{
  "abstract": "Background: Youth vaping is increasing in Australia and internationally, highlighting the need for effective prevention and cessation strategies. Large-scale public health campaigns targeting vaping remain relatively uncommon, particularly those incorporating youth-informed design and rigorous evaluation. This project aimed to develop and evaluate a national, peer-to-peer anti-vaping campaign (UNCLOUD) using a multi-stage research approach.\n\nMethods: We conducted three sequential studies with young people aged 14–25 years in Australia (2022–2024). In Study 1, we used a cross-sectional national survey (n = 2,204) to assess vaping behaviors, attitudes, and perceived social norms. In Study 2, we conducted a qualitative study (n = 135) using interviews and group discussions to explore responses to anti-vaping messaging and inform campaign development. In Study 3, we implemented a repeated cross-sectional evaluation (n = 3,000) to assess campaign awareness, media performance, and self-reported attitudinal and behavioral outcomes. We compared participants who were aware versus unaware of the campaign using weighted analyses.\n\nResults: In Study 1, 29% of participants reported vaping in the past 30 days, while 77% perceived vaping as common among peers. In Study 2, participants identified messaging that focused on relatable, short-term harms and authentic peer-to-peer communication as most effective. The UNCLOUD campaign reached over 136 million individuals and generated over 9 million content views in the first 3 months post-launch. In Study 3, young people who vaped and recalled the campaign reported a greater desire to quit vaping (p = 0.001) and greater avoidance of vaping around others (p = 0.007) than those who were unaware of the campaign. Among young people who did not vape, 74% reported increased confidence to refuse vaping. Overall, 66% of participants reported taking at least one action after exposure to the campaign, such as discussing vaping with others or seeking additional information about vaping.\n\nConclusions: A multi-stage, youth-informed approach enabled us to develop a national anti-vaping campaign with substantial reach and engagement. Exposure to the campaign was associated with favorable self-reported attitudes and behaviors related to vaping. These findings support the potential value of theory-informed, peer-to-peer public health campaigns targeting youth vaping, although findings should be interpreted in light of the study design.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28534-3.",
  "abstract_shown": true,
  "affiliations": [
    "School of Clinical Medicine, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia",
    "Division of Quality of Life and Pediatric Palliative Care, Department of Pediatrics, Stanford University and Stanford Medicine Children’s Health, Stanford, USA",
    "Minderoo Foundation, Perth, Australia",
    "Hall and Partners, Sydney, Australia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
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        0,
        1,
        2
      ],
      "name": "Claire E. Wakefield"
    },
    {
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        0
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      "name": "Jordana K. McLoone"
    },
    {
      "affs": [
        2
      ],
      "name": "Nicole Lawrence"
    },
    {
      "affs": [
        2
      ],
      "name": "Tess Howard"
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    {
      "affs": [
        3
      ],
      "name": "Zoe Brown"
    },
    {
      "affs": [
        3
      ],
      "name": "Janelle Fandialan"
    },
    {
      "affs": [
        2
      ],
      "name": "Melan Hegermann"
    },
    {
      "affs": [
        2
      ],
      "name": "Melissa Gill"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9x0nkvq1qx9kt.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-28534-3",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13749692/",
  "id": "9x0nkvq1qx9kt",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://doi.org/10.1186/s12889-026-28534-3",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2739|Smoking Behavior and Cessation"
    ]
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  "openalex": "W7170075725",
  "pdf_url": null,
  "pmcid": "PMC13749692",
  "pmid": "43004248",
  "published": "2026-07-22",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/9x0nkvq1qx9kt.ris",
  "sources": [
    {
      "first_seen": "2026-11-14T12:22:24Z",
      "native_id": "PMC13749692",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12889-026-28534-3"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Smoking Behavior and Cessation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "‘UNCLOUD’ young lives: development and evaluation of a national peer-to-peer anti-vaping campaign for young people in Australia",
  "title_text": "‘UNCLOUD’ young lives: development and evaluation of a national peer-to-peer anti-vaping campaign for young people in Australia",
  "type": "peer-reviewed",
  "updated_at": "2026-11-14T12:22:24Z",
  "url": "https://research.draconitic.com/paper/9x0nkvq1qx9kt",
  "venue": "BMC Public Health",
  "versions": []
}