Virtual Transportation as a Strategy to Reduce Resistance to Cigarette and e-Cigarette Graphic Health Warnings in Adolescents and Young Adults
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Most adult smokers initiate tobacco use before age 18, with considerable increases in initiation and the highestrates of use observed between the ages of 18 and 29. Although conventional cigarette use is decliningsomewhat, use of e-cigarettes that can promote future nicotine addiction is on the rise, particularly for youth.These statistics speak to the need to identify new methods of delivering messages designed to reduce bothcigarette and e-cigarette (e-cig) use to younger Americans (i.e., adolescents and young adults). One promisingapproach involves delivery of graphic health warnings that communicate the risks associated with theseproducts. The proposed research explores delivery of graphic health warnings from within virtual gamingenvironments. Previous research indicates that videogames can be used effectively to deliver smoking-prevention messages, but past efforts have focused on videogames designed around health-education themes(what are called â€œseriousâ€ games). With surveys indicating that 97% of adolescents and 80% of young adultsplay videogames for entertainment, use of entertainment videogames as a tool for delivering graphic warningshas tremendous potential to influence youth cigarette and e-cig rates. However, before such an approach canbe pursued, researchers need to better understand health communication dynamics in computer-mediated,virtual gaming worlds. The current project addresses this need and tests the viability of The VirtualTransportation Model of Health Communication. This model posits that, as gamers become psychologicallyimmersed (or â€œtransportedâ€) into virtual reality, their tendency to resist persuasive messages they encounter inthese worlds is disrupted. The model further posits that such disruption will typically be strongest amongindividuals who are most likely to resist or reject â€œreal-worldâ€ interventions. Support for predictions comes frompilot research conducted by our research team. In this research, graphic health warnings against alcohol-impaired driving and cigarette smoking were embedded in background scenes of entertaining, interactive 3Dvirtual gaming worlds. Such messages were shown to reduce willingness to engage in these behaviors in thefuture, particularly among higher-risk individuals who reported feeling psychologically â€œtransportedâ€ duringgame play. The proposed research will build on this work by testing the viability of videogame-basedinterventions. In Phase 1 (Years 1 & 2) we will refine two existing videogames and develop two new ones whilesimultaneously empirically evaluating the best methods of delivering in-game health communications and themechanisms by which transportation heightens in-game influence. In Phase 2 (Years 3 & 4), we will conductrandomized field trials of game-based interventions with two groups, a probability sample of adolescents (13 â€“18) and an at-risk sample of young adults (18 â€“ 24). In Phase 3 (Year 5) we will aggregate data across studiesto create helath campaign recommendations and to launch an interactive gaming server that will permit broaddistribution of empirically validated games, for use by independent health communication researchers.