Breaking the vape-stress cycle: communicating mental health risks of vaping to mitigate reactance

Despite concerns that e-cigarettes worsen mental health symptoms, the tobacco industry markets them as stress-relief tools. In response, anti-vaping campaigns have integrated mental health cues into their messaging; yet, their effectiveness remains unclear.

This study examines how mental health cues in anti-vaping messages influence young adults' perceived threat to freedom, attitudes, and intentions to quit vaping, and how these effects vary by message format. Using an experiment with daily vapers (N = 436), participants were assigned to one of five conditions: 2 (mental health cue: yes vs. no) × 2 (message format: narrative vs. non-narrative) + control.

Mental health cues alone did not significantly impact perceived threat to freedom, attitudes, or intentions to quit vaping. However, interaction effects revealed a nuanced role of message format. In a narrative format, mental health cues reduced perceived threat to freedom, whereas in a non-narrative format, these cues heightened threat perceptions. Further analyses showed that while reduced threat in narrative led to more positive attitudes toward quitting, it did not translate into stronger behavioral intentions.

Findings highlight the complexity of using mental health cues in anti-vaping campaigns and the need to address reactance challenges in message design.