Middle School Students Provide Insight on Using Television Clips for Vaping Education
BY Beth L. Hoffman
Over the last five years adolescent use of e-cigarettes, also known as vaping, has risen rapidly. The 2022 National Youth Tobacco Survey found that 2.5 million high school and 380,000 middle school students in the United States currently vape. This is concerning because vaping in young people is associated with several harms. For example, vaping in adolescence is associated with nicotine addiction and starting to smoke combustible cigarettes later in life. There is also the risk of acute illness, such as e-cigarette, or vaping, product-use associated lung injury (EVALI), a disease that first garnered public attention in summer of 2019. By February 2020, more than 2,700 cases requiring hospitalization of EVALI had been reported to the Centers for Disease Control and Prevention (CDC), with over 75% of these patients under 35. In mid-January 2020, the CDC reported a link between vaping THC containing devices and EVALI, but noted that 14% of cases were in patients who exclusively used nicotine containing products.
As can be expected from a disease that garners a lot of media attention, primetime medical dramas took note, and at the end of January 2020 New Amsterdam, Chicago Med, and Grey’s Anatomy all aired episodes that featured an adolescent patient with EVALI. Our previous research found that some viewers discussed on Twitter plans to quit vaping as a result of watching the episodes, which led us to think that clips from these storylines could be useful for adolescent vaping education. But, we weren’t sure what young people would think about this. Would they find the storylines engaging or overly dramatic? Would the storylines spark discussion about the harms of vaping? To answer these questions, we conducted focus groups with 7th and 8th graders.
During the focus groups our participants watched clips from all three storylines, and we talked about each clip separately before getting their overall thoughts about using the clips for vaping education. We had 78 participants total, and about half were Black and half were Female. None of the students who participated in the focus groups had knowledge of EVALI before watching the clips. Interestingly, while almost all knew about vaping, many did not realize that e-cigarette is another word for vaping. This was surprising and affirmed the importance of including young people in intervention design to make sure health educators are using the same terminology as they are.
Focus group participants were really engaged while watching the clips, with many audibly gasping or leaning in to watch more closely. We found that viewing the clips taught participants about EVALI and reinforced perceptions that vaping can be harmful. We also found that the clips generated a lot of unprompted discussion and questions for the adult focus group facilitators about targeted advertisements on social media, flavored vaping products, and marijuana and other substances.
Participants noted that viewing the clips was more interesting than having a lecture or presentation, with one student commenting that having the information presented through television clips was “a little less annoying” than a traditional presentation. Several participants noted that the visual aspect, particularly seeing a character throwing up blood in one of the clips, really helped to emphasize the harms of vaping. Participants also mentioned that the clips would be best as part of a prevention program (as opposed to cessation), meaning that it would be best for middle school students.
Overall, results from this study suggest that these clips could be a useful jumping off point for engaging middle school students in discussions about vaping. The discussion that emerged around tobacco advertising also suggests that these clips could be used as part of media literacy education, or teaching young people about how to critically examine the messages they see in the media and in advertisements. In the future, we hope to build from this study to make sure adolescent voices are being heard when conducting research around vaping or other substance use. We also hope to explore the use of clips from popular television programs to generate discussion with adolescents around other timely health topics.
Article Details
Better Than Any DARE Program”: Qualitative Analysis of Adolescent Reactions to EVALI Television Storylines
Beth L. Hoffman, PhD, MPH, Jaime E. Sidani, PhD, MPH, CHES, Elizabeth Miller, MD, PhD, Jennifer A. Manganello, PhD, MPH, Kar-Hai Chu, PhD, MS, Elizabeth M. Felter, DrPH, MCHES and Jessica G. Burke, PhD
First Published: June 13th, 2023
DOI: 10.1177/15248399231177049
Health Promotion Practice
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