Systematic review and meta-analysis of vaping prevention messages for adolescents and young adults

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Frontiers in Medicine Published May 4, 2026 Medically reviewed May 4, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider that prevention messages may modestly increase risk perception but have uncertain effects on vaping intentions.

This is a systematic review and meta-analysis of campaign-related vaping prevention messages for adolescents and young adults aged 11 to 29 years. The analysis pooled data from 11,235 participants to assess cognitive and behavioral outcomes.

The authors found a statistically significant moderate protective effect on perceived vaping-related risk (Hedges' g = 0.254, 95% CI: 0.187 to 0.321). A smaller but statistically significant protective effect was observed for vaping susceptibility (Hedges' g = -0.166, 95% CI: -0.256 to -0.076). For intentions to vape, the effect was non-significant and heterogeneous (Hedges' g = -0.089, I² = 62.3%).

Key limitations noted by the authors include the small number of studies, which made publication bias testing exploratory, and the heterogeneity of effects on intentions to vape. The authors also call for longitudinal and population-level studies to determine whether cognitive shifts translate into sustained behavioral change.

The authors underscore the importance of strategic message design and thematic framing. Practice relevance is restrained, given the evidence gaps and the need for further research on long-term behavioral outcomes.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundVaping among adolescents has decreased but remains common among young adults, with ongoing concerns about nicotine health risks. Public health campaigns have increased vaping prevention messages, but evidence on their effectiveness, especially on cognitive and behavioral outcomes, is limited.ObjectiveThis systematic review and meta-analysis aimed to synthesize recent experimental evidence on the effects of campaign-related vaping prevention messages on cognitive outcomes (e.g., knowledge, risk perception, perceived message effectiveness) and behaviorally proximal indicators (e.g., susceptibility to vaping and intentions to vape) among adolescents and young adults.MethodsA systematic search of five databases (Cochrane, PubMed, Scopus, CINAHL, and Web of Science) was conducted through January 2025. Thirteen Randomized Controlled Trials (RCTs) met the inclusion criteria, with six eligible for meta-analysis. The review adhered to PRISMA guidelines and was registered in PROSPERO ( CRD42025643032). The risk of bias was assessed using the RoB 2.0 tool. Meta-analyses were performed using a random-effects model to estimate pooled effect sizes.ResultsThe included studies (n=13) involved 11,235 participants aged 11–29 years. Most of the studies evaluated large-scale media campaigns or message-based interventions. Meta-analysis of six studies showed a statistically significant moderate effect on perceived vaping-related risk (Hedges’ g = 0.254; 95% CI: 0.187–0.321), with zero heterogeneity (I² = 0.0%). Due to the small number of studies, publication bias testing was exploratory. For behaviorally proximal outcomes, subgroup analyses revealed a statistically significant protective effect on vaping susceptibility (g = -0.166; 95% CI: -0.256 to -0.076; I² = 0.0%), while effects on intentions to vape were non-significant and heterogeneous (g = -0.089; I² = 62.3%). Narrative synthesis indicated consistent improvements in knowledge, attitudes, and perceived message effectiveness, particularly for messages emphasizing health harms and chemical exposure.ConclusionCampaign-related vaping prevention messages demonstrate consistent and robust effects on cognitive outcomes and susceptibility to vape, but yield heterogeneous and context-dependent effects on intentions. These findings underscore the importance of strategic message design and thematic framing while highlighting the need for longitudinal and population-level studies to determine whether cognitive shifts translate into sustained behavioral change.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42025643032, identifier CRD42025643032.