Nicotine and Tobacco Message Framing Among LGBT Young Adults

The Effect of Nicotine and Tobacco Message Framing on Use Among Diverse Groups of Young Adults

This trial refines and evaluates how cultural targeting influences the effectiveness of anti-tobacco messages among lesbian, gay, bisexual, and transgender (LGBT) young adults at risk for the use of more than one tobacco product (polytobacco use). Polytobacco use is associated with nicotine dependence and tobacco use into adulthood, and is disproportionately high among LGBT young adults. This trial seeks to determine how cultural targeting can be applied to communicate polytobacco use risk to at-risk LGBT young adults.

Study Overview

• Status: Completed
• Conditions: Tobacco-Related Carcinoma
• Intervention / Treatment: Behavioral: Health communications

Detailed Description

The goal of this study is to identify if culturally targeted (CT) or non-targeted (NT) anti-polytobacco messages are most effective for engaging LGBT consumers. Using the most effective NT messages from Aim 1, investigators will create a set of CT messages. Message framing will remain consistent between CT and NT messages; however, CT messages will include language and graphics representing LGBT values formative research and the existing peer-reviewed literature. Participants will be randomized to view CT or NT messages in a virtual lab where investigators will assess eye-tracking, self-reported perceived effectiveness, risk perceptions, and behavioral intentions. Participants will also complete a 1-week follow-up. The study aims to determine the effects of cultural targeting on attention to anti-polytobacco messages and perceived effectiveness among LGBT young adults susceptible to polytobacco use.

• Study Type: Interventional
• Enrollment (Actual): 252
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Columbus, Ohio, United States, 43210
      • The Ohio State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Speaks English fluently
• Self-identifies as lesbian, gay, bisexual, transgender, queer, or another non- heterosexual orientation or non-binary gender identity
• Ever used e-cigarettes AND combustible cigarettes
• Currently uses e-cigarettes, combustible cigarettes, or both e-cigarettes and combustible cigarettes
• Resides in the United States
• Access to a laptop or desktop computer with a camera for virtual eye-tracking

Exclusion Criteria:

• Glaucoma
• Cataracts

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Culturally targeted messages; Participants will view 8 nicotine and tobacco health messages with LGBT culturally targeted messages and imagery	Behavioral: Health communications; Participants will view eight culturally targeted or non-targeted health communications about the health risks of nicotine and tobacco use.
Other: Non-targeted messages; Participants will view 8 nicotine and tobacco health messages with universal messages and imagery	Behavioral: Health communications; Participants will view eight culturally targeted or non-targeted health communications about the health risks of nicotine and tobacco use.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Attention - Dwell Time	Visual attention measured by dwell time (milliseconds) on areas of interest (AOI; e.g., text, graphic) within a stimuli was assessed via eye-tracking for each message (n=8). Dwell times on AOIs were summed for all stimuli viewed by each participant and averaged. Scores represent total average dwell time on AOIs across stimuli.	During intervention on Day 1, on average 3 minutes
Visual Attention - Time to First Fixation	Time (milliseconds) to first fixation on areas of interest (text, graphic) within a stimuli was assessed via eye-tracking for each message (n=8). Time to first fixation on a specific AOI was summed for all stimuli viewed by each participant and averaged. Scores represent total average time to first fixation on AOIs across stimuli.	During intervention on Day 1, on average 3 minutes.
Perceived Message Effectiveness - Message Perceptions	6-items on a 5-point scale where 1 = Not at all and 5 = Very much. Please rate each statement from 1 (not at all) to 5 (very much). These message are worth remembering. These messages grabbed my attention. These messages are powerful. These messages are convincing. These messages are meaningful. These messages are informative. Individual items are summed and averaged for a total score ranging from 1 to 5. Higher scores indicate a better outcome.	Immediately post-exposure to intervention
Perceived Message Effectiveness - Effects Perceptions	6-items. 5-point scale where 1 = Strongly disagree to 5 = Strongly agree These messages discourage me from smoking cigarettes. These messages make me concerned about the negative effects of smoking cigarettes These messages make smoking cigarettes seem unpleasant to me. 3-items above are summed and averaged. Higher scores indicate better outcome. These messages discourage me from vaping nicotine. These messages make me concerned about the negative effects of vaping nicotine. These messages make vaping nicotine seem unpleasant to me. 3-items above are summed and averaged for a total score ranging from 1 to 5. Higher scores indicate a better outcome.	Immediately post-exposure to intervention
Change in Behavioral Intentions	8 items total. 4-point scale 1 = Definitely not to 4 = Definitely will. The following items were asked at baseline and post-exposure. How likely is it that in the next 3 months, you will refrain from vaping nicotine....; completely and permanently?; when you get lonely?; when you are with your friends who use them?; when someone hands you a vape? How likely is it that in the next 3 months, you will refrain from smoking cigarettes...; completely and permanently?; when you get lonely?; when you are with your friends who use them?; when someone hands you a cigarette? For each subscale, pre-test and post-test items were summed and averaged. Change scores were calculated for each subscale by subtracting pre-test scores from post-test scores. Change scores could range from 0 to 3. Higher change scores indicate a better outcome (i.e. greater change in intentions to refrain from smoking or vaping)	Change from Baseline in behavioral intentions immediately post-exposure to intervention
Behavioral Intentions: Quitting Smoking	Number of participants who answer "Yes" to the following: Do you plan to quit smoking cigarettes in the next 30 days? (Yes/No)	Difference between conditions in behavioral intentions to quit smoking at 1-week follow-up after intervention exposure
Behavioral Intentions to Quit Vaping	Number of participants who answer "Yes" to the following: "Do you plan to quit vaping nicotine in the next 30 days?" (Yes/No)	Difference between conditions in behavioral intentions to quit vaping at 1-week follow-up after intervention exposure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Liking	Single item; 5-point Likert scale where 1 = Strongly disagree and 5 = Strongly agree I like these messages.	Immediately post-exposure to intervention
Reactance	3-items; 5-point Likert scale where 1 = Strongly disagree and 5 = Strongly agree These messages are trying to manipulate me. These messages annoy me. The health effects of these messages are overblown. Items are summed and averaged for a total score ranging from 1 to 5. Higher scores indicate a worse outcome.	Immediately post-exposure to intervention
Ad Relevance	5 items; 7-point Likert scale where 1 = Strongly Disagree and 7 = Strongly agree These ads were created just for me. These ads were created for people like me. These ads were relevant to me. These ads were of value to me. These ads were important to me. Items were summed and averaged for a total score ranging from 1 to 7. Higher scores indicate a better outcome.	Immediately post-exposure to intervention
Attitudes	Two items; 7-point Likert scale where 1 = These message made me feel much worse and 7 = These message made me feel much better. Did these messages change how you feel about smoking combustible cigarettes? Did these messages change how you feel about vaping nicotine? Higher scores mean a worse outcome.	Immediately post-exposure to intervention
Response Efficacy	6-items; 5 point Likert scale where 1 = Strongly disagree and 5 = Strongly agree These messages will motivate CIGARETTE SMOKERS to switch to vaping. These messages will motivate people to quit ALL smoking and vaping. These messages will motivate NON-USERS to start vaping. These messages will motivate NON-USERS to start smoking cigarettes. These messages will motivate CIGARETTE SMOKERS to quit. These messages will motivate VAPERS to quit. Higher scores mean a better outcome.	Immediately post-exposure to intervention
Qualitative Recall of Health Messages	Participants will be asked the following question: "The images that you viewed included health messages. What do you remember about the health messages?" Outcome indicates then number of participants who qualitatively reported recalling something about the health message.	1-week follow-up after intervention exposure

Collaborators and Investigators

• Sponsor: Ohio State University Comprehensive Cancer Center
• Collaborators: National Cancer Institute (NCI); National Institutes of Health (NIH)
• Investigators: Principal Investigator: Joanne G Patterson, PhD, The Ohio State University College of Public Health

Publications and helpful links

Helpful Links

• The Jamesline

Study record dates

Study Major Dates

• Study Start (Actual): June 19, 2023
• Primary Completion (Actual): January 29, 2024
• Study Completion (Actual): February 6, 2024

Study Registration Dates

• First Submitted: June 26, 2023
• First Submitted That Met QC Criteria: July 25, 2023
• First Posted (Actual): August 2, 2023

Study Record Updates

• Last Update Posted (Actual): June 18, 2025
• Last Update Submitted That Met QC Criteria: June 16, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: LGBT; health communication
• Other Study ID Numbers: OSU-23020; 4R00CA260718-02 (U.S. NIH Grant/Contract); NCI-2024-05891 (Other Identifier: NCI)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No