Effects of Exposure to Tobacco and Electronic Cigarette Advertisements on Tobacco Use: An Analysis of the 2015 National Youth Tobacco Survey

Leontia Papaleontiou; Israel Terungwa Agaku; Filippos T Filippidis

doi:10.1016/j.jadohealth.2019.05.022

Effects of Exposure to Tobacco and Electronic Cigarette Advertisements on Tobacco Use: An Analysis of the 2015 National Youth Tobacco Survey

J Adolesc Health. 2020 Jan;66(1):64-71. doi: 10.1016/j.jadohealth.2019.05.022. Epub 2019 Aug 2.

Authors

Leontia Papaleontiou¹, Israel Terungwa Agaku², Filippos T Filippidis³

Affiliations

¹ Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
² Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
³ Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom. Electronic address: f.filippidis@imperial.ac.uk.

PMID: 31383392
DOI: 10.1016/j.jadohealth.2019.05.022

Abstract

Purpose: Tobacco advertising influences youth smoking behavior. Electronic cigarette (E-cigarette) advertising appears to encourage e-cigarette use among youth. Our aim was to explore the combined effect of exposure to both traditional tobacco advertising and e-cigarette advertising on youth's current use of traditional tobacco products and e-cigarettes.

Methods: Data were obtained from the 2015 National Youth Tobacco Survey (N = 17,711) in the U.S. Three levels of advertising exposure were assessed: none, traditional tobacco-only advertisements, and traditional tobacco and e-cigarette advertisements. Multivariable logistic regression models were used to explore the association between the three advertising exposure categories and current use of tobacco products.

Results: Young people reported frequent exposure to traditional tobacco advertising (64.4%) and e-cigarette advertising (38.7%) in 2015. Exposure to any advertising was associated with significantly increased odds of traditional tobacco product use and e-cigarette use. Compared with no exposure to traditional tobacco or e-cigarette advertising, exposure to both (adjusted odds ratio [aOR]: 1.51) and exposure to traditional tobacco-only advertising (aOR: 1.34) were associated with significantly higher odds of current use of cigarettes, cigars/cigarillos/little cigars (aOR: 1.62 vs. 1.27) and dual/poly use (aOR: 1.91 vs. 1.31); exposure to both was also associated with significantly higher odds of current e-cigarette (aOR: 1.56) and waterpipe with tobacco (aOR: 1.54) use.

Conclusions: E-cigarette advertising in addition to existing traditional tobacco advertising seems to be associated with the use of tobacco and nicotine products among youth. These findings suggest that stricter regulations for e-cigarette advertising may contribute toward reducing the use of tobacco products among youth.

Keywords: Advertisement; Electronic cigarettes; Tobacco; U.S..

MeSH terms

Adolescent
Advertising*
Electronic Nicotine Delivery Systems*
Humans
Tobacco Products*
Tobacco Use / epidemiology*
United States