This document describes a study assessing the knowledge, attitudes, and beliefs of university students at risk of becoming first-time electronic cigarette users. The study involved surveying 455 students, identifying 39 at-risk participants. Most students were aware of e-cigarettes and many had tried them or were contemplating using them. Based on pre-testing different communication designs with the at-risk group, three designs - a hand with text, aerosol spray can, and infographic - tested most favorably and will be implemented in a campus health communication campaign to educate students on e-cigarette risks. The project aims to contribute to the university's initiative to discourage first-time e-cigarette use among students.

1. Kiarash P. Rahmanian, MPH Candidate
E-Cigs ≠ Safe: A Health Communication Campaign Dissuading First Time Users of Electronic Cigarettes
1
Background: The Healthy Gators survey of 2015 revealed a staggering 84.54% of UF students are aware of
what e-cigarettes are; 40.9% had observed e-cigarette use on campus; 20.8% have tried an e-cigarette, 35.6% do
not think that e-cigarettes are harmful; 11.6% would try an e-cigarette or start using regularly in the next 6
months; and 3.2% used electronic cigarettes regularly in the past 30 days. The results of this survey show the
rate of UF Students to be higher than the national rates for ever-use, attempted use, and awareness of electronic
cigarettes.
Objectives: The purpose of this study was to assess the knowledge, attitudes, and beliefs of students at the
University of Florida that were defined as “at-risk” of becoming first-time users of e-cigarettes in order to guide
message designs for a health communication campaign that educates and promotes awareness of the negative
health outcomes of e-cigarettes.
Methods: This study consists of 5 stages: 1) Recruitment; 2.) Two-Part Questionnaire; 3.) Development of
preliminary health communication products (based on findings from Two-Part Questionnaire); 4.) Pre-testing
first drafts of health communication products; and 5.) Pre-testing revised health communication products.
Results: 455 UF students were recruited through convenience sampling, with 39 “at-risk” participants
continuing in the study. Amongst the overall sample (n=455), 98% are aware of what e-cigarettes are, 57% have
tried an e-cigarette (66% “at-risk”), 53% would try an e-cigarette (83% “at-risk”), 35% would become regular
users of e-cigarettes (71.8% “at-risk”), 57% are in the contemplation or preparation stage of becoming first-time
users of e-cigarettes (59% “at-risk”- contemplation stage, 40%- preparation stage).
Conclusion: Based on pre-testing results, design 1 (hand with text), design 2 (aerosol spray can), and design 3
(Infographic) tested the most favorably amongst the “at-risk” target population and will be implemented in the
Fall of 2015.
MPH Core Competency Strengthened Details
1. Monitoring health status to identify and solve
community health problems
X
“At-risk” population status was defined by two-part
questionnaire. Participants were studied for health
communication campaign.
2. Diagnosing and investigating health problems
and health hazards in the community using an
ecological framework
X
The intern engaged with students at the community
level. Other levels were discussed with participants.
3. Informing, educating, and empowering people
about health issues
X
The intern created and presented a presentation to
various community partners (Tobacco Free Taskforce,
etc.), and GatorWell Staff. Presentation included an
educational, empowerment, and informative portion.
4. Mobilizing community partnerships and action
to identify and solve health problems
X
Mobilized Tobacco Free Taskforce to aid as expert
reviewers of campaign materials and to guide in the
vision of campaign following Stage 1 results.
5. Developing policies and plans that support
individual and community health efforts
------- N/A
6. Applying laws and regulations that protect
health and ensure safety
------- N/A
7. Linking people to needed personal health
services and assure the provision of health care
when otherwise unavailable
X
Provided counseling and GatorWell resources through
the campaign designs (tobacco Quitline and GatorWell
resources) for those in need of cessation.
8. Evaluating effectiveness, accessibility, and
quality of personal and population-based health
services
------- N/A
9. Conducting research for new insights and
innovative solutions to health problems
X
Conducted research about e-cigarettes to gain further
insight to solutions for the cessation and prevention of
use for UF students.
10. Communicating effectively with public health
constituencies in oral and written forms
X
Consistent communication was kept with all parties and
constituents. Upon completion, all designs were
released to GatorWell for further use and research.

2. Kiarash P. Rahmanian, MPH Candidate
E-Cigs ≠ Safe: A Health Communication Campaign Dissuading First Time Users of Electronic Cigarettes
2
SBS Core Competency Strengthened Details
1. Critically describe and evaluate the state of
public health social and behavioral science
research and literature.
X
Conducted a comprehensive literature review to inform
the development of a health communication campaign
for e-cigarettes within the college student population.
2. Apply social and behavioral science theories
and concepts to public health problems.
X
Developed a theory-based health communication
campaign for e-cigarettes, using health belief model,
diffusion of innovation, and theory of reasoned action.
3. Describe and apply the social ecological
framework to public health problems.
X
Conducted Healthy Gators Secondary data analysis and
advised future recommendations & PH interventions at
the intrapersonal, interpersonal, and community levels.
4. Understand and apply the principles of
community participation in public health research
and interventions.
X
Worked closely with campus and community
stakeholders, in order to gain a deeper insight into the
target population and gain advisory aid.
5. Demonstrate the knowledge and skills necessary
to conduct socialand behavioral science research.
X Achieved through various aspects of specialproject.
6. Demonstrate an understanding of health
disparities in the US and the underlying role of
power differentials to disparities.
X
The CDC states, “tobacco use causes very harmful
health effects alongside diseases and premature death in
all demographic populations”. The “disparity” lies with
college students that use tobacco products in
imbalanced sums to other age groups. This disparaging
inequality of health is the projects’ target population.
7. Demonstrate knowledge and skills needed to
design and implement a public health information
campaign.
X
Completed first two stages of a health communication
campaign on dissuading UF students from becoming
first time users of e-cigarettes. Stage 3 & 4 were
planned by intern and will be implemented by
GatorWell in the Fall of 2015 and Spring of 2016.
8. Demonstrate communication skills key to public
health workforce participation and advocacy.
X
Worked closely with the research team and GatorWell
staff on e-cigarette health communication campaign.
Outside resources were also collaborated with
(Brantley Jarvis, doctoralcandidate at UF).
Public Health Relevance
Current research into the possible negative effects of e-cigarettes falls short of their level of popularity
and so the e-cigarette epidemic is here. The e-cigarettes is a billion-dollar industry- on track to far surpass the
tobacco industry within a decade’s time. The number of teens using e-cigarettes doubled between 2011 and
2012. The nicotine within the cartridges of e-cigarettes is the same addictive substance within tobacco products
and leaves users with withdrawal symptoms when use is halted. Thus far in the world of research, evidence
suggests that e-cigarettes could potentially be safer than conventional cigarettes. With one of the biggest
dangers of conventional cigarettes solved (smoke), tests still show the levels of dangerous chemicals they give
off are a fraction of what you'd get from a conventional cigarette. The issues lie with what chemicals they
contain, in what dosages, the fact that some secondhand smoke cases are already popping up, lack of long-term
evidence of safety, and the obvious statement that “less harmful doesn’t mean safe”. All of these have triggered
a huge debate through the public health field creating an area of need for research studies to be completed.
The University of Florida has joined the efforts to find out more about electronic cigarettes and their
negative health effects. GatorWell Health Promotion Services works closely with the Healthy Gators Coalition
and the University of Florida’s Tobacco-Free Taskforce. Thus, all three parties are working toward outreach
programs to educate and make our student body aware of the little that is known about electronic cigarettes.
This internship will contribute to the University of Florida’s initiative to dissuade UF students from
becoming first-time electronic cigarette users. The health communication campaign designed for the special
project will be directed at informing and empowering students to gain knowledge and awareness of the negative
health effects and health outcomes associated with electronic cigarettes.