Translations:ENDS Youth & Young Adults/58/en

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  • The U.S. Food and Drug Administration (FDA) launched ‘The Real Cost Youth E-cigarette Prevention Campaign’ in late September 2018 as part of the Youth Tobacco Prevention Plan
  • In addition to the digital campaign ads and posters, ‘The Real Cost’ campaign launched an immersive video game experience called ‘What’s In A Vape – The Real Cost’ on a website. This game was first launched in 2018 and was located in the website, which was linked to the main FDA campaign website; as of 2020, that website domain is no longer available and the game is no longer found on any of the FDA campaign web pages. This video game was not accessible through smartphones (the venue youth use the most) and was only available via computer.
  • From the campaign ads on social media, a video game, and posters, we identified fear-based messaging as primary part of our content analysis. The fear messages of the ‘vape epidemic’ and deformed images of teens’ bodies were utilized as the main driver in digital campaign ads and a game as part of the e-cigarette prevention campaign.
  • Based on our analysis, we found no evidence of positive messaging in all three main venues of the campaign. We did not find any message of hope, support, and empowerment in the campaign ads. We also could not find any positive role model messaging to demonstrate the desired and intended behavior change.
  • The FDA campaign, ‘Real Cost Youth E-cigarette Prevention Campaign,’ aimed to educate youth about the potential risks of e-cigarettes by the repeated use of exaggerated fear appeals that target the youth audience. These sensationalized and exaggerated images and statements highlighted its fear-based campaign approach. With unrealistic and exaggerated images of teens having worm-like creatures crawling underneath their skins from vaping, the campaign ads lacked the credibility to elicit concerns of negative health effects. Fear tactics used in health promotion campaigns will likely be unsuccessful if the fear-based outcome seems to be an unlikely event.
  • These fear appeals were employed in this campaign without additional messaging to promote self-efficacy for positive behavioral changes or to motivate youth to take action against vaping. This FDA campaign may have alienated the youth audience further by not engaging with them directly and not emphasizing the logic behind why youth e-cigarette use is increasing over the years.
  • Campaigns with ineffective use of fear may produce an unwanted effect, such as making the target audience continue with their unhealthy behavior. Furthermore, exposure to these campaigns may even have boomerang effects. One study found that the frequent exposure to the campaign ads created a ‘meta-message’ among the audience that the youth drug use was prevalent and led to an increase in uses as a result.
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  • Citation: Ziming Xuan & Jasmin N. Choi (2021) Content analysis of the use of fear in the real cost youth e-cigarette prevention campaign, Journal of Communication in Healthcare, DOI: 10.1080/17538068.2020.1860671