Co-producing an advocacy video on e-cigarette advertising with adolescents in Scotland: a multi-stage qualitative study

• Published in: The Lancet (British edition) 2024-11, Vol.404, p.S15-S15
• Main Authors: Smith, Marissa J, Vaczy, Caroline, Hilton, Shona
• Format: Article
• Language: English
• Subjects: Adolescents; Advertisements; Advertising; Cigarette smoking; Cigarettes; Drug addiction; Electronic cigarettes; Exposure; Flavors; Focus groups; Legislation; Liquor; Marketing; Occupational exposure; Qualitative analysis; Qualitative research; Teenagers; Workshops
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(24)01970-6

Researchers, advocacy workers, and adolescents have raised concerns about the uptake of e-cigarettes (‘vapes’) among adolescents. Currently, vaping is not part of NHS Scotland's smoking cessation resources. This study investigated adolescents’ exposure to and perceptions of e-cigarette advertising to co-produce an advocacy video. This focus on e-cigarette marketing and adolescents is timely as policymakers in the UK are actively shaping new regulations in response to these concerns, such as banning disposable e-cigarettes. Between March and September, 2023, a four-phase project was conducted with adolescents aged 11–16 years from the central belt of Scotland. The phases included 1) three workshops with 33 adolescents (10–12 per workshop) about their experiences with e-cigarette marketing; 2) photographs from 28 adolescents depicting examples of marketing in their local areas and online; 3) six focus groups (a total of 28 adolescents, 2–6 per group) to discuss the photographs and 4) co-production of an advocacy video with a video production company, including one additional workshop with six adolescents. Workshops were not recorded; however, researchers took field notes, and the materials produced were kept for analysis. Focus group transcripts were thematically analysed. This study explored adolescents’ exposure to and views on e-cigarette advertising to co-produce an advocacy video aimed at reducing such exposure. Our qualitative thematic analysis of the workshop and focus group data revealed adolescents’ concerns about e-cigarettes’ potential health effects, pervasive advertising targeting adolescents, and peer usage, which became the focus of the final video. Although none of our participants were current e-cigarette users, some had encountered targeted online advertisements, despite being under 18, or had seen friends of public figures using e-cigarettes on social media. The advocacy video, produced in collaboration with the adolescents, effectively integrated their insights and experiences, highlighting their collective concerns about e-cigarette advertising. Our findings show adolescents are highly exposed to e-cigarette advertising, feel uncertain about their harms, and are aware of marketing tactics like vibrant colours and flavour variations. This highlights the need for advocacy work which focuses on promoting stronger marketing legislation to protect them. Our advocacy video, is one such example of this which is being used by advocacy groups to