Advancing Communication Science to Reduce Disparities in Young Adult Cigar Use

ABSTRACT: PROJECT 1 Almost 9 million US adults currently smoke cigars, which cause multiple cancers, including oral, esophageal, laryngeal, and lung cancer. Over the last two decades, while cigarette consumption declined 48%, cigar consumption increased 115%, mostly due to increased use of little cigars and cigarillos (LCCs). LCC rates are

highest in young adults (YA) ages 18-29, with disproportionately higher prevalence among Black YAs. Communication campaigns have played powerful roles in reducing cigarette use, but no national campaigns have yet focused on cigar or LCC use. There has been little research in communication science to reduce LCC

use, especially in social media, where YAs spend substantial time. Research is needed on identifying the themes most likely to reduce LCC use; whether changing incorrect beliefs about flavors, harm, and addiction is an effective approach; and how to increase attention and engagement with digital messages. These advances

will help reduce disparities in LCC use if done with a content co-creation approach, including involving Black and other YAs in the development process. This project’s goal is to advance communication science to inform campaigns to decrease YA LCC use, especially among Black YAs. This aligns with the UNC TCORS

integrative theme of building the science for effective regulation of and communication about tobacco products disproportionately used by priority populations, including cigars. Project 1’s Aim 1 develops potentially impactful theory-driven communication themes for reducing LCC use among YA LCC users. The team will

identify a comprehensive set of beliefs about LCC use and use a national survey to determine which beliefs about LCC use are most promising to develop campaign messages that are then vetted with YA LCC user focus groups. Aim 2 tests digital ad design features and messaging to identify those ads that maximize

attention and engagement among YA LCC users. The research team will work with design professionals to create Instagram-like LCC ads for the messages and enhance them with design features to increase attention and engagement. These ads will then be refined with focus groups and used in an eye-tracking experiment on

smartphones to compare digital LCC messages with and without the enhanced design features in a simulated Instagram environment. Aim 3 conducts a multi-week randomized controlled trial to determine the effectiveness of digital campaign ads with enhanced design features in promoting increased quit intentions

among YA LCC users. Participants in the trial will be exposed to Instagram-like enhanced LCC campaign digital ads or control ads. The research team is optimally prepared for this project based on unique expertise in cigar communication, message and campaign development, and reducing disparities. The proposed studies

respond to the RFA’s Communication and Behavior domains and will inform communication campaigns to reduce LCC and other tobacco use and advance methods to reduce tobacco-related disparities.