Shaping Youth Tobacco Use: Tobacco 21 Policy Messaging to Increase Policy Support and Reduce Intentions to Use

Abstract

Objectives: Research has established that increasing policy support among adults can encourage behavior change; however, policy support, particularly regarding Tobacco 21 (T21), remains understudied among youth. This study examines whether exposure to T21 policy messages can increase support for the policy and reduce intentions to use tobacco among youth.

Methods: We recruited an online convenience sample of U.S. youth aged 18-20 (final analytic N = 583; about half with a history of tobacco use) who completed the study via Prolific and were randomly assigned to either a T21 or a control message condition. T21 messages promoted policy support, while control messages were neutral and unrelated to health. Participants viewed three messages based on their assigned condition and completed pre- and post-exposure surveys assessing T21 support and tobacco use intentions. Two repeated-measures ANCOVAs were used to test the impact of message exposure on these outcomes.

Results: Participants exposed to T21 messages showed a greater mean pre-to-post increase in support for T21 than those who viewed control messages, F (1, 574) = 11.39, p < .001. Exposure to T21 messages also resulted in a greater mean pre-to-post reduction in intentions to use tobacco compared to control, F (1, 574) = 5.98, p = 0.015.

Conclusions: Our findings underscore that T21 messaging can increase youth support for tobacco policies and reduce future tobacco use intentions. Integrating policy-focused messaging could strengthen youth engagement with tobacco prevention campaigns and enhance tobacco control efforts.

Keywords: Tobacco 21; perceived message effectiveness; policy messaging; public support; youth tobacco use.