The association of adolescent e-cigarette harm perception to advertising exposure and marketing type

Abstract

Background Despite controversy over their possible health consequences, manufacturers of e-cigarettes employ a variety of marketing media to increase their popularity among adolescents. This study analyzed the relationship between adolescent e-cigarette harm perception and five types of e-cigarette advertising exposures: social media, radio, billboard, newspaper, and television. Methods This study used data from Wave 4.5 of the Population Assessment of Tobacco and Health Study (PATH). PATH collects demographic data and interview individuals about issues pertaining to tobacco use, health outcomes, attitudes, and behaviors. This study applied factor analysis to three individual PATH harm perception items to develop a composite harm perception score. Using linear regression, the study explored the relationship of harm perception and participant responses to their recalled viewing of five different types (i.e., newspaper, radio, billboard, television and social media) of advertisements within the past 30 days. A second analysis explored if adjusting for exposure to anti-tobacco messaging and environmental factors such as family approval mitigated the association of harm perception and advertisement types. Results The study sample consisted of 12,570 (weighted N = 23,993,149) individuals aged 12 to 17 years old. Unadjusted past 30-day exposure to newspaper, radio, billboard, and social media advertising all correlated with a reduced harm perception, but only the associations for newspaper and social media were statistically significant (p<0.05). After adjusting for environmental support factors, exposure to warning labels, and anti-tobacco advertisements, the analysis yielded statistically significant associations between increased e-cigarette harm perception and exposure to radio, billboard, and television advertisements (p<0.05). Adjusting for covariates also reduced the association of marketing and harm perception for all forms of media. Conclusion E-cigarette advertising influences adolescent perceptions of harm in e-cigarette use, particularly for social media and newspaper advertisements. This association weakens when adjusted for covariates such as environmental support and exposure to anti-tobacco marketing. These findings provide evidence for policy makers to continue anti-tobacco marketing and incorporate environmentally supportive strategies such as holistic, family-centered educational approaches to reduce e-cigarette use among adolescents.

Factors associated with e-cigarette use among vocational students: A cross-sectional multistage cluster survey, Thailand

“…Individual attitudes can typically be developed based on their knowledge and impression of the received information or message 34 . E-cigarette products’ packaging, flavors, and advertising on various social media platforms might persuade clients to gain positive attitudes or believe e-cigarettes provide less harmful effects 35 . Perceived behavioral control on e-cigarette use involves the person’s self-confidence.…”

Do Young People Perceive E-Cigarettes and Heated Tobacco as Less Harmful Than Traditional Cigarettes? A Survey from Poland

“…Scientific evidence of a link between exposure to tobacco advertising and increased use of tobacco, including e-cigarettes, has been implicated before. Published data show that e-cigarette marketing may have an impact on enabling potential users to perceive e-cigarettes as being safer for conventional cigarettes [ 23 , 24 , 25 , 26 , 27 ]; however, more detailed research could verify this thesis and determine whether the advertisement influences the perception in harmfulness of new nicotine and other tobacco products.…”

Beyond the label: current evidence and future directions for the interrelationship between electronic cigarettes and mental health

“…These vaping-related TikTok videos were largely found to positively depict electronic cigarette use ( 26 ). This is alarming given that advertising via social media significantly influences the perception of electronic cigarette harm in adolescents, even when controlling for exposure to warning labels and anti-tobacco advertising ( 27 ). Conversely, this highlights the potential by which social media can be used to communicate the harms of electronic cigarette use to these same adolescent and young adult populations.…”

“…Electronic cigarettes have been promoted as a safer alternative to tobacco cigarettes, which has led to increased product use among various populations (25)(26)(27)(28). However, electronic cigarette liquid and aerosols can pose many health risks to users (Figure 1).…”