Associations of attitudes towards electronic cigarettes with advertisement exposure and social determinants: a cross sectional study. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Reinhold, Benjamin; Fischbein, Rebecca; Bhamidipalli, Surya; Bryant, Jennifer; Kenne, Deric
• Is Part Of: Tobacco induced diseases. Volume 15:Issue 1(2017)
• Page Start: 1
• Page End: 9
• Publication Date: 2017-12
• Subjects: Electronic Cigarettes -- Advertising -- E-cigarettes -- Nicotine -- Perceptions -- Harm -- Transitional youth -- Adolescents; Tobacco -- Health aspects -- Periodicals; Tobacco -- Physiological effect -- Periodicals; Tobacco use -- Health aspects -- Periodicals; Tobacco use -- Physiological effect -- Periodicals; Nicotine addiction; Smoking; Internal medicine -- Periodicals; 616.865
• DOI: 10.1186/s12971-017-0118-y
• Languages: English
• ISSNs: 1617-9625

Abstract

Abstract Background The exposure of young adults to electronic cigarette (e-cigarette) advertisements has risen rapidly. E-cigarette ads have been shown to increase short term perceived acceptability of using e-cigarettes in places where traditional cigarettes are banned. We set out to investigate if advertising exposure was related to perceptions of harm, addictiveness, and acceptability of use of e-cigarettes in places where traditional cigarettes are banned. Methods Using a cross-sectional design, 6037 students at a large Midwestern university between the ages of 18–24 were surveyed about e-cigarette use and smoking status. Bivariate analyses were performed associating perception of harm, addictiveness, and acceptability of e-cigarette use in places where smoking is banned with demographic and other background factors, and e-cigarette advertising exposure through different media channels. Logistic regression analyses were used to explore the relationship of these factors on perceptions of harm, addictiveness and acceptability of e-cigarette use in places where smoking is banned. Results More than a quarter (27.4%) of respondents had used an e-cigarette, greater than half (53.2%) had seen an advertisement on TV and 42.0% had seen an advertisement on the Internet. Logistic regressions revealed that being white, male, an e-cigarette user, a smoker, having a mother who smoked, and Internet advertisement exposure were associated with lower perceived harm of e-cigarettes. The same factors, plus having seen advertisements on TV, were associated with increased likelihood of perceiving e-cigarette use in bars, stores, at work and in a dorm as acceptable. Perceiving use of e-cigarettes as acceptable in classrooms was also associated with the aforementioned factors and also included race. Only being male and an e-cigarette user were associated with lower perceived addictiveness of e-cigarettes. Conclusions E-cigarette use is increasing in adolescents and young adults, as is exposure to e-cigarette advertising. Independent of nicotine use and demographics factors, e-cigarette advertising is associated with increased beliefs in acceptability of e-cigarette use in places where cigarettes are banned. E-cigarette advertisements may be responsible for normalizing e-cigarette use. Exposure to internet e-cigarette advertisements was associated with lower perceived harm; this may be due to the false health claims often made in internet advertisements.