Nicotine and Tobacco Message Framing to Change Smoking Behavior in Diverse Groups of Young Adult Smokers

PRIMARY OBJECTIVES:

I. Assess the feasibility of delivering mobile multimedia messaging (MMS) anti-tobacco messages developed in the K99 to LGBT young adults via texting.

II. Estimate effect sizes of exposure to anti-tobacco messages on risk perceptions and tobacco use over time.

OUTLINE: Participants are randomized to 1 of 3 arms.

ARM I: Participants receive AR anti-polytobacco MMS messages 3 times a week (TIW) and a check-in text message once a week (QW) for a total of 6 weeks.

ARM II: Participants receive RR anti-polytobacco MMS messages TIW and a check-in text message QW for a total of 6 weeks.

ARM III: Participants receive control MMS messages on health risks of ultraviolet (UV)/sun exposure TIW and a check-in text message QW for a total of 6 weeks.

All participants also receive smoking cessation resources via email during follow up.

After completion of study intervention, participants are followed up at 6 and 12 weeks.

• Health Education (Behavioral): Receive control MMS messages
• Interview (Other): Ancillary studies
• Smoking Cessation Intervention (Behavioral), also known as Smoking and Tobacco Use Cessation Interventions: Receive AR MMS messages
• Smoking Cessation Intervention (Behavioral), also known as Smoking and Tobacco Use Cessation Interventions: Receive RR MMS messages
• Smoking Cessation Intervention (Behavioral), also known as Smoking and Tobacco Use Cessation Interventions: Receive smoking cessation resources
• Survey Administration (Other): Ancillary studies
• Text Message-Based Navigation Intervention (Other), also known as Automated Text Message-Based Navigation, Text Message-Based Navigation: Receive check-in text message

Primary outcomes

• Total tobacco cessation [At 12 weeks post-baseline]: 2 items. Asks for current use of nicotine vapes and combustible cigarettes Every day, Some days, or Not at all.
• Acceptability of multimedia messaging service (MMS) anti-polytobacco messages [At 6-week post-enrollment]: In a qualitative interview, Participants will be asked the following question: How did you find participating in a study with images sent via text message? How smoothly would you say it went?
• Feasibility of MMS anti-polytobacco messages [At 6-weeks post-enrollment]: 6 items per study arm. Experimental arms 1 and 2: 6 Yes/No questions (1 per week) checking for engagement with the study content, specifically regarding nicotine and tobacco use. Control Group: 6 Yes/No questions (1 per week) checking for engagement with the study content, specifically regarding sun safety.

Secondary outcomes

• Switching to exclusive electronic nicotine delivery system (ENDS) use [At 6- and 12-weeks post-baseline]: 2 items. Asks for current use of nicotine vapes and combustible cigarettes Every day, Some days, or Not at all.
• Risk perceptions [At 6- and 12-weeks post-baseline]: 3 items. 2 items on a 5 point likert scale where 1= Not at all harmful and 5= Extremely harmful. How harmful do you think nicotine vapes, e-cigarettes, or other electronic products are to health? How harmful do you think cigarettes are to health?; 1 item with 3 response options: Less harmful, About the same, More harmful. Is using nicotine vapes, e-cigarettes or other electronic nicotine products less harmful, about the same, or more harmful than smoking cigarettes?
• Behavioral intentions [Difference between conditions in behavioral intentions from screener, and at 6 and 12-week post baseline]: 2 Items. Are you seriously thinking of quitting nicotine vapes? and Are you seriously thinking of quitting cigarettes? 5 response options: Yes, within the next 30 days; Yes, within the next 6 months; Yes, within the next year; Yes, but not within the next year; No, not thinking of quitting.
• Serious quit attempts [Difference between conditions in quit attempts from screener, and at 6 and 12-week post baseline]: 2 items. During the PAST 12 MONTHS, how many times have you stopped vaping nicotine for 1 day or longer because you were trying to quit? and During the PAST 12 MONTHS, how many times have you stopped vaping nicotine for 1 day or longer because you were trying to quit? 5 response options: None; 1-2 times; 3-5 times; 6-10 times; More than 10 times

Sex: All, ages: 18 Years to 35 Years, accepts healthy volunteers

Inclusion Criteria:

* 18-35 years old
* Self-identify as LGBTQ+
* Able to speak English fluently
* An ever user of ENDS and combustible tobacco who currently use ENDS, combustible cigarettes, or both ENDS and combustible cigarettes
* Currently reside in the United States (US)
* Have a mobile phone through a U.S. carrier with MMS messaging and can send and receive text messages for study participation
* Access to the internet with Zoom capabilities

Exclusion Criteria:

* Have a landline or Voice Over Internet Protocol (VOIP) phone number

• Joanne G Patterson, Principal investigator, Ohio State University Comprehensive Cancer Center

NIH grants: R00CA260718