Effects of E-cigarette Advertising Message Form and Cues on Cessation Intention: An Exploratory Study

Abstract

A common message in e-cigarette advertising is that e-cigarettes can be used anywhere. Ecigarette advertisements often express this message implicitly (e.g., "Whenever, wherever") alongside images of e-cigarettes that physically resemble combustible cigarettes. These implicit messages and "cigalike" images may cross-cue combustible cigarette smoking cognitions and behavior. This exploratory study was a 2 (message form: implicit or explicit e-cigarette use anywhere message) by 2 (presence or absence of e-cigarette cue) experiment with U.S. adult smokers (n = 2,201). Participants were randomized to view e-cigarette advertisements that varied by study condition. Three combustible cigarette outcomes were investigated: smoking cessation intention, smoking urges, and immediate smoking behavior. Mediation analysis was also performed to investigate mechanisms of the message form effect through descriptive and normative beliefs about smoking. Compared to its explicit counterpart, the implicit e-cigarette use anywhere message evoked greater smoking urges. Participants exposed to the implicit message also perceived cigarette smoking to be more prevalent and, in turn, reported greater cessation intention. There was no evidence of e-cigarette cue or message form × cue interaction effects. Implicit e-cigarette use anywhere messages may create a predisposition towards smoking compared to their explicitly written counterparts, but whether this effect undermines cessation deserves further attention.

Cue Reactivity to Electronic Cigarettes: A Systematic Review

“…Cue exposure to ENDS was found to enhance craving for conventional (tobacco) cigarettes in 10 studies, 67 , 70 - 77 , 82 while eight studies reviewed did not demonstrate such a relationship. 65 , 66 , 68 , 78 , 79 , 83 - 85 To ensure that this dichotomy was not the result of study quality or design, the groups were compared for whether studies had been conducted in person or online, their number of participants, year of publication, the generation of ENDS used and the quality or Risk of Bias assessment. No differences were found.…”

“…More than half of the studies (n = 15) investigated secondary outcomes, [65][66][67][69][70][71]74,[76][77][78][79][83][84][85][86] with some studies exploring more than one. Smoking latency, which relates to the participant's ability to abstain from smoking tobacco cigarettes (measured in time) versus obtaining money as a reward, was determined in five studies.…”