Reducing at-Risk Teen Smoking and Vaping: Evidence of Success from the Syke "Alternative" Teen Campaign

Background: While peers influence teen risk behaviors, few programs target the behavioral norms of risky subcultures. However, these subcultures must change to cause lasting behavior change.

Program background: The "Syke" Campaign was developed to reach “Alternative” subculture youth and has been implemented in Virginia since 2009 with funding from the Virginia Foundation for Health Youth. Syke uses a social marketing strategy that promotes the association between healthy behaviors and desired social identities through the use of carefully tailored messages, cultural experiences and influencers. By working with rock bands and other influencers, Syke aims to change the social norms around smoking and vaping within the Alternative subculture and promote the idea that living tobacco-free is an important component of the Alternative social identity.

The Syke Campaign uses a variety of approaches to reach the target audience, including: 1) Experiential marketing, which includes in-person interactive experiences at organized rock concerts; 2) Brand ambassadors, which are socially influential youth within the subculture trained to conduct peer-to-peer anti-tobacco and anti-vaping messaging; 3) Direct mail, which allows messaging to be delivered in an uncluttered and uncompetitive manner; 4) Paid digital and facilitated social media with the goal of building relationships with Alternative teens; and 5) Traditional media which expands Syke’s message to a larger, state-wide audience while reinforcing the campaign’s cultural authority to those who experience it through one of the other strategies.

Paid digital and social media were particularly important for Syke. The advanced targeting tools available on YouTube, Facebook, Instagram, Snapchat and Twitter were used to target teens with specific cultural interests that are associated with smoking. This reduced media waste and maximized the latest digital technologies.

Evaluation Methods and Results: Data collection since 2010 includes two methodologies: 1) In-person time-location sampling method (Raymond et al., 2007) at five time points from 2010 to 2014; and 2) Keyword targeted Facebook ad recruitment in 2015 and 2016. Campaign awareness, campaign exposure, campaign receptivity, knowledge, attitudes, and beliefs regarding smoking and vaping were assessed.

By the fifth year of campaign implementation, 61% of all teens surveyed were aware of Syke, 60% had been to a Syke event and nearly 60% had been to the Syke website or Facebook page. From 2011 to 2014, there was a 35.9% reduction in overall past 30-day smoking rates among all teens. This decline was most prominent for Alternative teens, whose smoking prevalence have reduced 49.7% since 2011 compared to 26.7% reduction for non-Alternative teens.

Following the transition to the online data collection method, overall past 30-day tobacco use decreased 11.1% between 2015 and 2016 with the decline more prominent among Alternative teens.

Conclusions: Not all youth are at the same risk for smoking and vaping, and risk varies based on subculture identification. Specific targeted campaigns can reach high-risk subcultures with proper targeting and tailoring.

Implications for research and/or practice: Interventions may prove more effective if they target at-risk youth in a culturally authentic way similar to how Syke targets teens that identify with the Alternative subculture.