Comparing belief in short-term versus long-term consequences of smoking and vaping as predictors of non-use in a 3-year nationally representative survey study of US youth.

INTRODUCTION: Efforts to prevent youth tobacco use are critical to reducing smoking-related deaths in the USA. Anti-tobacco messaging often focuses on the severe long-term consequences of smoking (eg, fatal lung disease, cancer). It is unclear whether these long-term consequences are more likely to deter youth use than shorter term consequences (eg, headaches, friend disapproval). METHODS: A nationally representative 3-year rolling survey of adolescents and young adults (ages 13-26 years) measured belief in potential consequences of two types of tobacco products: combustible cigarettes (n=11 847) and electronic cigarettes (n=4470) as well as intentions and current use. Independent coders classified 23 consequences as either short or long term. Logistic regression tested the associations between short-term (vs long-term) beliefs and current intentions, as well as non-smoking behaviour at 6-month follow-up. RESULTS: Believing in both short-term and long-term consequences was associated with outcomes, but short-term beliefs were more highly associated with anti-smoking (OR=1.40, 95% CI (1.30 to 1.51)) and anti-vaping (OR=2.10, 95% CI (1.75 to 2.52)) intentions and better predicted non-smoking behaviour at follow-up, controlling for prior use (OR=1.75, 95% CI (1.33 to 2.31)). CONCLUSIONS: These results support temporal discounting by adolescents and young adults and suggest health communication efforts aiming to reduce youth tobacco use should emphasise shorter term consequences.

The doctor knows or the evidence shows: An online survey experiment testing the effects of source trust, pro-vaccine evidence, and dual-processing in expert messages recommending child COVID-19 vaccination to parents.

Increasing child vaccination rates is a critical step toward mitigating the spread of COVID-19. Both distrust in expert sources and concern about the safety and efficacy of vaccines may contribute to parent vaccine hesitancy. The present study is the first to test the effectiveness of building trust and providing evidence supporting child COVID-19 vaccines in recommendation messages for parents. Based on dual-processing theories, emphasis on source trustworthiness and pro-vaccine evidence may each be particularly effective when the other is not present. It was hypothesized that these two approaches would have main and interaction effects on perceived message effectiveness and pro-vaccine beliefs. A between-subjects 2 (trust-building appeal vs. no trust-building appeal) X 2 (pro-vaccine evidence vs. no pro-vaccine evidence) online survey experiment was conducted in December 2021 and January 2022 with United States parents/guardians of children <18 years old (n = 401). As hypothesized, trust and pro-vaccine evidence each had significant simple main effects on both outcomes. Analysis of variance showed a significant negative interaction effect of trust and pro-vaccine evidence on perceived message effectiveness [F(3, 394) = 6.47; η2 = 0.02, p = 0.002; 95% CI (0.01, 0.11)], supporting the dual-processing hypothesis. The interaction effect on pro-vaccine beliefs was also negative but not significant [F(3, 394) = 2.69; η2 = 0.01; p = 0.102; 95% CI (0.00, 0.03)]. Either highlighting evidence supporting vaccines or building trust in expert sources can influence parent vaccine support. Messages which include strong evidence supporting recommended behaviors may influence recommendation acceptance even among those with lower trust in expert sources and establishing trust may reduce the need to describe available evidence.