If you’ve ever wondered why those dramatic anti-vaping posters — the ones with blackened lungs, coughing teenagers, and doom-filled slogans — seem to work on some people but bounce right off others, scientists have finally cracked the code.

A new study looked at how young people respond to fear-based e-cigarette warnings, and the takeaway is surprisingly human:
Fear doesn’t hit everyone the same way. And in some cases, it doesn’t hit at all.

The Big Idea: Fear Works… But Only If You Use It Right

Most public health campaigns rely on fear like it’s a Swiss Army knife.
“Show them something scary → they’ll stop.”

But that’s not how the human brain works.

So this study tested a more realistic model called the Extended Parallel Process Model (EPPM) — basically the psychology behind:

  1. whether fear grabs your attention, and
  2. whether you actually feel capable of doing something about the threat.

The twist? Researchers didn’t just measure fear — they also tested two other emotions that show up when someone feels threatened:

  • Anxiety
  • Anger

Turns out fear isn’t the only player in the game.

The Experiment: Scare People, Then See What Happens

Researchers showed young people different vape warnings with varying levels of:

  • Threat (low = “meh,” high = “you’re in danger”)
  • Efficacy (low = “not sure this helps,” high = “you can totally avoid this”)

Then they watched how fear, anxiety, and anger changed the results.

What They Found: Fear + Anger = Action

Here’s the low down of the actual science:

1. Big, scary warnings DO raise perceived risk — but mostly for older young adults

  • Ages 25–35? The dramatic warnings work.
  • Ages 15–24? Nothing.
    It’s like the Gen Z crowd collectively shrugged and said, “lol ok.”

2. High-threat warnings trigger both fear and anger

Not just fear.
Anger also drives people to take action.
That’s big — because public health campaigns rarely factor in anger as a useful emotion.

3. Fear doesn’t necessarily boost confidence

The surprising part?
Even big scary warnings don’t make young people feel more capable of avoiding vaping.
(Probably because most health messaging only screams about danger but never tells people what to actually do.)

4. But high-threat messages DO make people trust the recommendations more

If the warning feels serious, people are more likely to believe the suggested protective behavior actually works.

5. Smokers are basically numb to fear campaigns

  • Young smokers: no major reactions.
  • Young non-smokers: feel more threat → more fear → more motivated to avoid e-cigs.

6. Women respond more than men

  • Young women: fear boosts their sense of control and motivation to protect themselves.
  • Young men: almost no measurable change.
    Basically: women take vape warnings seriously, men… not so much.

Why Fear Campaigns Often Fail in China

The researchers highlight something weird:
Most Chinese public health messaging about e-cigs focuses on danger, policy, and industry stuff…
but barely mentions what people can do.

One analysis found that among 165 tobacco-control reports:

  • Only 8 explained how effective a recommended action was
  • Only 6 explained how capable people were of doing it

No wonder fear alone isn’t raising people’s sense of efficacy.

So What Should We Actually Do? The Study Offers 3 Solutions

1. Don’t just scare people — tell them what to do next

Show the danger and concrete ways to avoid it.
People need:

  • Simple steps
  • Realistic options
  • Something they can do today

2. Make the advice relevant to real life

Young people don’t want generic “vaping is bad” lectures.
They want:

  • Tips tied to daily routines
  • Strategies they’d actually use
  • Messaging that feels like it’s written for them

3. Tailor the message to specific groups

Because different people react differently:

  • Ages 25–35: high-threat messages with clear actions work best
  • Ages 15–24: fear alone won’t work — focus on knowledge + real-life impact
  • Young women: high-fear messaging increases protective motivation
  • Young men: need more than fear — try relevance, real consequences, and behavior-focused advice
  • Non-smokers: already sensitive to risk → reinforce their choices
  • Smokers: fear won’t budge them → use different tactics (skills, support, alternative behaviors)

Where the Research Goes Next

The scientists point out that “perceived susceptibility” — basically asking “How likely is it you’ll be harmed by vaping?” — might be too abstract.

Future studies should focus on correlation instead:

“Does vaping connect to problems in your life — relationships, money, stress?”

If people feel connected to the risk, fear might hit harder.

They also want to explore why fear, anxiety, and anger — three very different emotions — all lead to the same protective behavior.
(Anxiety has the strongest effect, by the way.)

Plus, the researchers admit the study had some limitations:

  • Small sample size
  • Fear-appeal materials need refining
  • The questionnaire may have been too long (people got bored)

But overall? This study gives public health officials a massive cheat code.

The Takeaway

Fear works…
but only on some people, at some ages, if you pair it with actionable advice, and only if the message doesn’t bore them to death.

If public health campaigns keep screaming “VAPING WILL DESTROY YOU” without telling young people what to do instead… the message gets lost.

But if you tell them:

  • “Here’s why e-cigs are risky”
  • “Here’s what you can do today to avoid the harm”
  • “Here’s why it actually works”
  • “Here’s why it matters to you”

…that’s when behavior actually changes.

The future of anti-vaping campaigns isn’t louder fear.

It’s smarter fear — targeted, actionable, and emotionally intelligent.

Sun C, Wang F, Jiang M. How Can E-Cigarette Fear Appeals Improve the Perceived Threat, Fear, Anger, and Protection Motivation of Young People. Front Psychol. 2021 Aug 30;12:676363. doi: 10.3389/fpsyg.2021.676363. PMID: 34526929; PMCID: PMC8435607.