Finding an Effective Means to Change Health Attitudes on E-Cigarettes
“It’s easier to prevent bad habits than to break them.” So wrote Benjamin Franklin, and legislators and public health officials in California and a handful of other states appear to agree as they undertake programs to curb the use of electronic cigarettes. But when it comes to patient engagement strategies, are state and public health bodies the best option or should healthcare organizations lead the charge?
Why California is Taking On ‘Vaping’
According to a recent Kaiser Health News report, California boasts the second-lowest adult smoking rate in the nation, but the rising popularity of smoking e-cigarettes — known as vaping — represents a setback. Dr. Ron Chapman, director of the California Department of Public Health, told KHN that “e-cigarettes represent a new public health challenge that threatens to undo and reverse the progress we’ve made by re-normalizing smoking behavior and tempting a new generation of youth and young adults into the cycle of nicotine addiction.”
He’s not wrong.
Last year, the CDC published a study in the journal Nicotine and Tobacco Research, which found that in 2013, more than 250,000 youth who had never smoked a cigarette used e-cigarettes, tripling the number from just two years before. Based on the array of fruit- and candy-flavored nicotine liquids available, public health officials claim that e-cigarette manufacturers are specifically targeting this young audience. In addition, the lack of child-proof caps on nicotine liquids has led to a rise in accidental poisonings among children five years old and under.
In addition to a public health advertising campaign and partnerships with local health providers, childcare facilities and schools to increase awareness of health risks associated with e-cigarettes, state legislators have proposed banning their use in bars, restaurants and hospitals, similar to laws restricting traditional tobacco products. On a national level, the U.S. Food and Drug Administration is stepping up its regulatory efforts as well.
The American Vaping Association and other industry advocates disagree, noting that they support restrictions of sales to minors but see e-cigarettes are a viable alternative to smoking cessation tools like nicotine patches or gum.
A recent Washington Post article quotes Greg Conley, president of the American Vaping Association, who suggests that California has deliberately ignored clinical trials that measure how effective e-cigarettes are for smoking cessation. He says, “What’s most disgraceful is that they are telling California smokers that if they’ve tried the gum and the lozenge and the patch and it hasn’t worked for them, they might as well keep smoking.”
The result is that the public is experiencing a confusing mix of messages.
Who Should Be Starting the E-Cig Conversation?
Instead of relying on broad campaigns which may not have the desired impact with such a diverse audience, healthcare providers may want to develop their own patient engagement strategies regarding e-cigarettes. The success of those strategies depends on how well hospitals and other healthcare organizations understand the unique motivations and attitudes towards health and wellness of patients. The latest research findings from the PatientBond Consumer Diagnostic show that over a third of smokers are under age 35 (note, all respondents to this national study were age 18+). Hispanics/Latinos are also more likely than other races/ethnicities to smoke, as are consumers who have not attained more than a high school education.
Even more importantly, PatientBond has looked at smoking from a psychographic perspective and found that one segment among the five is clearly the most likely to smoke. Willful Endurers — a group that is not generally invested in wellness and tends to be reactive rather than proactive in their health — represents 40% of all smokers, yet makes up only 29% of the general population. Moreover, Willful Endurers make up 46% of the population suffering from emphysema, despite the fact that Willful Endurers skew younger and are heavily represented among the Millennials. It goes to show that the five psychographic segments can be found across the age spectrum.
Such patients will need to receive a significantly different message regarding the health risks of e-cigarettes in order to activate the desired behavior. Willful Endurers are among the most challenging patients to activate, but health interventions have been shown to be successful.
Will a universal public health advertising campaign strike the right chord? Perhaps with some people, but each psychographic segment has its own priorities and motivations so a “one-size-fits-all” message will be limited in its effectiveness. A trusted healthcare provider who develops a patient engagement strategy based on deeper insights from psychographic segmentation will be better positioned to address e-cigarettes and their health risks.