Background: Teen use of electronic nicotine delivery systems (ENDS) is on the rise, along with the exchange of ENDS-related information through social media channels. Given today’s highly connected environment, understanding how social factors influence risk is important. This study explored social media use and youth sociability, as measured through the Social Prioritization Index (SPI), as potential predictors of teen ENDS use.

Methods: Data were collected from an online convenience sample of 13-19 year-olds (N=1,594). Participants reported past 30-day ENDS use and past 7-day use of various social media platforms. Participants also completed the SPI, which measured how much youth prioritize their social lives.

Results: The regression of recent social media platform use on ENDS use, while controlling for demographics, was significant for Instagram (AOR 1.91 [95% CI: 1.21 - 3.01]) and Snapchat (AOR 2.64 [95% CI: 1.68 - 4.16]), but was not significant for Facebook, Twitter, Tumblr, or Pinterest. The impact of recent Instagram and Snapchat use on current ENDS use was partially mediated through sociability, as measured by the SPI (z = 5.26, p < .001).

Conclusion: Use of Instagram and Snapchat may directly influence ENDS use. These platforms may also shape how teens prioritize their social identities, possibly increasing the salience of social cues that drive ENDS use. Future interventions should explore platform-specific approaches and consider ways to leverage the social characteristics and cultural influences shared by high-risk teens to deliver targeted messaging.

Social media connections can be valued and trusted relationships among individuals, businesses, brands and their followers. Therefore, the perception of what important social media influencers think about a certain behavior may be useful to impacting behavior change with these groups. Using the FDA’s tobacco public education campaigns Fresh Empire, This Free Life and The Real Cost Smokeless as case studies, this presentation discusses the use of lower cost, niche micro-influencers to promote a tobacco-free lifestyle among at-risk populations and will share learnings on how this model can be replicated by other campaigns.

Micro-influencers are influencers with a modest number of followers on social networks. They may not have an expansive following, but they do have great influence over targeted, engaged followers. The campaign worked with micro-influencers to weave tobacco-free messages into their social media posts in a highly authentic manner to increase the salience and impact of messaging. The campaigns found the use of micro-influencers to be successful as they offered a combination of credibility, higher engagement, and affordability compared to working with celebrities or mega-influencers. The emotionally driven content resonated with audiences and provided opportunities for deeper conversation while authentically reinforcing the campaign’s message, evident by the high number of engagements and quality feedback received from the audience. This content, when re-used for the campaigns’ social channels, resulted in an 8% increase in engagement rate. These findings demonstrate the potential value in selecting authentic micro-influencers that can reach niche audiences to reinforce campaign messaging and increase engagement.

Gaining the trust and interest of a target audience can increase the potential impact of a public health message, but it can be a challenge for public health campaigns, particularly when the target audience is a vulnerable or hard-to-reach population. This session will (1) discuss the messaging strategy of Fresh Empire and This Free Life, tobacco public education campaigns designed to prevent and reduce tobacco use among multicultural teens who identify with the Hip Hop peer crowd and LGBT young adults who use tobacco occasionally, respectively, (2) share results of social media content performance analyses that compare the campaign lifestyle messages with their tobacco prevention-focused messages, and (3) describe the implementation strategies for increasing tobacco messaging and their early results.

To help establish trust and credibility with their target audiences, Fresh Empire and This Free Life employ a lifestyle brand strategy to deliver a mixture of lifestyle content and tobacco prevention messages. Initially lifestyle content often performed better on social media than tobacco messaging; however, this evolved as the campaigns became more established and their credibility deepened among the intended target audiences. By performing analyses such as A/B testing on their social media channels, the campaigns saw that the gap in performance between lifestyle content and tobacco messages had closed and were performing similarly over time. As a result, tobacco messaging was increased and early results have supported the change, suggesting both campaigns have built credibility with their respective target audiences and they are embracing the tobacco prevention messages.

Background: As adolescent cigarette use declines, practitioners must understand who remains at-risk, and how to reach them, to reduce tobacco use disparities. This abstract describes an evaluation of Syke, a counter-marketing campaign to reduce cigarette use among Virginia teens who identify with the Alternative peer crowd, a macro-level subculture with shared values and norms found to be at increased risk for smoking cigarettes.

Methods: Syke used a Social Branding approach to social marketing, leveraging tailored and targeted ads, events, and influencers to connect living tobacco-free with Alternative teen values. To evaluate the campaign, cross-sectional surveys were conducted annually over four years to measure campaign exposure, campaign engagement, and smoking behavior. Frequencies and logistic regressions explored smoking and the role of brand awareness and engagement in behavior amongst Alternative and non-Alternative teens over time.

Results: Among Alternative teens, brand awareness increased 20% from Year 1 to Year 4, reaching 47.3%. From Year 1 to 4, the smoking rate among Alternative teens who engaged with the brand decreased by 27.4%, compared to 16.2% among non-Alternative teens. Regressions identified a decrease in odds of past 30-day cigarette smoking among Alternative teens from Year 1 to 4 (OR=0.63, p=.01), while no significant difference was observed for non-Alternative teens.

Conclusions: Results suggest the Syke campaign reached the intended audience, and reduced smoking rates among Virginia Alternative teens. Success of Syke’s tailored approach provides insight not only for addressing cigarette use, but also emerging concerns such as adolescent e-cigarette use.

Background: Tobacco warning labels are intended to communicate health risk information to current tobacco users on products and their advertisements. Current mandatory warnings use loss-framing to highlight negative consequences. Although women smoking at lower prevalence than men, they experience equal if not more difficulty sustaining cessation. Positive or gain-framed warning may be more effective to reach female smokers, especially during a stigmatized behavior of smoking during pregnancy. Currently mandated cigarette warnings include a single message focused on pregnancy, using a loss-framework. Examination of tobacco warning framing focused on women is warranted.

Methods: In a clinic-based convenience sample, female current smokers of reproductive age (18-44 years old) were recruited to complete a brief self-administered survey on health warnings. Participants were asked to rate 5 gain- and 5 loss-framed warning messages as text-only statements, such as “Start Living. Stop Smoking” versus “Stop hurting yourself. Stop smoking.” Participants self-reported ratings for every warning on 7 attributes of perceived effectiveness (e.g., believability, relevance) using a 10-point Likert-type scale. Mean perceived effectiveness scores were calculated across each message and aggregated by gain- and loss-framing.

Results: Preliminary data show that gain-framed messages rated higher on perceived effectiveness compared to loss-framed warning (Mean ratings 7.6 and 7.2, respectively).

Conclusions: Gain-framed health messages about smoking were deemed to be more effective than loss-framed messages among adult female smokers. Tailored communications to women of reproductive age may be a promising strategy to help promote sustained smoking cessation.