An observational study in E-cigarette, Vaping and Tobacco, sponsored by Boston Children's Hospital. Enrolling by invitation at 1 site in United States. Open to participants aged 13 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-08-19.
Sponsored by Boston Children's Hospital · Observational
The purpose of this study is to develop an electronic cigarette (e-cigarette) counter-marketing lesson for adolescents. The lesson will involve short videos designed to improve adolescents' cognition of e-cigarette marketing in the retail environment with the overall goal of reducing their susceptibility to use, intent to use, and actual use of e-cigarettes. Through this study, the study team will identify and refine the key messages that would make this lesson acceptable, feasible to implement, and effective in altering e-cigarette-related perceptions and potentially behaviors.
This research comprises of 2 qualitative activities:
These activities will occur sequentially over about 6 months. At the 6-month time point, the study team will have met the study's primary aim of having developed the e-cigarette counter-marketing lesson.
The study population will include individuals residing in the U.S. There will be 10 members of the expert working group (2 middle, 2 high school students, 2 young adults, 1 educator, 1 parent, and 4 curriculum design experts). There will be 36 adolescent and young adult participants of the focus groups.
WORKING GROUP MEMBERS
*Inclusion criteria
Youth participants:
Curriculum design experts:
Parent:
Educator:
Fluent in English
*Exclusion criteria
FOCUS GROUP PARTICIPANTS
*Inclusion criteria
10 members of the expert working group: 2 middle school students, 2 high school students, 2 young adults, 1 educator, 1 parent, and 4 curriculum design expert
Other: Working group
36 adolescent/young adult participants
Other: Focus group
Participants will: 1) take a 10-min demographic survey; 2) join 3 x 60-min working group meetings in which they will review preliminary results, collaborate on curriculum design, and provide feedback; and 3) respond to prompts in 3 emails (approx 5-10 mins each).
Participants will take a 10-min demographic survey and join 1 x 30-min focus group meeting in which they will provide feedback on the curriculum in development.
Development of an e-cigarette counter-marketing lesson focused on the retail environment
Key messages and message-delivery strategy will be developed, potentially comprising of short-form videos. The study team will ask working group members to rank draft messages and strategies for delivery in addition to eliciting qualitative information.
Time frame: At 6 months
Feasibility: Preferred recruitment advertisement
Self-reported data and/or qualitative data elicited from participants by prompting: Which Instagram advertisement made you interested to join this study?
Time frame: Baseline (pre-focus group)
Acceptability: Relevance to population(s)
Qualitative data elicited from participants by prompting: How participants feel about relevance to and representation of age group and e-cigarette use status (e.g., "this message is not for me since I don't vape" or "I would not be interested," helpfulness of content to achieve different tobacco prevention goals such as raising awareness, prevention)
Time frame: During baseline focus group
Acceptability: Desired improvements
Qualitative data elicited from participants by prompting: How would you improve the messages? What changes would you make?
Time frame: During baseline focus group
Perceived influence of content: Awareness
Qualitative data elicited from participants by prompting: How helpful was it to include \[key message in development\] to raise awareness about e-cigarettes and e-cigarette marketing?
Time frame: During baseline focus group
Perceived influence of content: Reducing appeal
Qualitative data elicited from participants by prompting: How helpful was it to include \[key message in development\] to prevent adolescents from liking e-cigarette products?
Time frame: During baseline focus group
Perceived influence of content: Purchase behaviors
Qualitative data elicited from participants by prompting: How helpful was it to include \[key message in development\] to prevent/reduce e-cigarette purchase?
Time frame: During baseline focus group
Perceived influence of content: Use prevention
Qualitative data elicited from participants by prompting: How helpful was it to include \[key message in development\] to prevent/reduce adolescent e-cigarette use?
Time frame: During baseline focus group
Feasibility: Device used to access lessons
Qualitative data elicited from participants by prompting: Device most commonly used to access similar online/video content
Time frame: During baseline focus group
Feasibility: Duration of engagement with components
Average time in minutes to engage with draft messages, and study activities
Time frame: During baseline focus group
E-cigarette use
A survey will ask participants, "Have you ever tried any of the following products, even one or two puffs?" (Yes/No). If "Yes," participants will see the question, "During the past 30 days, did you use any of the following products, even one or two puffs? (Yes/No)." If "Yes," participants will see the question, "On how many days out of the past 30 days, did you use a…" with a numeric response from 0-30 (drop-down option where participants could select only one response). If participants provided an answer from 1-30 to this question, the survey will ask, "In the past 7 days, on how many days did you use an e-cigarette or vape?" with a numeric response from 0-7 (drop-down option where participants could select only one response). (Products include:nicotine vape, THC (marijuana) vape, some kind of vape (don't know what was in it), cigarette, and nicotine pouch).
Time frame: Baseline (pre-focus group)
Susceptibility to Use E-cigarettes
A survey will ask participants 4 questions adapted from the Enhanced susceptibility to smoking index, (1) "Have you ever been curious about e-cigarettes/vapes?; (2) "Do you think you will try an e-cigarette/vape in the next month?;" (3) Do you think you will try an e-cigarette/vape in the next year?; and (4) "If one of your best friends were to offer you an e-cigarette/vape, would you try it?" with responses on a 4-point Likert-type scale (Definitely yes; Probably yes; Probably not; and Definitely not). Across all 4 questions, any participant response except "Definitely not" will be classified as susceptible to using e-cigarettes.
Time frame: Baseline (pre-Focus Groups)
Acceptability: Perceptions of anti-vaping educational content or counter-marketing
The facilitator will ask participants about perceptions of anti-vaping ads, specifically inside and around retail stores
Time frame: During focus groups
Marketing receptivity inside and around retail stores
A survey and the focus group facilitator will ask about perceptions of e-cigarette brand recall among adolescents, appealing locations of advertising, ownership of merchandise, and receipt of free samples
Time frame: At Baseline (pre-Focus groups) and During Baseline Focus Groups
Feedback on counter-marketing messages
The facilitator will ask participants: 1) Could you describe what was interesting or engaging? Probes: How would you improve what you just saw? What changes would you make? Comments on: a) individualized delivery; b) influencer-style; c) message? 2) Are there parts you would recommend excluding? Why? 3) How relevant was it to you? To people your age? 4) Was the language used easy to understand? 5) How does this messaging compare to what you have already seen? 6) How helpful was it to include the messages on marketing? a) raise awareness; b) prevent adolescents from liking products; c) prevent/ reduce e-cigarette purchase (in stores); d) prevent/ reduce e-cigarette purchase or sharing (with friends/family); and prevent/ reduce e-cigarette use? 7) If you were trying to prevent someone from starting to vape, what could be effective: a) aspects about vaping that you could bring up?; b) language that you could use?; c) images that you could use?; d) appeals that you could use?
Time frame: During baseline focus groups
Plan to share: Yes — De-identified participant survey data will be made available.
Supporting information: Study protocol, Sap
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