11–18 years.</div></div><div><h3>Methods</h3><div>Data were analyzed from the first 2 waves of a longitudinal evaluation of the campaign (baseline: August–December 2023; follow-up: June–September 2024; analyses: 2025). The analysis included youth who reported never having tried an e-cigarette at baseline and completed the follow-up survey (<em>n</em>=3,408). An exposure index (range: 0–16) was generated using respondents’ self-reported frequency of exposure to each of four campaign advertisements (0=<em>never</em>; 4=<em>very often</em>). The impact of exposure on e-cigarette initiation was examined at follow-up using a discrete-time survival analysis logistic regression model, controlling for potential confounding variables. The estimated number of youth prevented from initiating e-cigarette use was extrapolated to the national youth population.</div></div><div><h3>Results</h3><div>The odds of reporting e-cigarette initiation at follow-up decreased as exposure to campaign advertisements increased. For every unit increase in the exposure index, there was a 6% reduction in the probability of initiation. The campaign prevented an estimated 444,252 (95% CI=73,639; 814,866) U.S. youth aged 11–18 years from initiating e-cigarettes between 2023 and 2024.</div></div><div><h3>Conclusions</h3><div>Youth with higher exposure to “The Real Cost” E-cigarette Prevention Campaign ads were less likely to initiate e-cigarettes during the study period. These findings indicate that the campaign has contributed to recent declines in e-cigarette use among U.S. youth.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 107614"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Objective Features of Vaping Prevention Video Ads: A Content Analysis","authors":"Bonjoo Gu MA,&nbsp;Sarah D. Kowitt PhD,&nbsp;Youjin Jang PhD,&nbsp;Ran Tao PhD,&nbsp;Kexin Li MA,&nbsp;Caroline Ritchie MPH,&nbsp;Victoria Triana MPH,&nbsp;Minji Kim PhD,&nbsp;Nisha Gottfredson O’Shea PhD,&nbsp;Seth M. Noar PhD","doi":"10.1016/j.amepre.2025.108043","DOIUrl":"10.1016/j.amepre.2025.108043","url":null,"abstract":"<div><h3>Introduction</h3><div>To address youth and young adult vaping, the Food and Drug Administration and other organizations have launched vaping prevention video ads. However, limited research exists on the objective features of these ads (i.e., observable and systematically codable elements). This study identified and described these features through a content analysis.</div></div><div><h3>Methods</h3><div>A total of 302 video ads, released between 2015 and 2024, were collected on the basis of the following criteria: focused on vaping prevention, targeted youth or young adults, 35 seconds or shorter, and in English. Twenty-nine codes were developed to capture objective features in 5 categories: (1) message themes; (2) structural features (genre, visual, audio, and format); (3) tobacco product depictions; (4) audience targeting; and (5) other features, such as source and length. Data were analyzed in 2024.</div></div><div><h3>Results</h3><div>Most ads (49.3%) were from U.S. national organizations, followed by U.S. state governments (43.7%) and international sources (7.0%). Nearly half (46.0%) were 11–20 seconds. Nicotine addiction was the most common primary theme (34.4%), followed by harmful chemicals/metals (16.2%) and mental health (13.9%). Ads predominantly used live action (68.2%), visual effects (54.0%), background music (78.5%), and an acted-out format (57.3%). Vaping imagery appeared in most ads (68.5%). Few ads were explicitly designed for specific racial/ethnic (3.6%) or lesbian, gay, or bisexual (0.3%) communities.</div></div><div><h3>Conclusions</h3><div>This study provides the groundwork for future research to identify which objective ad features most effectively influence vaping-related outcomes. Findings also serve as a practical resource for campaign developers who design ads on the basis of objective features.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108043"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12940065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amplifying Impact: FDA’s “The Real Cost” Youth E-Cigarette Prevention Campaign Drives Engagement With NCI’s SmokefreeTeen Vaping Cessation Resources","authors":"Mihaela Johnson PhD,&nbsp;Jamie Guillory PhD,&nbsp;Merrybelle Guo MPH,&nbsp;Sarah Helen Cooper MPH,&nbsp;McKinley Saunders BA,&nbsp;Elizabeth L. Petrun Sayers PhD,&nbsp;Jessica M. Sobolewski MA","doi":"10.1016/j.amepre.2026.108282","DOIUrl":"10.1016/j.amepre.2026.108282","url":null,"abstract":"<div><h3>Introduction</h3><div>The U.S. Food and Drug Administration’s “The Real Cost” Youth E-Cigarette Prevention Campaign partnered with the National Cancer Institute to provide SmokefreeTeen cessation resources to the campaign audience. This study explored how traffic directed to the SmokefreeTeen website from campaign messages interacted with content and how engagement differed on the basis of traffic source.</div></div><div><h3>Methods</h3><div>Using SmokefreeTeen web traffic data from April 2021 to December 2022 (and analyzed in 2024), the study descriptively and statistically compared page views and engagement with cessation tools (3-step Vaping Reality Check quiz; Quit Plan builder) for referrals to SmokefreeTeen from “The Real Cost” Youth E-Cigarette Prevention Campaign advertising, direct traffic (e.g., typed website into browser), or organic searches (e.g., search engines).</div></div><div><h3>Results</h3><div>Campaign traffic generated higher proportions of page views for campaign-linking pages. Quit resources engagement was greater for campaign visits, with a higher proportion of Vaping Reality Check completions and Quit Plan completions and downloads than of other sources. Organic searches generated the highest proportion of overall traffic, followed by direct website and the campaign.</div></div><div><h3>Conclusions</h3><div>The primary goal of “The Real Cost” is youth tobacco prevention. Because many youth experience e-cigarette–related addiction, the campaign also shares evidence-based cessation resources. Linking to SmokefreeTeen resources from campaign assets resulted in substantial traffic to intended pages and engagement with cessation tools. The campaign’s ability to successfully link to SmokefreeTeen cessation resources demonstrates that digital media campaigns, such as “The Real Cost” tobacco prevention campaigns, can reach audiences at various stages of tobacco use and encourage engagement with online cessation resources.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108282"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Science to Practice: How FDA Applies Dissemination and Implementation Science Frameworks to Support Tobacco Public Education","authors":"Emily McDonald MPH,&nbsp;Anh Nguyen Zarndt PhD, MPH,&nbsp;Merrybelle Guo MPH,&nbsp;Jessica K. Pepper PhD","doi":"10.1016/j.amepre.2026.108418","DOIUrl":"10.1016/j.amepre.2026.108418","url":null,"abstract":"<div><div>The field of dissemination and implementation science facilitates the translation of research into practice and is especially relevant to tobacco control contexts. The U.S. Food and Drug Administration’s Center for Tobacco Products manages a robust research portfolio to inform public health programs that educate, prevent, and reduce tobacco use. Research translation is a critical component of Center for Tobacco Products’ comprehensive tobacco regulatory framework, which aims to reduce the population-level impact of tobacco use. This paper describes how Center for Tobacco Products applies dissemination and implementation science frameworks to enhance the effectiveness of tobacco prevention and education programs, including “The Real Cost” campaign and other educational activities. The RE-AIM framework applies an implementation science lens to Center for Tobacco Products’ flagship youth tobacco prevention brand, “The Real Cost,” which has demonstrated its effectiveness in preventing youth tobacco initiation. The Knowledge-to-Action Framework describes Center for Tobacco Products’ dissemination science application, with a focus on knowledge creation and synthesis for various audiences, including academia, educators, and parents. The integration of these dissemination and implementation science frameworks into Center for Tobacco Products’ public education program ensures continuous feedback between research and practice, ultimately maximizing the public health impact and population-level benefit.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108418"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The Real Cost” in Context: Comparative Surveillance of E-Cigarette Prevention Campaigns on Twitter (2018–2023)","authors":"Miao Feng PhD,&nbsp;Chandler C. Carter MA,&nbsp;Simon Page BA,&nbsp;Mateusz Borowiecki MSc,&nbsp;Ganna Kostygina PhD,&nbsp;Sherry L. Emery PhD, MBA","doi":"10.1016/j.amepre.2025.108216","DOIUrl":"10.1016/j.amepre.2025.108216","url":null,"abstract":"<div><h3>Introduction</h3><div>E-cigarette prevention campaigns face visibility and sustainability challenges on social media, where provaping content dominates, and coordinated opposition is common. National initiatives such as the Food and Drug Administration’s “The Real Cost” campaign operate alongside regional efforts, yet their comparative resilience and reach in digital spaces remain understudied.</div></div><div><h3>Methods</h3><div>To evaluate and compare national and state/local campaigns (2018–2023) on Twitter/X, machine-learning classifiers (F1&gt;0.90 for opposition detection) and geotagged data from Twitter’s Historical PowerTrack and Academic application programming interfaces were used to analyze campaign-related content across 4 domains: volume, valence (opposition versus prevention/neutral), engagement (retweets, potential reach), and user behavior (cross-campaign participation). Tweets were algorithmically assigned to campaigns using regular expressions and filtered for relevance. Data were collected from 2018 to 2023 and analyzed in 2025.</div></div><div><h3>Results</h3><div>From April 2018 to April 2023, campaign-related posts declined by 61.8%, with opposition content consistently comprising &gt;70% of posts and exceeding 90% in some months. Opposition was concentrated among a small subset of users (top 10% generated 57.9% of opposition retweets). About one fifth (20.5%) of “The Real Cost” campaign–related messages were classified as opposition, whereas regional campaigns, particularly Chicago’s Vaping Truth, faced overwhelming opposition (99.6% of posts), with 96.2% originating outside intended campaign jurisdictions.</div></div><div><h3>Conclusions</h3><div>The relative resilience of “The Real Cost” reflects the advantages of sustained investment, national scope, and constant branding. Regional campaigns were particularly vulnerable to cross-jurisdictional narrative hijacking. Future prevention efforts must proactively identify and counter coordinated opposition strategies to improve digital reach and effectiveness.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108216"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The Real Cost” Campaign: Efficacy by Design","authors":"Bret Koplow PhD, JD","doi":"10.1016/j.amepre.2026.108422","DOIUrl":"10.1016/j.amepre.2026.108422","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108422"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Message Evaluation Equivalence in Pre Versus Postproduction Tobacco Education Ads","authors":"Emily B. Peterson PhD,&nbsp;Matthew E. Eggers PhD,&nbsp;Emily C. Sanders MPH,&nbsp;Anh Nguyen Zarndt PhD, MPH,&nbsp;Emily McDonald MPH,&nbsp;Xiaoquan Zhao PhD,&nbsp;James M. Nonnemaker PhD,&nbsp;Nicole B. Swires BA,&nbsp;Margaret G. Moakley MPH","doi":"10.1016/j.amepre.2025.108120","DOIUrl":"10.1016/j.amepre.2025.108120","url":null,"abstract":"<div><h3>Introduction</h3><div>The U.S. Food and Drug Administration’s “The Real Cost” campaigns inform the public about the harms of tobacco use. The U.S. Food and Drug Administration has followed a 2-part approach to advertise formative testing to ensure sufficient audience receptivity: preproduction qualitative testing and postproduction quantitative testing. This process provides safeguards for ad performance but course corrections to message selection or development after the ads are already fully produced can be time and resource intensive. This study assesses equivalence in message evaluations between pre and postproduction campaign ads.</div></div><div><h3>Methods</h3><div>Data were collected in 2023 from an online panel survey of 804 youth aged 13–17 years, who currently use or are susceptible to use e-cigarettes or cigarettes. Participants were randomly assigned to a set of 4 preproduction or postproduction “The Real Cost” campaign ads. Participants completed a series of message evaluation measures after each ad. Authors tested for equivalence of mean message evaluation scores between the pre and postproduction versions of each ad using 2 one-sided <em>t</em>-tests and estimated concordance correlation coefficients. Data were analyzed in 2024.</div></div><div><h3>Results</h3><div>Aggregate ad performance scores between pre and postproduction versions were equivalent. Patterns varied for individual ads, with most demonstrating equivalence on some but not all message evaluation measures. Concordance correlation coefficients for pre and postproduction ads were positive and moderate in size.</div></div><div><h3>Conclusions</h3><div>Results suggest that message evaluation assessments of preproduction ads are likely a good indicator of message evaluation assessments for postproduction ads. Public health practitioners may consider incorporating quantitative copy testing earlier in the formative testing process to identify the most promising ad concepts.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108120"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural Predictors of Vaping: Covert Emotional Engagement Versus Reactance to Overt Emotional Appeals in Vaping Prevention Message Processing","authors":"Jiaying Liu PhD,&nbsp;Yidi Wang MA,&nbsp;Jessica L. Fabbricatore PhD,&nbsp;Emily Norton MS,&nbsp;Colleen E. Markey MS,&nbsp;Joshua T. McMains PhD,&nbsp;Allison Worsdale PhD,&nbsp;Tianlai Ye MS,&nbsp;Zhenhao Shi PhD,&nbsp;Lawrence H. Sweet PhD","doi":"10.1016/j.amepre.2025.108194","DOIUrl":"10.1016/j.amepre.2025.108194","url":null,"abstract":"<div><h3>Introduction</h3><div>Vaping products are the most widely used tobacco products among young adults in the U.S., driven partly by added flavors that are palatable and misperceived as safe. Vaping prevention public service announcements often use cognitive, emotional, and social appeals, yet little is known about the neurobehavioral mechanisms driving their effectiveness. This study employed functional magnetic resonance imaging to determine whether neural responses to vaping prevention public service announcements in the salience, emotional, cognitive control, and default mode networks predict subsequent vaping and whether these effects vary by message type.</div></div><div><h3>Methods</h3><div>Forty-six young adult nonsmokers who vaped ≥15 days during the past month viewed vaping prevention public service announcements during functional magnetic resonance imaging. Public service announcements were adapted from existing campaigns with cognitive, emotional, and social appeals. Subsequent vaping behavior was tracked weekly for 1 month. Data were collected between 2019 and 2022, with formal analyses conducted in 2024.</div></div><div><h3>Results</h3><div>Greater reactivity in the emotional network during public service announcement exposure predicted reduced vaping 1 month later, especially when viewing cognitive and social public service announcement. In contrast, heightened cognitive control network reactivity was linked to increased vaping, driven primarily by responses to emotional public service announcements.</div></div><div><h3>Conclusions</h3><div>Emotional network responses to cognitive and social public service announcements and cognitive control responses to emotional public service announcements may serve as useful and possibly differential neuromarkers of future vaping behavior. Specifically, public service announcements that elicit reflective emotional processing may be more effective than those relying on overt emotional intensity. These findings suggest the utility of functional magnetic resonance imaging in informing optimization of health message design in the evolving nicotine product landscape.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 5","pages":"Article 108194"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}