Design and baseline evaluation of a social media vaping prevention trial (Preprint)
Authors: Evans William Douglas , Ichimiya Megumi , Bingenheimer Jeffrey B , Cantrell Jennifer , D'Esterre Alexander P , Pincus Olivia , Yu Linda , Hair Elizabeth 
Published: February 2025

UNSTRUCTURED

Introduction. Electronic Cigarette (e-cigarette) use is a major public health problem and young adults age 18-24 are at high risk. In addition to e-cigarettes, oral nicotine products (ONP) are growing in popularity in this population. Poly-use is widespread. New methodologies for rigorous online studies using social media have been conducted and shown to reduce nicotine use. This study reports on the design and baseline evaluation of a large-scale social media based randomized controlled trial to evaluate the effects of anti-vaping social media on young adult vaping and determinants of use.
Methods. Using the Virtual Lab social media platform, participants were recruited into the study using an artificial intelligence (AI) chatbot and social media advertising, completed a baseline survey, and were then randomized to 1 of the 4 study arms. The design was to achieve specific numbers of impressions per arm over three survey time points. We recruited N=8,437 participants in total, stratified by vaper (5,026) and non-vaper status (3,321). Questionnaire data were collected using the Qualtrics survey platform. Future analyses will examine the effects of social media content on vaping at endline. Current data analysis presented here describes the two cohort samples; examines balance across the four study arms on baseline variables in each of the cohorts; and evaluates the internal consistency of several multi-indicator measures of psychosocial constructs.
Results. Among vapers, almost three-quarters were current vapers, over 40% were current smokers (use in the past 30 days), and over 48% were current poly-users (using e-cigarettes and one or more other tobacco products). Substantial numbers of current vapers also currently used some other product, including cigars (30.2%), hookah (15.8%), smokeless (9.2%), and oral nicotine products (11.5%). The average age of participants was 21.2 years. Just under 45% of participants were non-Hispanic white (44.7%), just under 47% (46.9%) of the sample was male, over 44% (44.4%) reported completing high school, and 79.3% reported meeting basic needs or better. There were no significance differences between arms/strata by any of these demographics. We also calculated scale scores for depression and co-variates related to nicotine use and found high alphas. Finally, we found that participants who reported having seen anti-tobacco brand advertising were more likely to higher levels of these variables/scales than participants who reported not having seen the advertising. These results will be examined in future studies.

Discussion. Social media can be used as a platform at scale for longitudinal RCTs over extended periods of time, which extends previous research on short-term trials. Interventions delivered by social media can be used with large samples to evaluate social media health behavior change interventions. Future studies based on this research will evaluate intervention effects of social media exposure on vaping behavior and determinants.