“Don't vape, nobody uses these poisonous sticks”: A content analysis of adolescents' self-generated anti-smoking and anti-vaping messages

Media literacy interventions are promising approaches to mitigate the harmful impact of media on substance use behaviors, including smoking and vaping. Some media literacy interventions adopt an interactive format, involving adolescents in the creation of counter messages that challenge pro-substance media narratives. However, research has largely focused on the impact of media literacy interventions on behaviors, leaving a critical gap in understanding the actual content of messages that adolescents produce. Consequently, this study presents a content analysis of N = 256 anti-smoking/vaping messages created by Belgian adolescents during the #Smokefree intervention, which aimed to discourage smoking and vaping by involving adolescents in the planning/design of their own messages. Overall, adolescents mostly focused on vapes in their messages, which reflects a societal trend whereby vaping is becoming more prevalent while smoking is decreasing among adolescents. More importantly, adolescents relied on negative outcome expectations and descriptive norms to discourage smoking/vaping, and they were able to implement basic heuristic cues necessary to enhance message appeal in their messages. These findings suggest that adolescents can apply critical media literacy skills to their own anti-smoking/anti-vaping messages. It also sheds light on which elements of the media literacy intervention resonated with youth, thereby informing the development of future health campaigns and interventions.