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Grant Details

Grant Number: 7R01CA217861-04 Interpret this number
Primary Investigator: Mays, Darren
Organization: Ohio State University
Project Title: Optimizing Risk Messages to Promote Waterpipe Tobacco Cessation in Young Adults
Fiscal Year: 2019


Project Summary Waterpipe tobacco is one of the most commonly used tobacco products among U.S. young adults. Waterpipe tobacco exposes users to high levels of carcinogens and other harmful toxicants, can lead to long-term addiction, and is associated with cancer and other negative health outcomes. Despite this evidence, young adults do not view waterpipe tobacco as harmful or addictive, beliefs representing unique motives that drive the high prevalence of waterpipe use. Waterpipe tobacco intervention research has focused on clinical cessation interventions among older, dependent users. These interventions likely have limited impact among young adults because their use of clinical cessation interventions is low and they do not view themselves to be in need of such cessation supports. Our research indicates public health messages conveying harms and addictiveness of waterpipe tobacco can shift young adult waterpipe tobacco users' perceptions and motivate cessation. This study builds from our preliminary work and addresses a critical gap in this research area by adapting messaging strategies that have been successful for addressing cigarette smoking to optimize their impact on young adults' waterpipe tobacco use. We will rigorously examine the effects of messages conveying harms and addictiveness of waterpipe tobacco using text and visual imagery and delivered by mobile phone multimedia messaging service (MMS) among young adults ages 18 to 30 who use waterpipe tobacco. Our approach leverages online crowdsourcing for message refinement and interactive mobile technology to engage with participants, deliver MMS messages, and test added effects of personally tailored MMS content. Participants will complete baseline measures, receive basic messages on harms and addictiveness of waterpipe tobacco, and be randomized to three conditions: 1) a control condition receiving no additional messaging, 2) an untailored MMS condition, or 3) a tailored MMS condition. For 1-month, those assigned to MMS conditions will receive text message prompts on two days each week delivered to their mobile phones via an interactive messaging system to assess waterpipe tobacco perceptions and behavior. After responding to prompts, participants will receive MMS messages on harms and addictiveness of waterpipe tobacco. For the tailored MMS condition, message content will be personalized to responses to baseline measures and dynamically through the interactive text message exchanges during the intervention period. Waterpipe tobacco use and hypothesized mediators will be reassessed 1-, 3-, and 6-months post-baseline. Our study will generate critically needed data on the effects of mobile MMS and tailored MMS message content to inform waterpipe tobacco use interventions. Our study directly addresses National Cancer Institute tobacco control research priorities and the findings can be translated to population intervention efforts by the NCI, Food and Drug Administration public education about the harms of waterpipe tobacco, and other targeted interventions.


Correlates of motivation to quit waterpipe tobacco smoking among US young adults: implications for cessation interventions.
Authors: Alalwan M.A. , Keller-Hamilton B. , Long L. , Lipkus I. , Wagener T.L. , Mays D. .
Source: Health education research, 2023-07-25; 38(4), p. 338-349.
PMID: 36880171
Related Citations

Exploring motivation to quit and risk appraisals of hookah tobacco smoking for self and partner among a member of single and dual smoker couples.
Authors: Lipkus I.M. , Mays D. , Sanders C. , Hatch D. .
Source: Journal of behavioral medicine, 2023 Jun; 46(3), p. 460-471.
EPub date: 2022-11-01.
PMID: 36318399
Related Citations

Influencing Perceptions of Harm of Waterpipe Tobacco Smoking Among One Member of Couples Who Use Waterpipe.
Authors: Lipkus I.M. , Sanders C. , Mays D. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2022-06-15; 24(7), p. 1071-1078.
PMID: 34953166
Related Citations

Effects of mental simulation of future waterpipe tobacco smoking on attitudes, perceived harms and intended use among young adults.
Authors: Lipkus I.M. , Mays D. , Sheeran P. , Pan W. , Cameron L.D. , De Brigard F. .
Source: Journal of behavioral medicine, 2022 Feb; 45(1), p. 76-89.
EPub date: 2021-08-18.
PMID: 34406549
Related Citations

Testing the Effects of Hookah Tobacco Social Media Risk Communication Messages Among Young Adults.
Authors: Johnson A.C. , Mays D. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2021 Oct; 48(5), p. 627-636.
EPub date: 2020-10-19.
PMID: 33073594
Related Citations

Tailored Mobile Messaging Intervention for Waterpipe Tobacco Cessation in Young Adults: A Randomized Trial.
Authors: Mays D. , Johnson A.C. , Phan L. , Sanders C. , Shoben A. , Tercyak K.P. , Wagener T.L. , Brinkman M.C. , Lipkus I.M. .
Source: American journal of public health, 2021 Sep; 111(9), p. 1686-1695.
EPub date: 2021-08-26.
PMID: 34436927
Related Citations

Initial development of the Hookah Smoker Scale: Assessing young adults' mental schemas about hookah "smokers".
Authors: Phan L. , Mays D. , Tercyak K.P. , Johnson A.C. , Rehberg K. , Lipkus I.M. .
Source: Translational behavioral medicine, 2021-02-11; 11(1), p. 206-215.
PMID: 31722424
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Effect of risk messages on risk appraisals, attitudes, ambivalence, and willingness to smoke hookah in young adults.
Authors: Mays D. , Johnson A.C. , Phan L. , Tercyak K.P. , Rehberg K. , Lipkus I. .
Source: Health psychology and behavioral medicine, 2020; 8(1), p. 96-109.
EPub date: 2020-02-20.
PMID: 33033657
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Development and Pretesting of Risk-Based Mobile Multimedia Message Content for Young Adult Hookah Use.
Authors: Johnson A.C. , Lipkus I. , Tercyak K.P. , Luta G. , Rehberg K. , Phan L. , Abroms L.C. , Mays D. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2019 Dec; 46(2_suppl), p. 97-105.
PMID: 31742460
Related Citations

Comparing harm beliefs and risk perceptions among young adult waterpipe tobacco smokers and nonsmokers: Implications for cessation and prevention.
Authors: Lipkus I.M. , Mays D. .
Source: Addictive behaviors reports, 2018 Jun; 7, p. 103-110.
EPub date: 2018-03-17.
PMID: 29892704
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