E-cigarette Social Media Marketing and Its Perceptions by Youth

Evolution of Influencer-driven E-cigarette Marketing on Social Media and Its Effect on E-cigarette Perceptions and Use Patterns Among Adolescents

The proposed study will conduct two randomized between-subject experiments among 6,000 adolescents (per each experiment) recruited nationwide to test the effects of audio-visual features of e-cigarette influencer marketing on perceptions of influencer credibility, e-cigarette harm perceptions, appeal, and susceptibility to e-cigarette use. This protocol represent the first experiment.

Study Overview

• Status: Not yet recruiting
• Conditions: Vaping
• Intervention / Treatment: Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing

Detailed Description

We will estimate the effects of visual features often used in e-cigarette influencer marketing on social media on perceptions of influencer credibility, harm perceptions, appeal and susceptibility to e-cigarette use among adolescents. We will assess interaction of the perceived age of influencers (young-looking vs older-looking) with the following features of influencer marketing, using two survey-based experiments: Experiment 1 will assess the effects of theme or social context appeal, i.e., use of generally positively perceived lifestyle contexts (e.g., healthy lifestyle, entertainment) alongside e-cigarette marketing.

• Study Type: Interventional
• Enrollment (Estimated): 6000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jennifer B Unger, PI, PhD; Phone Number: (323) 442-7200; Email: unger@usc.edu
• Study Contact Backup: Name: Julia Vassey, PhD; Phone Number: (323) 442-7200; Email: vassey@usc.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 14-17 years of age,
• English fluency,

Exclusion Criteria:

Not meeting the following criteria:

• 14-17 years of age,
• English fluency,

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

12

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental: Videos featuring young influencers promoting e-cigarettes alongside fitness	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring young influencers promoting e-cigarettes alongside entertainment	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring young influencers promoting e-cigarettes alongside fashion	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring young influencers promoting e-cigarettes alongside avatar	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring older influencers promoting e-cigarettes alongside fitness	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring older influencers promoting e-cigarettes alongside fashion	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring older influencers promoting e-cigarettes alongside avatar	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring young influencers promoting e-cigarettes alone	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Active Comparator: Experimental: Videos featuring older influencers promoting e-cigarettes alone	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Placebo Comparator: Experimental: Videos featuring two neutral profiles of older influencers	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Placebo Comparator: Experimental: Videos featuring two neutral profiles of younger influencers	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Experimental: Videos featuring older influencers promoting e-cigarettes alongside entertainment	Other: Youth Perceptions of Influencer Age and Various Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Harm Perceptions of e-cigarettes	Responses to one question adapted from PATH, "Based on the videos you just watched, do you think using e-cigarettes for vaping nicotine is harmful to your health?" The outcome was assessed on the 5-point ordinal scale with the following response choices: Not at all harmful, slightly harmful, somewhat harmful, very harmful, extremely harmful.	Assessed 10 times immediately after each of the 10 videos during the 15-minute-long survey-based experiment
Perceived appeal of e-cigarettes	Responses to the following questions: using e-cigarette is: not cool/cool, unattractive/attractive were assessed on the 7-point semantic differential scale with the word pairs anchored at each end. The scale was adapted from prior research. The items were combined (by summing all the non-missing values of the items) into one variable (α=0.94).	Assessed 10 times immediately after each of the 10 videos during the 15-minute-long survey-based experiment
Susceptibility to e-cigarette use	Susceptibility to e-cigarette use was measured (among never-users of e-cigarettes), using the validated three-item scale (indicating peer influence, intention, and curiosity about e-cigarette use) adapted from PATH, and combined into one variable (α=0.93). Consistent with prior research, the measure was dichotomized with responses "definitely not" to all items being coded as "not susceptible" and responses "probably not," "probably yes", or "definitely yes" being coded as "susceptible.	Assessed 10 times immediately after each of the 10 videos during the 15-minute-long survey-based experiment
Perceived influencer credibility	Perceived influencer credibility (i.e., honesty, trustworthiness, knowledge) were assessed using a 0 (e.g., dishonest) -100 (e.g., honest) scale that has been validated in prior research.	Assessed 10 times immediately after each of the 10 videos during the 15-minute-long survey-based experiment

Collaborators and Investigators

• Sponsor: University of Southern California
• Collaborators: National Institutes of Health (NIH)
• Investigators: Principal Investigator: Jennifer B Unger, PhD, University of Southern California

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2027
• Primary Completion (Estimated): December 30, 2028
• Study Completion (Estimated): December 30, 2030

Study Registration Dates

• First Submitted: July 3, 2026
• First Submitted That Met QC Criteria: July 3, 2026
• First Posted (Actual): July 10, 2026

Study Record Updates

• Last Update Posted (Actual): July 10, 2026
• Last Update Submitted That Met QC Criteria: July 3, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Smoking; Vaping
• Other Study ID Numbers: 1R01CA300653-01A1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: survey is anonymous. Data will be publicly available on GitHub repository if manuscripts related to this study are accepted for publication

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No