JMIR Publications

ABSTRACT

Background:

E-cigarette or vaping use-associated lung injury (EVALI), first reported in July 2019, caused over 2,800 hospitalizations and 68 deaths by February 2020, when the outbreak ended. Media coverage of EVALI was extensive but not always accurate concerning the cause, which turned out to be a compound added to certain illicit cannabis vapes.

Objective:

This study examined knowledge of EVALI among adolescents and explored the impact of media messages on their perceptions of the condition.

Methods:

Archived news reports on EVALI from an online tobacco media analysis engine, Tobacco Watcher (July 2019–March 2020), and data from the California Student Tobacco Survey (September 2019–March 2020; N = 157,499) were analyzed. Middle and high school students’ awareness of EVALI and perceptions of its cause were examined in relation to their sources of information about EVALI. Students’ perceived risk of vaping was assessed according to their awareness of EVALI.

Results:

Of 19,661 news reports on Tobacco Watcher that discussed EVALI, only 46.2% mentioned cannabis. Among the 157,499 included students, 75.0% had heard about EVALI. Their primary source of information was media (63.1%), followed by parents (16.6%), teachers (8.1%), friends (7.7%), and peers (4.6%). Most students, 55.0%, believed nicotine was the cause of EVALI, while only 11% thought it was related to cannabis in vapes. Students who had heard about EVALI rated vaping every day more harmful than those who had not heard about it (67.8% vs 50.9%, P < .001).

Conclusions:

Most adolescents were aware of EVALI and cited media as how they learned of it. Most incorrectly believed that nicotine in vapes was the cause of EVALI, likely being impacted by how the outbreak was covered in early media reports. Media coverage of EVALI presents a case study of the critical but complicated role of modern media in communicating health information.