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• Posted June 19, 2023

Using 'Grey's Anatomy' to Warn Teens Away From Vaping

Could popular TV medical dramas jump-start a discussion about vaping among teens and almost teens?

A recent experiment using clips from "Grey's Anatomy,” “New Amsterdam” and “Chicago Med” suggests the answer is yes. Watching the clips appeared to help kids open up and talk about the health impacts of using electronic cigarettes.

Along the way, researchers learned more about the terminology kids do and don't understand when it comes to e-cigarettes, and how they feel about being targets of marketing.

“I'm not necessarily surprised that students found TV clips more engaging than having an adult stand in front of the room and talk to them about the dangers of substance use,” said study leader Beth Hoffman, a postdoctoral associate in University of Pittsburgh School of Public Health's Department of Behavioral and Community Health Sciences. “But one of the things I was surprised about is how watching these clips really sparked students to ask really good questions about not only the harms associated with vaping, but questions about advertising.”

Among those questions: Why were they seeing targeted ads on social media about vaping flavors?

“I remember one student said, ‘Well, why can tobacco companies do that?' And I thought, ‘Well, that that's a really good question,'" Hoffman said. "To me, that really showed how these clips could create an environment where students were not only engaged but felt comfortable to ask these types of questions in a way that more traditional health education or instruction from an adult might not lend itself to.”

For the study, Hoffman's team partnered with CHAMP, a mentorship program that connects medical students with students at Arsenal Middle School in Pittsburgh. Researchers worked with 78 seventh- and eighth-graders in four focus groups, sharing clips from the three TV shows that aired during January 2020.

Each featured an adolescent who was hospitalized with EVALI, a lung injury marked by coughing and shortness of breath associated with vaping. (The acronym stands for E-cigarette or Vaping Use-Associated Lung Injury.)

It first gained attention in July 2019, according to the study. By February 2020, there were more than 2,800 hospitalizations and 68 deaths in the United States associated with EVALI.

Students in the focus groups were mostly ages 13 and 14. About half were Black.

Few had watched any of the TV shows, according to the researchers. They were not familiar with EVALI before seeing the clips.

While watching the shows, the students in the focus groups leaned in, shook their heads and gasped, researchers said.

"Sometimes you have to see it to believe it," one of the kids said.

During the study, researchers learned that participants were familiar with the term “vaping” but not with “e-cigarette.”

This led researchers to conclude that interventions using words kids are less familiar with are likely to be less effective.

Vaping is a big issue for American teens.

In the 2022 National Youth Tobacco Survey, more than 2.5 million high school students and 380,000 middle schoolers said they had vaped within the past month.

Researchers said the clips may have resonated because kids could see themselves in the storylines, such as one featuring a student athlete.

“I also think the visual aspect is really compelling. A number of students commented on that, particularly with the 'Grey's Anatomy' clip, seeing the patient cough up blood,” Hoffman said.

The clips were high-quality because they were for television shows, she said.

“I think that, especially in this day and age when we have such a media-saturated environment, it didn't surprise me that students found these clips more engaging than, for example, a video that I might try to make and post on Instagram,” Hoffman said.

Presenting information through entertaining TV shows may have felt more relatable to teens than facts alone would, said Dr. S. Christy Sadreameli, a volunteer medical spokeswoman for the American Lung Association and pediatric pulmonologist at Johns Hopkins Hospital in Baltimore. She was not involved in the study.

“It does raise the question of when teachers are interested in sharing information about vaping with their classes could they consider taking a similar approach, like showing an episode from one of these shows instead of a health-related video,” Sadreameli said.

Talking about marketing, especially when kids did not know they were the targets of it, can also be an entry point, she said.

“Our young people do not want to be taken advantage of that way,” Sadreameli said.

Concerns about vaping are significant because it sets up kids for lifelong nicotine addiction and also leads to health issues, including reduced ability to clear chest infections, worsening asthma and more.

“One group that I'm very interested in helping is this age group that the study targeted, because the rates of middle schoolers who are using vapes and e-cigarettes regularly is not as high as the high school students, and so you have more of a chance to impact them before they become addicted,” Sadreameli said.

Researcher Hoffman said testing this in other academic settings, such as suburban, rural and private schools, is a logical next step. Her team next plans to study nicotine and tobacco misinformation on social media.

“I'm really hopeful that research like this can help keep this bridge going between public health and content creators, so that we can help make sure that even though this content is designed primarily to entertain that the messages that students are taking and viewers are taking away are as educational as possible,” Hoffman said.

Study findings were published June 13 in the journal Health Promotion Practice.

More information

The U.S. Centers for Disease Control and Prevention has more on vaping and teens.

SOURCES: Beth Hoffman, PhD, MPH, postdoctoral associate, University of Pittsburgh School of Public Health, Department of Behavioral and Community Health Sciences; S. Christy Sadreameli, MD, MHS, volunteer spokeswoman, American Lung Association, and pediatric pulmonologist, Johns Hopkins Hospital, Baltimore; Health Promotion Practice, June 13, 2023, online