Perceived effectiveness of objective elements of vaping prevention messages among adolescents.

INTRODUCTION: In recent years, vaping prevention campaigns have proliferated in response to a surge of e-cigarette use among adolescents in the USA. To date, the research literature has provided minimal guidance as to what vaping prevention message elements have the greatest potential for discouraging vaping, are ineffective or have unintended negative effects. The purpose of the current study was to identify and test a large set of vaping prevention ads used by federal, state, local and non-governmental agencies, examining how objectively coded message elements of vaping prevention messages might affect youth. METHODS: A convenience sample of adolescents (N=1501) completed an online survey with each participant rating seven randomly selected vaping prevention ads from a pool of 220 ads on perceived message effectiveness (PME) and vaping appeal. Ads were coded on 37 objective elements in three message categories: themes, imagery and other features. Analyses examined how objective elements predicted PME. RESULTS: Addiction, chemicals, negative health symptoms and effects, and cigarette comparison themes were associated with higher PME, as were graphic images and warning symbols. Industry targeting, environmental impact, flavour themes, images of food and people's faces were associated with lower PME, as were hashtags, statistics and first-person language or the word 'teen'. Most elements were not associated with appeal, but ads with a flavour theme were associated with increased vaping appeal. CONCLUSION: Promising vaping prevention messages focus on the adverse consequences of vaping, use negative imagery and avoid speaking for teens using their vernacular or perspective.

What's in the message? An analysis of themes and features used in vaping prevention messages.

Introduction: Federal, state, local, and non-government officials have developed and implemented a variety of vaping prevention messages to curtail the vaping epidemic among youth in the US. This study sought to collect a comprehensive set of vaping prevention messages and characterize the themes and features of those messages. Methods: We used a two-fold search strategy to identify messages, utilizing the existing content database from Vaping Prevention Resource (vapingprevention.org) and supplementing those messages with web searches. Potential messages were included if they were vaping prevention-oriented, appropriate or relevant for youth, and in a static web or print format. Results: A total of 220 messages met criteria. Messages were coded on the presence or absence of 37 objective features within five categories: message themes, imagery, text features, message perspective, and other (e.g., source). The most common themes were nicotine addiction (32%), chemicals (30%), health effects (24%), and industry targeting (19%). Eighty-five percent of messages included imagery, with 27% showing a vaping device, 22% showing smoke or vapor, and 21% showing a person's face. Just over half (56%) included a message source. Conclusions: Vaping prevention messages for youth have commonly focused on addiction and health risks of vaping, and they vary on a series of text and image features. Further research is needed to understand the efficacy of messaging approaches in preventing vaping among youth.

Indications for Keratoplasty at 3 Academic Centers from 2002 to 2012.

OBJECTIVES: To determine whether indications for keratoplasty differ between academic centers and the Eye Bank Association of America (EBAA) annual statistics from 2002 to 2012. METHODS: A retrospective review was performed for the indications for keratoplasty from 2002 to 2012 based on surgical specimens originating from three different academic centers. Data were compared with statistical reports obtained from the EBAA for the corresponding years. RESULTS: From 2002 to 2007, at Washington University in St Louis (WU), the most common indication for keratoplasty was graft failure at 31.6%. At St Louis University, the most common indications for keratoplasty were pseudophakic and aphakic bullous keratopathy (PBK/ABK) at 34.6% followed closely by graft failure at 32.7%. Combining the 2002 to 2007 EBAA data, the most common indication for keratoplasty was PBK/ABK at 19.5%, whereas regrafts accounted for only 13.0% of keratoplasties. From 2008 to 2012, regrafts accounted for 41.9% of keratoplasties at WU and 33.1% of keratoplasties at University of California, Davis. In contrast, the EBAA data showed that only 11.4% of keratoplasties were regrafts. CONCLUSIONS: Graft failure accounted for approximately 30% to 40% of indications for keratoplasties at three academic centers from 2002 to 2012, which was more than double and in some cases triple that of the EBAA data during this period. These higher frequencies of regrafting may represent a referral bias of patients with complicated cases to academic centers who then require multiple keratoplasties.