Young adults who are more familiar with e-cigarette marketing practices are more likely to have attitudes against vaping than those unaware of the industry's marketing, according to a study led by Drexel University public health researchers published this month in the BMJ journal Tobacco Control. Expanding on ways cigarettes were marketed in the 1970s, such as using models and hosting smoking events, e-cigarette marketing includes more modern tactics, like paying social media influencers to promote vaping. The findings, from researchers at Drexel's Dornsife School of Public Health and The National Institute on Minority Health and Health Disparities, suggest that efforts to educate young people about e-cigarette marketing tactics can help reduce the number of new vape users.
The researchers surveyed 1,329 young adults, 18-30, who never used tobacco products — but were deemed "susceptible to vaping," from their responses to screening questions — about their awareness of the e-cigarette industry's marketing practices and their level of agreement with anti-e-cigarette attitude statements, such as "taking a stand against vaping is important to me."
All respondents were considered "susceptible" to taking up vaping based on their answers to questions like: "Do you think you will use a vape soon?" and "if one of your best friends were to offer you a vape would you use it?"
Overall, having awareness of the e-cigarette industry's marketing practices (as opposed to having no awareness of these practices) was associated with stronger agreement with the statements: "Not vaping is a way to express my independence," "taking a stand against vaping is important to me," "I want to be involved with efforts to get rid of vaping" and "I would like to see electronic vaping companies go out of business."
Although tobacco control researchers already knew that exposing cigarette industry marketing practices can influence attitudes about smoking and effectively help prevent smoking among young adults, the current study shows that this public education strategy may also be applicable to addressing the vaping epidemic.
"Our data shows that many young adults may not know about the e-cigarette industry's marketing practices, which are quite similar to the insidious marketing practices that were once used to sell cigarettes," said lead author Lilianna Phan, PhD, an assistant professor with a joint appointment in Drexel's Dornsife School of Public Health and College of Nursing and Health Professions. "Exposing e-cigarette marketing practices to young adults should continue to be investigated as a potential public education messaging strategy as it may help shape attitudes against vaping. These attitudes, in turn, could help protect against initiating vaping for susceptible young adults."
The current paper's findings — although they may not be representative of all e-cigarette- susceptible young adults in the U.S. who have not used tobacco products – provide insights for policymakers and anti-drug efforts about who may be most susceptible to starting vaping, and support strategies that expose e-cigarette marketing as a way to prevent new vape users from starting.
According to the study, Hispanic and Black young adults, and those with less than $75,000 annual household income, knew of fewer e-cigarette industry practices and showed less agreement with anti-e-cigarette attitudes.
"While more studies are needed to better explain these findings, racial and ethnic minority populations have a lower prevalence of vaping, and thus may potentially have less awareness about some of the examined marketing practices," said Phan.
Previous studies show that communicating about these marketing tactics is effective in preventing cigarette smoking among young people, the authors said, noting that future studies are needed to examine whether this can help prevent the current generation of young people from vaping.
Roughly one in 10 adults (11%) 18 to 24 years old in the United States use e-cigarettes —approximately 3.4 million people, according to data from the Centers for Disease Control and Prevention's National Center for Health Statistics. According to the American Lung Association, e-cigarettes produce chemicals that can contribute to lung disease and heart disease. They can also cause long-lasting impact on the brain, according to the U.S. Surgeon General, in the form of mood disorders, loss of impulse control and addiction to nicotine, among other detrimental health effects.
This research was supported by the NIMHD DIR, NIH and Food and Drug Administration's Center for Tobacco Products (FDA CTP). Phan was supported by the NIH FIRST Program (U54CA267735), with funding support from the Office of Director (OD), NIH and the Pathway to Independence Award in Tobacco Regulatory Research by the National Cancer Institute (NCI), NIH (R00CA272919).
Phan completed this research work as part of the Intramural Research Training Award Fellowship Program in the Tobacco-Related Disparities and Control Lab led by Kelvin Choi, PhD, at the National Institute on Minority Health and Health Disparities, Division of Intramural Research (NIMHD DIR)/National Institutes of Health (NIH). Choi, the study's senior author, is a senior investigator at NIMHD DIR/NIH. Phan is also a Drexel FIRST faculty member. Drexel FIRST is a partnership between Drexel University's Dornsife School of Public Health and the College of Nursing and Health Professions to recruit diverse cohorts of early-stage research faculty on detecting, understanding or reducing health disparities.
The full paper is available online at: https://tobaccocontrol.bmj.com/content/early/2023/12/07/tc-2023-058245.
