Objective We examined the impact of e-cigarette advertising on e-cigarette use behaviors among youth over time. Methods At baseline, 3907 students participated in a youth tobacco surveillance study from 2014–2015 and 2488 students completed a 6-month follow-up. Weighted logistic regression models investigated the recall of e-cigarette advertisements (TV/radio/billboards/retail/Internet) as a risk factor for e-cigarette perceived harm, use, and susceptibility. Results The odds of ever e-cigarette use was 3 times higher (AOR=2.99; 95% CI, 1.50–5.97) at 6-month follow-up among e-cigarette never-users who recalled e-cigarette advertisements in retail stores at baseline, compared to those who did not. Likewise, the odds of current e-cigarette use and susceptibility to e-cigarette use at 6-month follow-up were 2.03 (95% CI, 1.11–3.72) and 1.77 (95% CI, 1.20–2.61), respectively. Additionally, recall of e-cigarette advertisements on the Internet at baseline was significantly related to current use (AOR=2.17; 95% CI, 1.05–4.48) and susceptibility to use e-cigarettes (AOR=1.72;95% CI, 1.15–2.58) at 6-month follow-up. Conclusions Recall of e-cigarette advertisements at point-of-sale and on the Internet was significantly associated with adolescent e-cigarette susceptibility and use, which supports the need to minimize adolescent exposure to these advertisements.

E-cigarettes are the most commonly used tobacco product among youth. In addition to harm potential, e-cigarette use is associated with initiating cigarette smoking. Limited research exists whether susceptibility to e-cigarette use is a risk factor for future tobacco and other substance use initiation. This study examined associations between baseline e-cigarette susceptibility and initiation and past 30-day use of e-cigarettes and cigarettes as well as initiation of marijuana and alcohol one year later, after adjusting for other risk factors and sociodemographic confounders. The study sample consisted of 5156 nationally representative youth (12–17 years) who completed both waves 1 (2013–2014) and 2 (2014–2015) of the Population Assessment of Tobacco and Health (PATH) study and were never users of tobacco, marijuana, and alcohol in Wave 1. Youth who were susceptible to e-cigarettes had increased odds of initiating e-cigarettes (adjusted OR: 2.22, 95% CI: 1.55–3.18), marijuana (aOR: 1.66, 95% CI: 1.12–2.46), and alcohol (aOR: 1.61, 95% CI: 1.26–2.06) between waves, as well as past reporting 30-day e-cigarette use (aOR: 3.64, 95% CI: 1.93–6.89) in Wave 2. Additionally, cigarette susceptibility, but not e-cigarette susceptibility, was associated with cigarette initiation (aOR: 3.36, 95% CI: 1.95–5.82) and past 30-day use (aOR: 2.83, 95% CI: 1.34–5.97). Prevention policies, as well as future research, could target youth susceptible to e-cigarettes to reduce the current trends on the use of these alternative tobacco products. Such efforts may also reduce the use of cigarettes and other substances.

Objective Understanding the impact of tobacco marketing on e-cigarette (EC) susceptibility and perceptions is essential to inform efforts to mitigate tobacco product burden on public health. Methods Data were collected online in 2016 from 634 conventional cigarette (CC) smokers and 393 non-smokers using a convenience sample from Amazon Mechanical Turk. Logistic regression models, stratified by smoking status and adjusted for socio-demographics, examined the relationship among tobacco advertisements and coupons, EC and CC susceptibility, and EC perceptions. Results Among non-smokers, increased exposure to tobacco advertising and receiving tobacco coupons was significantly related to measures of EC and CC susceptibility (p < .05). Older, more educated non-smokers had decreased odds of EC susceptibility (p < .05). Additionally, increased exposure to tobacco advertising was significantly associated with the perceptions of EC not containing nicotine and being less addictive than CC among smokers (p < .05). Conclusions Increased exposure to tobacco advertising outlets could influence future EC and CC use in non-smokers and perceptions in smokers, while receiving coupons could affect EC and CC susceptibility among nonsmokers. Future research is needed to determine whether policies to minimize exposure to tobacco marketing reduce EC use by decreasing susceptibility.

Parent encouragement of PA and neighborhood safety are potential predictors of child outdoor PA and could be targeted in youth PA interventions.

Background: While e-cigarette use is increasing, reasons to use e-cigarettes are poorly summarized in the literature. The objective of this study was to organize reasons to use e-cigarette items into factors and determine associations between these factors and e-cigarette user characteristics. Methods: Data were drawn from youth (12–17) and adults (18+) in Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) study. Exploratory factor analysis was conducted on 13 reasons to use survey items from experimental and established adult e-cigarette users and past 30 day youth e-cigarette users to determine two factors – “alternative to cigarettes” and “larger social environment”. Weighted linear regression models tested the associations between e-cigarette user group and sociodemographics and reasons to use factors among youth and adults. Results: Adult current established e-cigarette users were associated with both alternative to cigarettes (β = 0.128, p < .001) and larger social environment (β = 0.063, p < .001) factors, while former established e-cigarette users were associated with alternative to cigarettes (β = 0.064, p < .001). Several adult socio-demographic characteristics were associated with one but not the other factor, or both but in opposite directions. Youth that used e-cigarettes earlier today were also associated with both reasons to use factors (β = 0.127–0.130, p < .01, each); however, youth using any other day in the past 30 days was not associated with either factor. Conclusions: Reasons to use are associated with patterns of e-cigarette use among youth and adults. These factors could support a comprehensive approach to addressing rising e-cigarette use among youth and adults and target certain user populations.