Electronic Cigarette Advertising Impacts Adversely on Smoking Behaviour Within a London Student Cohort: A Cross-Sectional Structured Survey

Abstract

IntroductionIn contrast to tobacco smoking, electronic cigarette (“vaping”) advertisement had been approved in the United Kingdom (UK) in January 2013. Currently, there are an estimated 3.2 million UK e-cigarette users. The impact of e-cigarette advertisement on tobacco use has not been studied in detail. We hypothesised that e-cigarette advertisement impacts on conventional smoking behaviour.MethodsA cross-sectional structured survey assessed the impact of e-cigarette advertising on the perceived social acceptability of cigarette and e-cigarette smoking and on using either cigarettes or e-cigarettes (on a scale of 1 to 5/‘not at all’ to ‘a lot’). The survey was administered between January to March 2015 to London university students, before and after viewing 5 UK adverts including a TV commercial.ResultsData were collected from 106 participants (22 ± 2 years, 66% male), comprising cigarette smokers (32%), non-smokers (54%) and ex-smokers (14%). This included vapers (16%), non-vapers (77%) and ex-vapers (7%). After viewing the adverts, smokers (2.6 ± 1.0 vs. 3.8 ± 1.1, p = 0.001) and non-smokers (3.2 ± 0.7 vs. 3.7 ± 0.8, p = 0.007) felt smoking was more socially acceptable, compared to before viewing them. Participants were more likely to try both e-cigarettes (1.90 ± 1.03 to 3.09 ± 1.11, p < 0.001) and conventional cigarettes (1.73 ± 0.83 to 2.27 ± 1.13, p < 0.001) after viewing the adverts compared to before. Vapers were less likely to smoke both an e-cigarette, and a conventional cigarette after viewing the adverts.ConclusionE-cigarette advertising encourages both e-cigarette and conventional cigarette use in young smokers and non-smokers. The adverts increase the social acceptability of smoking without regarding the importance of public health campaigns that champion smoking cessation.Electronic supplementary materialThe online version of this article (10.1007/s00408-019-00262-z) contains supplementary material, which is available to authorized users.

Exposure to e-cigarette advertising and provaping websites, and the social acceptability of their use among nicotine users

“…In a separate model that included the number of channels through which participants were exposed to e-cigarette advertisements (Table 3), participants who noticed advertisements in more places were more likely to perceive e-cigarettes of the acceptability of their use. This finding is consistent with a study in a cohort of university students (20-24 years) in the United Kingdom of Great Britain and Northern Ireland which found that exposure to e-cigarette advertisements increased the social acceptability of both e-cigarette use and smoking (14). Previous research has shown that e-cigarette advertisements as lifestyle marketing tend to be more effective when the advertisements feature characters who are similar to a person's peers (15), and such advertising could increase how socially acceptable or desirable these devices are, thus increasing their use or even functioning as a gateway to smoking initiation (16,17).…”

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

“…Exposure to e-cigarette marketing and advertising has increased among youth in recent years [11] and prior research suggests such exposure may be associated with perceptions of, interest in, and use of e-cigarettes among youth and young adults . The majority of previous studies on e-cigarette advertising utilized either a cross-sectional [12][13][14][15][16][17][18][19][20]33,36,39,40] or experimental design [21][22][23][24][25][26] to assess associations between advertising and e-cigarette perceptions, susceptibility, or use. Among the cross-sectional studies, many utilized National Youth Tobacco Survey (NYTS) data on reported advertising exposure via several media channels and e-cigarette use, or intentions to use [12,[14][15][16][17][18][19]39].…”

“…Additionally, much of the prior e-cigarette advertising research involves only youth aged 11-17 years [12][13][14][15][16][17][18][19][21][22][23][24][25][28][29][30]32,33,[38][39][40], with few examining the impact of ecigarette advertising specifically on young adults aged 18-29 years [20,26,31,35,37]. Chen-Sankey et al examined a cohort of both youth and young adults to assess the impact of advertising exposure on e-cigarette use, finding a relationship between marketing exposure and e-cigarette experimentation [27].…”

Beliefs and perceptions of electronic cigarettes among medical staff in respiratory departments of Fujian Province, China, in 2021

“…Studies have shown that e-cigarette aerosols contain nicotine, carbonyl compounds, nitrosamines, lead, cadmium and other harmful substances 5 , 6 , but the content of these harmful substances is significantly lower than that of tobacco 7 . The industry has adopted active marketing strategies on media and social networks to promote e-cigarettes as a healthier alternative to cigarettes 8 , 9 . However, harm reduction does not mean ‘no risk’.…”