Recall of E-cigarette Advertisements and Adolescent E-cigarette Use

Nicksic, Nicole E.; Harrell, Melissa B.; Pérez, Adriana; Pasch, Keryn E.; Perry, Cheryl L.

doi:10.18001/trs.3.2.9

Cited by 44 publications

(63 citation statements)

References 48 publications

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“…Exposure to EC advertising were associated with susceptibility to trying ECs, [ 28 , 29 , 51 , 52 ] and we further showed the AORs were similar when exposed to online and traditional broadcast media (Supplementary Table 1 ). Tobacco advertising in traditional media are increasingly banned globally.…”

Section: Discussionsupporting

confidence: 52%

“…Cohort studies have reported that adolescents exposed to online tobacco marketing were more likely to initiate tobacco use and progress to poly-tobacco use [ 27 ]; those who recalled EC advertisements at baseline were 77% more likely to be susceptible to EC use (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] 1.20–2.61) and twice more likely to use ECs (2.99, 1.50–5.97) within 6 months [ 28 ]. A randomised controlled trial (RCT) showed that exposure to EC advertising increased curiosity to try ECs (2.85, 1.07–7.61) in young adults who had never used cigarettes or ECs [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Exposure to e-cigarette advertising, attitudes, and use susceptibility in adolescents who had never used e-cigarettes or cigarettes

Wang

Chen

et al. 2020

BMC Public Health

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Background Tobacco advertisements have been banned in Hong Kong, but low intensity e-cigarette (EC) advertising can still be found in various media outlets. We investigated the associations between exposure to EC advertising and susceptibility to EC use in adolescents who had never used cigarettes or ECs, with potential mediation by attitudes towards ECs and the tobacco industry. Methods The School-based Smoking Survey 2016/17 assessed exposure to EC advertising in the past 30 days, attitudes towards ECs and the tobacco industry, susceptibility to EC use, and other covariates. Generalised linear mixed models and multiple mediation analysis methods were used in data analyses. Results Among 7082 students (mean age 14.9 years), 28.8% reported exposure to EC advertising. Exposure was associated with being uncertain about the harm of EC use, being tolerant towards ECs, believing the tobacco industry is respectable, and being susceptible to EC use; the magnitudes of these associations increased with the number of types of advertising exposed (0, 1, and ≥ 2) (all p -values < 0.01). These attitudinal factors were in turn associated with EC use susceptibility (all p-values < 0.001). The perception that tobacco companies make youth smoke was not associated with the advertising exposure or EC use susceptibility. Of the total effects of EC advertising on use susceptibility, only 16.6% were mediated by attitudinal factors: perceived harm (3.1%), attitudes towards ECs (8.2%), and attitudes towards the tobacco industry (4.9%). Conclusions Even exposure to low intensity EC advertising was associated with susceptibility to EC use in adolescents who had never used cigarettes or ECs. The association was weakly mediated by tolerant attitudes towards ECs and the tobacco industry. The government should reinforce the regulations on EC advertising to protect adolescent health.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Exposure to e-cigarette advertising, attitudes, and use susceptibility in adolescents who had never used e-cigarettes or cigarettes

Wang

Chen

et al. 2020

BMC Public Health

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“… 41 Annual smokeless tobacco marketing expenditures nearly doubled from 2002 ($235 million) to 2010 ($444 million) and remained steady through 2014. 12 This widespread marketing exposure has been linked to increased product awareness 42 and product use 16 , 43 among adolescents. Furthermore, promotional tactics for these products have specifically targeted existing tobacco users.…”

Section: Discussionmentioning

confidence: 99%

Marketing Exposure Recall is Associated With Past 30-Day Single, Dual, Polytobacco Use Among US Adolescents

Mantey

Creamer

Pasch

et al. 2018

Nicotine &Amp; Tobacco Research

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IntroductionThis study assesses the relationship between tobacco/e-cigarette marketing exposure and single, dual, and polytobacco product use, among adolescents. Given the increased use of noncigarette tobacco products (eg, cigars, e-cigarettes, hookah) among youth, it is imperative to understand if marketing exposure is associated with dual and polytobacco product use.MethodsData were obtained from the 2014 National Youth Tobacco Survey and weighted to be representative of US middle and high school students. Multivariable multinomial logistic regression models were used to assess the relationships between product marketing (via internet, print, retail, and TV/movies) and past 30-day single, dual, and poly (three or more) tobacco product use. Three analyses were conducted using different categories as referent groups to allow for comprehensive examination of the relationships between all groups.ResultsMarketing exposure was significantly correlated with a greater risk of single, dual, and polytobacco product use relative to nonusers. Relative to single product users, product marketing exposure was significantly correlated with a greater relative risk of dual and polytobacco use. There was no statistical difference in the association of marketing exposure between dual and polytobacco use, in any model.ConclusionA positive relationship between tobacco product marketing exposure and number of tobacco products used was observed. The magnitude of the relationship grew from single product to dual/poly use. Restrictions of marketing of all tobacco products, similar to cigarettes, particularly in the retail setting, should be considered.ImplicationsThis study has two primary public health implications. First, self-reported exposure to tobacco/e-cigarette marketing is widespread among adolescents of all tobacco product categories. Second, this widespread exposure to tobacco/e-cigarette marketing appears to not only be correlated with use of a single tobacco product (eg, cigarettes, e-cigarettes), but also multiple tobacco products. While longitudinal studies are needed to further investigate the relationships observed in this study, findings justify further study given the known relationship between tobacco marketing exposure and subsequent cigarette use.

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“…Youth were asked how often they recalled seeing ads or promotions for tobacco products in four contexts: online, in newspapers or magazines, outdoors and in stores [39]. Categorical responses were recoded (‘never’, 0; ‘rarely/sometimes,’ (1); ‘most of the time/always’, (2); and summed across the four questions, creating a linear index (range = 0–8) measuring cumulative exposure to tobacco ads [3,40].…”

Section: Methodsmentioning

confidence: 99%

Effect of e‐cigarette advertisement themes on hypothetical e‐cigarette purchasing in price‐responsive adolescents

et al. 2020

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Aims To examine the effect on adolescents of exposure to different e‐cigarette advertisement themes on reported likelihood of purchasing e‐cigarettes in a hypothetical scenario. Design Between‐subjects design of four randomly assigned thematic conditions derived from a content analysis of 350 e‐cigarette advertisements: general, flavor‐ and taste‐themed, people‐ and product use‐themed or control advertisements for bottled water. Setting Virginia, USA. Participants Of 1360 adolescents (13–18 years old) participating, 1063 had complete data (519 current cigarette smokers, 544 tobacco‐susceptible non‐smokers). Measurements Participants completed an e‐cigarette purchase task, reporting the likelihood of buying an e‐cigarette at various prices. Indices of abuse liability included price responsiveness (whether likelihood of purchase decreased with increasing prices) and, among price‐responsive adolescents, breakpoint (highest price before definitely would not buy), maximum probability‐weighted expenditure (Omax) and price elasticity (how quickly willingness to purchase decreases as prices increase). Regressions controlled for demographics, prior tobacco ad exposure, tobacco/substance use and sensation‐seeking. Findings Prior advertisement exposure was positively associated with being price‐responsive [odds ratio (OR) = 1.12, 95% confidence interval (CI) = 1.03, 1.22; P < 0.05]. Among price‐responsive adolescents (n = 579), breakpoints were 58% higher in the flavor‐ and taste‐themed condition (β = 0.46, 95% CI = <0.01, 0.92) and 75% higher in the people‐ and product use‐themed condition (β = 0.56, 95% CI = 0.10, 1.03) compared with control (Ps < 0.05). Exposure to people‐ and product use‐themed advertisements was associated with a 60% higher Omax (β = 0.47, 95% CI = 0.01, 0.93; P < 0.05). The general and people‐ and product use‐themed conditions were associated with 19% (β = −0.21, 95% CI = –0.38, ‐0.04) and 21% (β = −0.24, 95% CI = –0.42, −0.06) lower elasticity, respectively (Ps < 0.05). Conclusions E‐cigarette advertising exposure may increase reported likelihood of purchasing e‐cigarettes, with effects differing by advertisement content. People‐ and product use‐themed e‐cigarette advertisements increased reported likelihood of purchasing in price‐responsive adolescents.

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Recall of E-cigarette Advertisements and Adolescent E-cigarette Use

Cited by 44 publications

References 48 publications

Exposure to e-cigarette advertising, attitudes, and use susceptibility in adolescents who had never used e-cigarettes or cigarettes

Exposure to e-cigarette advertising, attitudes, and use susceptibility in adolescents who had never used e-cigarettes or cigarettes

Marketing Exposure Recall is Associated With Past 30-Day Single, Dual, Polytobacco Use Among US Adolescents

Effect of e‐cigarette advertisement themes on hypothetical e‐cigarette purchasing in price‐responsive adolescents

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