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Purpose To determine the association between exposure to FDA’s Fresh Empire tobacco public education campaign and tobacco-related beliefs. Design Repeated cross-sectional data collection design with embedded longitudinal cohort over six data collection waves. Setting 30 US evaluation markets. Sample Hip Hop peer crowd-identified US youth aged 12–18 (N = 5,378). Measures Self-reported brand and video ad awareness (saw any ad at least sometimes) and perceived effectiveness (1–5 scale) to describe campaign awareness and receptivity. Exogenous exposure was measured using population-adjusted broadcast and digital video impressions. Tobacco-related beliefs included beliefs about smoking risks, attitudes towards tobacco-free people and lifestyles, and normative beliefs about smoking. Analysis Descriptive analyses of awareness, receptivity, and agreement with tobacco-related beliefs. Logistic regression models to determine the relationship between broadcast and digital video impressions and beliefs. Intervention Fresh Empire campaign. Results The campaign generated a high level of reach (71% brand and 66% video ad awareness at final wave) and messages were well-received (across waves 3.5–4.1 mean perceived effectiveness scores). Higher broadcast television exposure was associated with increased agreement with five beliefs related to addiction/control, being a bad influence on family/friends, and cosmetic effects of smoking (breath and attractiveness) (ORs = 1.16–1.27, ( Ps < .05)). Conclusion Fresh Empire successfully reached and resonated with Hip Hop-identified youth. The campaign was associated with a limited number of targeted beliefs.

Virtual reality (VR) is widely recognised as a promising technology for training emergency first responders and other safety–critical workers. It is uniquely able to immerse trainees in extreme situations that are too risky or dangerous to be examined in traditional real-world safety training. Most organisations seeking to implement VR safety training often limit their decisions to financial and technological factors. However, in this paper, we argue that a socio-technical systems approach is required to better appreciate the social costs and benefits of VR training, which are important for a successful implementation. The paper also reports our own research on a real-world implementation of VR safety training for the Mine Rescue Brigades in New South Wales, Australia. The training—conducted in both fully immersive (360 VR) and non-immersive (Desktop VR) virtual reality—involved a search and rescue operation which was necessitated by an underground fire at the bottom of the transport drift in a coal mine. Following this training, the 368 trainees not only completed a post-training questionnaire, but also were interviewed, to assess their training experiences in the VR environment. The findings provide a comprehensive account of the social costs and benefits of adopting VR as a safety training tool. Overall, the trainees perceived the benefits to far outweigh the costs, with an overall high inclination to recommend the VR training to other colleagues. Desktop VR was found to be as fit for delivering successful training as the more immersive 360 VR. However, this Desktop VR generated considerably less motion sickness in trainees. These findings should help organisations and training providers decide on: (1) whether or not to invest in VR safety training solutions; (2) which type technology/method of delivery to use.

Cannabis legalization has rapidly spread throughout the United States and is associated with multiple public health outcomes, including driving under the influence of cannabis (DUIC). To improve understanding of the relationship between legalization and DUIC, we tested two potential mediators of this relationship: perceived safety and perceived legality of driving high. We analyzed data from 1,236 current (past 30-day) cannabis users who were recruited from states with recreational, medical only, or no legal cannabis between 2016 and 2017 using address-based and social media samples. Using a generalized linear model and adjusting for cannabis legalization, demographics, living in a state with a cannabis-specific drugged driving law, frequency of cannabis use, and weights, we found that perceived safety (risk ratio [RR] = 2.60, 95% CI [1.88, 3.58]), but not perceived legality (RR = 0.96, 95% CI [0.67, 1.37]), was significantly associated with DUIC. Perceived safety mediated the relationship between legalization and DUIC (Coeff: −0.12, 95% CI [−0.23, −0.01]). Models stratified by frequency of cannabis use yielded results consistent with those of pooled models except that, for frequent users, cannabis-specific driving laws were associated with a significantly lower risk of DUIC (RR = 0.64, 95% CI [0.44, 0.92]). Agencies developing cannabis-focused drugged driving educational campaigns should consider the potential role of perceived safety of driving high in DUIC campaigns.

The relationship between cannabis legalization and traffic safety remains unclear. Physiological measures of cannabis impairment remain imperfect. This analysis used self-report data to examine the relationship between cannabis legalization and driving under the influence of cannabis (DUIC). Using a cross-sectional national sample (2016-2017) of 1,249 past-30-day cannabis users, we regressed self-reported DUIC (driving within three hours of "getting high") on cannabis legalization (recreational and medical (recreational), medical only (medical), or no legal cannabis), adjusting for demographics, days of use (past 30 days), days of use*legal status, calibration weights, and geographic clustering. The risk of DUIC in recreational (risk ratio [RR] = 0.41, 95% confidence interval (CI):0.23-0.72) and medical (RR = 0.39, 95% CI:0.20-0.79) states was lower than in states without legal cannabis, with one exception. Among frequent cannabis users (≥20 days per month), there was a significantly lower risk of DUIC for those living in recreational states (RR = 0.70, 95% CI: 0.49-0.99), but not for those living in medical states (RR = 0.87, 95% CI: 0.60-1.24), compared to users living in states without legal cannabis. The risk of self-reported DUIC was lower in recreational and medical cannabis states compared to states without legal cannabis. The only exception was for frequent users in medical states, for whom there was no difference in risk compared to frequent users living in states without legal cannabis.

Cannabis legalization has spread rapidly in the United States. Although national surveys provide robust information on the prevalence of cannabis use, cannabis disorders, and related outcomes, information on knowledge, attitudes, and beliefs (KABs) about cannabis is lacking. To inform the relationship between cannabis legalization and cannabis-related KABs, RTI International launched the National Cannabis Climate Survey (NCCS) in 2016. The survey sampled US residents 18 years or older via mail (n = 2,102), mail-to-web (n = 1,046), and two social media data collections (n = 11,957). This report outlines two techniques that we used to problem-solve several challenges with the resulting data: (1) developing a model for detecting fraudulent cases in social media completes after standard fraud detection measures were insufficient and (2) designing a weighting scheme to pool multiple probability and nonprobability samples. We also describe our approach for validating the pooled dataset. The fraud prevention and detection processes, predictive model of fraud, and the methods used to weight the probability and nonprobability samples can be applied to current and future complex data collections and analysis of existing datasets.

This study seeks to validate the original and expanded susceptibility scales for smokeless tobacco (SLT) use among a longitudinal sample of rural male youth. We also compare the predictive validity of both scales for SLT.Data are from a five-wave longitudinal sample of rural males in the Unites States aged 11-16 at baseline. Data were collected from January 2016 to December 2018. We used a series of logistic regressions to identify whether individual demographic variables, the original (use SLT soon, in next year, if friend offers), or the expanded (original plus curiosity) susceptibility scales predicted experimentation with SLT by 2018. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of both scales were also calculated to determine reliability. All analyses were limited to 2016 never SLT users.Both susceptibility scales were significant predictors of SLT initiation by follow-up. Susceptible youth had three times the odds of SLT initiation by follow-up compared to youth who were non-susceptible. Both scales have high specificity, identifying a large proportion of never users as non-susceptible. Sensitivity for the original scale was 37.0% and increased to 44.2% for the expanded scale. The PPV was approximately 20% for both the original and expanded scales.The SLT susceptibility scales are valid for predicting future SLT initiation; however, there remains room for improvement as the sensitivity of both scales is relatively low compared to the smoking scale. Future research should examine additional methods to identify youth at risk of SLT initiation.

This paper discusses results from two successive rounds of virtual mines rescue training. The first round was conducted in a surround projection environment (360-VR), and the second round was conducted in desktop virtual reality (Desktop-VR). In the 360-VR condition, trainees participated as groups, making collective decisions. In the Desktop-VR condition, trainees could control their avatars individually. Overall, 372 participants took part in this study, including 284 mines rescuers who took part in 360-VR, and 243 in Desktop-VR. (155 rescuers experienced both.) Each rescuer who trained in 360-VR completed a battery of pre- and post-training questionnaires. Those who attended the Desktop-VR session only completed the post-training questionnaire. We performed principal components analysis on the questionnaire data, followed by a multiple regression analysis, the results of which suggest that the chief factor contributing to positive learning outcome was Learning Context, which extracted information about the quality of the learning content, the trainers, and their feedback. Subjective feedback from the Desktop-VR participants indicated that they preferred Desktop-VR to 360-VR for this training activity, which highlights the importance of choosing an appropriate platform for training applications, and links back to the importance of Learning Context. Overall, we conclude the following: 1) it is possible to train effectively using a variety of technologies but technology that is well-suited to the training task is more useful than technology that is “more advanced,” and 2) factors that have always been important in training, such as the quality of human trainers, remain critical for virtual reality training.

Immersive virtual reality (VR) is a powerful tool for vocational training - especially for safety-critical vocations where real-world training is often too complicated, expensive, or risky. Despite its apparent utility in this context, there is not yet a coherent, systematic framework that captures the key features of user learning experiences in immersive virtual reality environments. With the use of Structural Equation Modelling (SEM), this article presents a comprehensive framework which brings different dimensions (assessment criteria) together. This framework is informed by the analysis of 45 VR training sessions conducted by Mines Rescue Pty Ltd and total of 284 mines rescue brigades partook in this study and received training on specific mines rescue operation. The result of this study shows that actual and perceived learning was enhanced by trainee engagement with the scenario, their perception of the fidelity of the scenario, their sense of co-presence with other trainees, the perceived usability of the system, an overall positive attitude towards the technology, and the involvement of skilled trainers. These results suggest that: 1) there are multiple paths by which immersive VR training can have a positive impact on learning, and 2) immersive VR training will not replace the requirement for skilled trainers, but rather it can serve as an effective vehicle to convey their expertise.

BACKGROUND JUUL is an electronic nicotine delivery system (ENDS) resembling a USB device that has become rapidly popular among youth. Recent studies suggest that social media may be contributing to its popularity. JUUL company claims their products are targeted for adult current smokers but recent surveillance suggests youth may be exposed to JUUL products online. To date, there has been little attention on restricting youth exposure to age restricted products on social media. OBJECTIVE The objective of this study was to utilize a computational age prediction algorithm to determine the extent to which underage youth are being exposed to JUUL’s marketing practices on Twitter. METHODS We examined all of @JUULvapor’s Twitter followers in April 2018. For followers with a public account, we obtained their metadata and last 200 tweets using the Twitter application programming interface. We ran a series of classification models to predict whether the account following @JUULvapor was an underage youth or an adult. RESULTS Out of 9,077 individuals following @JUULvapor Twitter account, a three-age category model predicted that 44.9% are 13 to 17 years old (N=4,078), 43.6% are 18 to 24 years old (N=3,957), and 11.5% are 25 years old or older (N=1,042); and a two-age category model predicted that 80.6% (N=7,313) are under 21 years old. CONCLUSIONS Despite a disclaimer that followers must be of legal age to purchase tobacco products, the majority of JUUL followers on Twitter are under age. This suggests that ENDS brands and social media networks need to implement more stringent age-verification methods to protect youth from age-restricted content.

The ultimate aim of training is to improve task performance towards expert level. Novices and experts differ in their capability to understand and make sense of sensory information (for example, perception on environmental hazard). Computer-aided training, from online course to immersive simulation such as Virtual Reality (VR) [1]. van Wyk and de Villiers [2] define VR-based training environments as “real-time computer simulations of the real world, in which visual realism, object behavior and user interaction are essential elements”. The use of VR-based training environments assumes that Human-Machine interaction stimulates learning processes through better experiencing and improved memorization, leading to a more effective transfer of the learning outcomes into workplace environments. However, there are many human factors (internally and externally), which have impact on the quality of the training and learning process which need to be identified and investigated. The present study was conducted with Coal Services Pty Ltd, a pioneering training provider for the coal mining industry in NSW, Australia. The research focussed on 288 rescuers and the specific training programs developed for them. In this article, initially factors affecting the quality of the training and learning process for underground mine rescuers have been identified and then measured by using pre- and post-training questionnaires. We attempted to determine how much of the trainees’ perceived learning could be explained by pre-training (9 in total) and post-training (16 in total) factors. The relatively small size of the sample (288 observations for 17 predictors) and the high level of correlation between variables led us to Principal Component Analysis (PCA). Principle Component Analysis (PCA) has been used to investigate the underlying relationship among different variables. This technique results in factor reduction based on hidden relationships. Based on the nature of the pre-training factors mostly contributing to each component we have used the first 3 Components to create 3 new aggregated variables: “Positive State of Mind” (Component 1), “Negative State of Mind” (Component 2) and “Technology Experience” (Component 3). Similarly, based on the nature of the post-training factors mostly contributing to each component we have used the first 3 Components to create 3 new aggregated variables: “Positive Learning Experience” (Component 1), “Negative Learning Experience” (Component 2) and “Learning Context” (Component 3).

Interactive virtual reality (VR) is the most recent technology used to train workers for extreme event scenarios. VR training occurs in a safe and controlled environment and has the added benefit that it allows replicable testing of such scenarios. Like any other training method, VR based training must be evaluated. This study investigated the extent to which virtual training environment is able to address the training needs of the mining industry and overcome onsite (real world) training constraints. The present study was conducted with Coal Services Pty Ltd, a pioneering training provider for the coal mining industry in NSW, Australia. The research focused on specific training programs developed for the mine rescue brigades. These brigade teams are made up of highly specialized miner volunteers who provide the primary response to major incidents. The research framework examined the adequacy of training needs, technological capabilities and the implementation of interactive simulation. The research outcomes provide evidence-based information on the advantages and limitations of VR-based training for mining rescue brigades.

BACKGROUND Tobacco public education campaigns focus increasingly on hard-to-reach populations at higher risk for smoking, prompting campaign creators and evaluators to develop strategies to reach hard-to-reach populations in virtual and physical spaces where they spend time. OBJECTIVE The aim of this study was to describe two novel recruitment strategies (in-person intercept interviews in lesbian, gay, bisexual, and transgender [LGBT] social venues and targeted social media ads) and compares characteristics of participants recruited via these strategies for the US Food and Drug Administration’s This Free Life campaign evaluation targeting LGBT young adults who smoke cigarettes occasionally. METHODS We recruited LGBT adults aged 18-24 years in the United States via Facebook and Instagram ads (N=1709, mean age 20.94, SD 1.94) or intercept in LGBT social venues (N=2348, mean age 21.98, SD 1.69) for the baseline evaluation survey. Covariates related to recruitment strategy were age; race or ethnicity; LGBT identity; education; pride event attendance; and alcohol, cigarette, and social media use. RESULTS Lesbian or gay women (adjusted odds ratio, AOR 1.88, 95% CI 1.54-2.29, P CONCLUSIONS Social media combined with intercept provided access to important LGBT subpopulations (eg, gender and other sexual minorities) and a more diverse sample. Social media methods have more data quality issues but are faster and less expensive than intercept. Recruiting hard-to-reach populations via audience-tailored strategies enabled recruitment of one of the largest LGBT young adult samples, suggesting these methods’ promise for accessing hard-to-reach populations.

This study reports consumer reactions to the graphic health warnings selected by the Food and Drug Administration to be placed on cigarette packs in the United States. We recruited three sets of respondents for an experimental study from a national opt-in e-mail list sample: (i) current smokers aged 25 or older, (ii) young adult smokers aged 18-24 and (iii) youth aged 13-17 who are current smokers or who may be susceptible to initiation of smoking. Participants were randomly assigned to be exposed to a pack of cigarettes with one of nine graphic health warnings or with a text-only warning statement. All three age groups had overall strong negative emotional (s = 4.7, P < 0.001 for adults; s = 4.6, P < 0.001 for young adults and s = 4.0, P < 0.001 for youth) and cognitive (s = 2.4, P < 0.001 for adults; s = 3.0, P < 0.001 for young adults and s = 4.6, P < 0.001 for youth) reactions to the proposed labels. The strong negative emotional and cognitive reactions following a single exposure to the graphic health warnings suggest that, with repeated exposures over time, graphic health warnings may influence smokers' beliefs, intentions and behaviors.

Virtual Reality (VR) is the most recent technology used to train workers for extreme event scenarios. VR training occurs in a safe and controlled environment which allows the replicable testing of scenarios. Like any other training method, VR based training must be evaluated. This paper reports the trainees’ (mines rescue brigades men) state of mind prior attending 360-VR training and experiences of trainees in 360-VR training. Their perceptions of the realism, success and usefulness of this 360-VR training are discussed, and limitations and implications for future research are identified.

The national truth© campaign has exposed U.S. youth to antismoking messages since 2000. Tobacco industry–sponsored campaigns, such as “Think. Don’t Smoke” (TDS), have also aired nationally. We examine the effects of recall of the truth© and TDS campaigns on changes in tobacco-related beliefs, intentions, and smoking initiation in a longitudinal survey of U.S. youth. Recall of truth© was associated with increased agreement with antismoking beliefs, decreased smoking intentions, and lower rates of smoking initiation. Recall of TDS was associated with increased intentions to smoke soon but was not significantly associated with tobacco beliefs or smoking initiation among youth overall.

Significantly improved wear properties are described for glassy carbon following implantation with 2 MeV helium and 50 keV nitrogen to doses in the range 1015–1017 ions cm−2. Implanted material is up to 100 times more wear resistant to diamond abrasion than unimplanted material. Enhanced wear resistance is available at the surface with nitrogen but lies below the surface with helium, reflecting the difference in modified depth associated with implant energy and ion mass. Unusually for ion implantation, dose related surface compaction is observed for both nitrogen and helium. Changes in microstructure during implantation with particular regard to collision processes and amorphisation of the graphitic fraction of glassy carbon are discussed.

Implanted glassy carbon (GC; 50 keV, 1016 N+ cm-2) is reported to be 400 times more wear-resistant to 1 μm diamond polishing than unimplanted GC. A number of samples were implanted with 15N to produce the modified surface layer and to allow a very high sensitivity measurement of wear, using the 15N(p, α)12C nuclear reaction.Optical interferometric wear measurements are also reported. Samples implanted with 1 MeV N to 1015 ions cm-2 indicated that the enhanced wear-resistance is correlated with the nuclear energy loss density within the ion range. Mechanisms likely to be responsible for the enhanced wear resistance are also discussed.