Introduction E-cigarettes are currently the most commonly used tobacco product among U.S. youth. However, unlike conventional cigarettes, e-cigarettes are not subject to marketing restrictions. This study investigates the association between exposure to e-cigarette marketing and susceptibility and use of e-cigarettes in youth. Methods Data were obtained from the 2014 National Youth Tobacco Survey. Participants were 22,007 U.S. middle and high school students. Multivariate logistic regression models assessed the relationship between e-cigarette marketing (internet, print, retail, TV/movies) and current and ever use as well as susceptibility to use e-cigarettes among never e-cigarette users. Results Exposure to each type of e-cigarette marketing was significantly associated with increased likelihood of ever and current use of e-cigarettes among middle and high school students. Exposure was also associated with susceptibility to use of e-cigarettes among current non-users. In multivariate models, as the number of channels of e-cigarette marketing exposure increased, the likelihood of use and susceptibility also increased. Conclusions Findings highlight the significant associations between e-cigarette marketing and e-cigarette use among youth, and the need for longitudinal research on these relationships.

These findings extend prior research on the timing of the onset of tobacco use by using longitudinal analyses from three contemporary cohort studies to include not just cigarettes, but also e-cigarettes, cigar products, and hookah. Among those who were never-users of tobacco products, young adults began to ever and currently use all tobacco products more than youth in these samples, a marked departure from prior decades of research.

BackgroundThis study investigates the association between exposure to tobacco advertising, promotion and sponsorship (TAPS) and cigarette use behaviours among adolescents in five Nigerian regions. This is imperative given a 2015 WHO report on the global tobacco epidemic, revealing Nigeria has not met any of the MPOWER TAPS ban indicators instituted since 2008.MethodsSecondary data analysis of the 2008 Global Youth Tobacco Survey for Nigeria. Participants were 1399 adolescents, representative of 5 Nigerian regions. Weighted multivariable logistic regression models were used to assess the relationship between TAPS exposure and (1) past 30-day (current) cigarette use, (2) ever cigarette use and (3) susceptibility to use cigarettes among never cigarette users. Sensitivity analysis via complete case analysis and multiple imputation were conducted.ResultsNinety-five per cent of Nigerian adolescents reported exposure to TAPS. Among adolescents who had never smoked, 15% were susceptible to use cigarettes. Cumulative TAPS exposure was significantly associated with both an increased odds of current cigarette use (AOR: 1.73; 95% CI 1.09 to2.99) and ever cigarette use (AOR: 1.29; 95% CI 1.15 to1.45); as well as increased susceptibility to cigarette smoking (AOR: 1.18; 95% CI 1.03 to 1.34), among non-smokers.ConclusionGiven study results, the emergence of new tobacco products and novel platforms for TAPS globally, implementation of existing policies and enhancement of efforts to attain comprehensive bans on all forms of direct and indirect TAPS in line with article 13 of the WHO Framework Convention on Tobacco Control are needed to reduce TAPS exposure and curtail tobacco use in Nigeria.