E-cigarette marketing linked to teen e-cigarette use

Using data from the 2014 National Youth Tobacco Survey, researchers found that youth were exposed to e-cigarette marketing messages through many channels: retail settings, internet, print, television and movies. Of the 22,007 middle and high school students who were surveyed, 20 percent had tried e-cigarettes before and 9 percent were current users.

Students who had tried e-cigarettes before were 16 percent more likely to have encountered an e-cigarette marketing message in print, retail settings, internet, television or movies compared to non-users. Further, current users of e-cigarettes were 22 percent more likely to have encountered one marketing message compared to non-users. With each additional exposure to another channel of e-cigarette marketing, students' odds of using e-cigarettes grew exponentially.

Half of the students reported seeing e-cigarette marketing messages in retail settings, making it the most common place they appeared, followed by messages on the internet at 40 percent.

"You go to a convenience store and the entire wall behind the cashier is tobacco advertising. We're seeing e-cigarettes are following that trend. The internet and social media are also a concern because e-cigarette companies have a big presence online," said Dale Mantey, M.P.A., lead author and predoctoral fellow at the Michael & Susan Dell Center for Healthy Living at UTHealth School of Public Health in Austin.

According to the paper, spending for e-cigarette marketing tripled from 2011 to 2012 from $6.4 million to $18.3 million and expenditures through the second quarter of 2013 outpaced all of 2012. Mantey said this reveals a trend that is not likely to change.

"E-cigarette companies are following what cigarette companies did. There are no restrictions on the messaging they can use, and health warnings do not appear on e-cigarettes like they do on cigarette packages. Flavored e-cigarettes are widely available and appeal to youth," said Maria Cooper, Ph.D., co-author and postdoctoral fellow at the Center for Healthy Living.

The authors are members of the Tobacco Center of Regulatory Science on Youth & Young Adults (Texas TCORS), a center created to develop research that can guide future decisions on tobacco regulations at the national level. The researchers are examining how marketing messages from e-cigarette companies affect youth in Texas over several years. They also have plans to study the role that e-cigarette marketing plays on college campuses.

"While the current study is unable to definitively say e-cigarette marketing causes e-cigarette use, since data on exposure to advertising and e-cigarette use were collected at the same time, the longitudinal studies underway at the Texas TCORS will be equipped to answer such questions," said Mantey.