Impact of Exposure to Electronic Cigarette Advertising on Susceptibility and Trial of Electronic Cigarettes and Cigarettes in US Young Adults: A Randomized Controlled Trial (original) (raw)

Association between E-Cigarette Advertising Exposure and Use of E-Cigarettes among a Cohort of U.S. Youth and Young Adults

International Journal of Environmental Research and Public Health

Youth and young adult (YYA) use of e-cigarettes increased rapidly between 2010 and 2019 in the United States, during which exposure to e-cigarette advertising was also increased. We aimed to examine whether exposure to e-cigarette advertising among YYAs may lead to subsequent e-cigarette use. A cohort of 3886 YYAs ages 13–24 was recruited from two survey panels in 2018 and followed up until 2019. Survey data were collected online and by telephone. The primary outcome was past 30-day use of e-cigarettes at the follow-up survey. Among 2304 YYAs who retained at the follow-up survey and were not past 30-day e-cigarette users at baseline, both youth and young adults exposed to e-cigarette advertising at baseline had elevated odds of past 30-day e-cigarette use at follow-up (Youth adjusted odds ratio (aOR): 2.77, 95% CI: 1.23, 6.24; Young adults aOR: 2.34, 95% CI: 1.08, 5.11) compared with those not reporting baseline advertising exposure. The majority of YYAs reported exposure to e-cigar...

A Randomized Trial of the Effect of Youth Appealing E-Cigarette Advertising on Susceptibility to Use E-Cigarettes Among Youth

Nicotine & Tobacco Research, 2017

Introduction: Very little is known about how e-cigarette marketing is being perceived by youth, and the potential effect it will have on youth vaping and smoking behaviors. This limits the ability to identify youth-focused marketing efforts and to design effective policies for the regulation of e-cigarette marketing content and placement. Methods: A sample of 417 nonsmoking youth (mean age = 15, SD = 1.3) were randomly assigned to either view four e-cigarette ads with low youth appeal, four e-cigarette ads with high youth appeal or four control ads. After exposure, participants completed covert and overt measurements of e-cigarette and tobacco cigarette attitudes and susceptibility to use. Results: Youth in an e-cigarette ad condition were more likely to select an e-cigarette item in a product choice task compared to control, and had more positive e-cigarette beliefs. Contrary to hypotheses, youth in the low youth appeal condition reported greater susceptibility to trying e-cigarettes and tobacco cigarettes compared to control. Conclusions: Exposure to any e-cigarette advertising may play a role in teens' decision to initiate e-cigarette and tobacco cigarette use. As the Food and Drug Administration now has regulatory authority over the marketing of e-cigarettes, regulations on e-cigarette advertising are suggested. Implications: Teens are increasingly being exposed to e-cigarette advertising, and many places are considering e-cigarette regulations, yet we know very little about how e-cigarette advertisements might influence youth tobacco use. This study utilized a novel dataset of e-cigarette ads coded for youth appeal and presented them to a sample of 417 nonsmoking teens in a randomized controlled design to test the effect of features on youth susceptibility to initiating e-cigarette and tobacco cigarette use. The findings inform evidence-based recommendations for regulating the marketing of e-cigarettes.

Who Is Exposed to E-Cigarette Advertising and Where? Differences between Adolescents, Young Adults and Older Adults

International Journal of Environmental Research and Public Health, 2019

Little is known about differences between adolescents’ and adults’ exposure to e-cigarette advertising in various media channels, such as retail establishments, print, television, radio, and digital marketing. We examined the exposure to e-cigarette advertising in these channels amongst adolescents (13–17), young adults (18–25), and older adults (26+). Adolescents (N = 1124), young adults (N = 809), and adults (N = 4186) were recruited through two nationally representative phone surveys from 2014–2015. Lifetime e-cigarette advertising exposure was prevalent (84.5%). Overall, older adult males and older adult cigarette smokers reported the highest exposure to e-cigarette advertising (p < 0.001). Television was the largest source of exposure for all age groups. Adolescents and young adults had higher odds than older adults of exposure through television and digital marketing. However, adolescents had lower odds than young adults and older adults of exposure through retailers and pr...

E-cigarette openness, curiosity, harm perceptions and advertising exposure among U.S. middle and high school students

Preventive medicine, 2018

Understanding factors associated with youth e-cigarette openness and curiosity are important for assessing probability of future use. We examined how e-cigarette harm perceptions and advertising exposure are associated with openness and curiosity among tobacco naive youth. Findings from the 2015 National Youth Tobacco Survey (NYTS) were analyzed. The 2015 NYTS is a nationally representative survey of 17,711 U.S. middle and high school students. We calculated weighted prevalence estimates of never users of tobacco products (cigarettes, cigars/cigarillos/little cigars, waterpipe/hookah, smokeless tobacco, bidis, pipes, dissolvables, e-cigarettes) who were open to or curious about e-cigarette use, by demographics. Weighted regression models examined how e-cigarette harm perceptions and advertising exposure were associated with openness using e-cigarettes and curiosity about trying e-cigarettes. Among respondents who never used tobacco products, 23.8% were open to using e-cigarettes and...

Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students

Pediatrics, 2016

Electronic cigarette (e-cigarette) use among US students increased significantly during 2011 to 2014. We examined the association between e-cigarette advertisement exposure and current e-cigarette use among US middle school and high school students. Data came from the 2014 National Youth Tobacco Survey (n = 22 007), a survey of students in grades 6 through 12. The association between current e-cigarette use and exposure to e-cigarette advertisements via 4 sources (Internet, newspapers/magazines, retail stores, and TV/movies) was assessed. Three advertising exposure categories were assessed: never/rarely, sometimes, and most of the time/always. Separate logistic regression models were used to measure the association, adjusting for gender, race/ethnicity, grade, and other tobacco use. Compared with students who reported exposure to e-cigarette advertisements never/rarely, the odds of current e-cigarette use were significantly (P < .05) greater among those reporting exposure sometim...

Exposure to e-cigarette TV advertisements among U.S. youth and adults, 2013–2019

PLOS ONE, 2021

Introduction E-cigarette advertising has been shown to increase e-cigarette awareness and use. Although e-cigarette marketing in the early 2010s has been well-documented, little is known about how it has changed in recent years in response to the regulatory scrutiny from the FDA and the Congress to combat youth vaping epidemic. This study aims to examine the exposure to e-cigarette TV advertising among youth and adults in the U.S. from 2013 to 2019, overall and by media market and brand. Methods Quarterly data on e-cigarette TV advertising exposure, measured by target rating points (TRPs), and expenditures from 2013 to 2019 were compiled from the StradegyTM of Kantar Media. Trends of quarterly e-cigarette advertising TRPs were reported by age group, market, and brand. Results Over the study period, overall exposure to e-cigarette TV advertising was higher among adults than among youth. E-cigarette advertising TRPs and expenditures were relatively stable, despite intermittent fluctua...

Marketing a healthier choice: exploring young people’s perception of e-cigarettes

2017

Background: As a consequence of insufficient evidence on the safety and efficacy of e cigarettes, there has been much controversy surrounding its use in the tobacco control field. Objectives: We sought to examine smoking prevalence and salience of e-cigarettes marketing stimuli, and whether these affected attitude-relevant responses toward e-cigarettes and intention to vape. Methodology: A convenience sampling procedure was used to recruit 436 ever- and never-smokers aged 18 or older in the UK. Correlation analysis and structural equation modelling tested direct and indirect relationships between salience of e-cigarettes marketing messages, attitude relevant variables, and intention to vape. Results: Just over half of never-smokers were females compared to two-thirds of ever-smokers who were males. Majority of respondents comprising 56% of ever-smokers and 63% of never-smokers had seen e-cigarette promotion in stores or gas stations. Only a third or less of ever- and never-smokers h...

Effects of branded health messages on e-cigarette attitudes, intentions, and behaviors: a longitudinal study among youth and young adults

BMC Public Health

Background Launched in 2000, the truth campaign was one of the first health-related campaigns to embrace the building of a brand to further amplify its message, such as by building brand equity. Brand equity is an asset that represents the audience’s perception of the brand. Previous research supports that strong brand equity is associated with lower tobacco intentions and behaviors; however, brand equity and its change over time have not been studied as it relates to e-cigarettes. This study examines the effects of change in brand equity on e-cigarette attitudes, intentions, and behaviors among youth and young adults. Methods The sample (N = 6427) is from the Truth Longitudinal Cohort, a nationally representative, longitudinal cohort of youth and young adults, ages 15–24. Variables include brand equity tobacco scale, demographic characteristics, and e-cigarette use status. The outcomes included anti-e-cigarette attitudes, intentions to use e-cigarettes, and use of e-cigarettes. Mul...