Changing Adolescents' Cigarette and E-Cigarette Cognitions via a Media Literacy-Based Active Involvement Intervention: A Randomized Cluster Trial.

Media are important socialization actors in adolescents' (e-)cigarette usage. This study evaluated the immediate and delayed effects of a media literacy intervention on adolescents' (e-)cigarette cognitions. Grounded in the theory of active involvement, we explored (a) whether having adolescents design their own counter campaign can reduce (e-)cigarette cognitions, (b) how long the effects persist, and (c) whether effects differ for cigarette and e-cigarette cognitions. Using a randomized cluster trial design with an intervention and control condition, adolescents (aged 13-15) completed three questionnaires (baseline measure, n = 1,189; immediate follow-up, n = 1,096; and 6-month delayed follow-up, n = 906). For cigarettes, the intervention produced delayed effects on descriptive norms and willingness. For e-cigarettes, the intervention improved social norms, and outcome expectations immediately after the intervention, and produced delayed effects on norms, attitudes, and willingness six months after the intervention. Exploratory analyses revealed delayed gender effects for e-cigarette cognitions. Hence, active involvement interventions appear to be effective, albeit depending on the type of product, the timeframe, and adolescents' demographics.