Effective features of e-cigarette prevention videos: A qualitative study with primary school students.

Introduction: While video-based prevention campaigns show promise in addressing the rising e-cigarette use among youth, little is known about what makes such videos effective from children's perspectives, particularly in China's cultural context. This study aimed to investigate which video content elements could be effective in preventing e-cigarette use among children, providing evidence-based guidance for developing e-cigarette prevention materials and information design targeting children.

Methods: Using purposive sampling, we conducted four gender-stratified focus groups with 35 primary school students (aged 12-13 years) in Beijing and Yunnan. Participants watched four stimulus videos with different messaging approaches and discussed their perceptions of effective and ineffective features. Focus group discussions were audio-recorded, transcribed, and analyzed using thematic analysis with NVivo software.

Results: Children identified several key features that enhanced prevention effectiveness -most prominently, explicit specific health consequences and testimonials were mentioned by a majority of participants - along with chemical component, maternal love, and emotional appeals (particularly fear). Visual elements like dynamic animations and medical expert appearances strengthened message credibility. Ineffective features included overly complex explanations, perceived inauthenticity, and news-style reporting. Notably, while some participants reported discomfort with fear-based appeals, they demonstrated high recall of these message elements.

Conclusions: This study provides novel insights into developing appropriate e-cigarette prevention videos for children. Findings suggest that effective videos should combine authentic testimonials with clear health risk information, appropriate fear appeals, and engaging visual elements while avoiding overly complex or news-style presentations. These insights can guide the development of more effective youth-focused e-cigarette prevention communication strategies.