18B.2 Advertising and promotion

Last updated: November 2017     

Suggested citation: Greenhalgh, EM, & Scollo, MM. InDepth 18B: Electronic cigarettes (e-cigarettes). In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2017. Available from: http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18b-e-cigarettes


The increasing popularity of e-cigarettes has been largely attributed to aggressive promotion over the Internet.1 Even prior to major promotion by tobacco companies, one study found that a large proportion of people in the US were aware of the existence of e-cigarettes, naming television, word of mouth, and the Internet as their top three sources of information.2 Between 2009 and 2010, awareness doubled from 16.4% to 32.2%3, and has continued to increase over time.4 E-cigarettes are now widely promoted using a range of channels, including online through banner and video adverts and social media (primarily YouTube and Twitter), print media, television, and in shops.5

E-cigarette promotional spending has rapidly increased over time.6 Revenue spent on advertising of e-cigarettes in the US is estimated to have trebled between 2011 and 2012 (from $US6.4 million to $18.3 million) and reached $88.1 million in 2014.7 Almost 40% of this expenditure was attributed to Altria’s promotion of Markten.8 Other research has shown that between 2011 and 2013, exposure to television advertisements for e-cigarettes increased among US youth (aged 12-17) by 256%, and in young adults (aged 18-24) by 321%.9

18B.2.1 Content of e-cigarette advertisements

The advertising of e-cigarettes is frequently aimed at smokers, often comparing electronic and tobacco cigarettes. E-cigarettes are frequently marketed as healthier, cheaper, more socially acceptable, and more amenable to use with indoor smoking restrictions in comparison with tobacco cigarettes. Despite limited evidence on their efficacy for this purpose, they are also frequently marketed as a useful cessation aid.10

An analysis of print advertisements in the US found that the advertisements typically implied use for harm reduction, or as a partial alternative to cigarettes (dual use) and often incorporated the theme of individuality, sociability, and sexuality. Particular demographics were targeted depending on the publication; for example, a blu ad in Rolling Stone magazine showed a shirtless man lying in bed next to an overweight, semi-naked woman with the words ‘no regrets’ boldly highlighted. In contrast, a blu ad in Us Weekly showed a stylish, attractive woman with the text: ‘Freedom never goes out of fashion… blu produces no tobacco smoke and no ash, only vapor, making it the ultimate accessory….Step out in style with blu.’11

Similarly, an analysis of e-cigarette retail websites found that almost all made explicit or implicit health-related claims—including many that featured doctors—and the majority had a smoking cessation-related claim. E-cigarettes are generally portrayed as cleaner, cheaper, and useful for circumventing smokefree policies. Celebrity endorsements, flavours, and implications of increased social status may be particularly appealing to young people.12

18B.2.2 Effects of e-cigarette advertising on adults

 

Several experimental studies have shown an association between exposure to e-cigarette advertising and intention or desire to use an e-cigarette among young adults in the general population.13, 14 Among smokers, e-cigarette advertising appears to increase desire both to use e-cigarettes and tobacco cigarettes,15, 16 and among ex-smokers, exposure to e-cigarette adverts can increase desire to smoke and weaken confidence in abstaining.17
A study of smokers’ reactions to e-cigarette advertising has found that their interest in trying e-cigarettes is highest after viewing ads with messages about differences between regular and electronic cigarettes, such as claims about e-cigarettes’ lower cost, greater ‘healthfulness’ and utility for smoking cessation, as well as when they see advertisements showing someone actually using the product.18   

18B.2.3 Effects of e-cigarette advertising on children

A growing body of experimental studies have examined the effects of e-cigarette advertising on the appeal of e-cigarettes and tobacco cigarettes among children. As with adults, children exposed to e-cigarette adverts report more positive attitudes toward and greater intention to use the products.19, 20 Correlational studies have also found an association between e-cigarette marketing exposure and greater use of e-cigarettes.21-24   

Adverts promote perceptions among children that e-cigarettes are fun, cool, healthier/safer than tobacco cigarettes, and can be used to circumvent smokefree policies.19, 20 Flavoured e-cigarette adverts appear to elicit greater appeal and interest in buying and trying e-cigarettes than ads for non-flavoured products.25  
Studies to date have not found evidence that exposure to e-cigarette adverts increases the appeal of tobacco smoking among children,25, 26 although one found that such exposure reduced the perceived harms of occasional tobacco smoking.26   

Recent news and research

For recent news items and research on this topic, click here (Last updated August 2017)  

References

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2. Zhu S-H, Gamst A, Lee M, Cummins S, Yin L, et al. The use and perception of electronic cigarettes and snus among the US population. PLoS ONE, 2013; 8(10):e79332. Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0079332 - pone-0079332-g002

3. Regan A, Promoff G, Dube S, and Arrazola R. Electronic nicotine delivery systems: Adult use and awareness of the 'e-cigarette' in the USA. Tobacco Control, 2013; 22:19–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22034071

4. Xu Y, Guo Y, Liu K, Liu Z, and Wang X. E-cigarette awareness, use, and harm perception among adults: A meta-analysis of observational studies. PLoS ONE, 2016; 11(11):e0165938. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27861501

5. Bauld L, Angus K, de Andrade M, and Ford A, Electronic cigarette marketing: Current research and policy. Cancer Research UK; 2016. Available from: https://www.cancerresearchuk.org/sites/default/files/electronic_cigarette_marketing_report_final.pdf.

6. Kornfield R, Huang J, Vera L, and Emery SL. Rapidly increasing promotional expenditures for e-cigarettes. Tobacco Control, 2015; 24(2):110–1. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24789603

7. Kim AE, Arnold KY, and Makarenko O. E-cigarette advertising expenditures in the US, 2011–2012. American Journal of Preventive Medicine, 2014; 46(4):409–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24650844

8. Cantrell J, Emelle B, Ganz O, Hair EC, and Vallone D. Rapid increase in e-cigarette advertising spending as altria's markten enters the marketplace. Tobacco Control, 2016; 25(e1):e16–e8. Available from: http://tobaccocontrol.bmj.com/content/25/e1/e16.short

9. Duke JC, Lee YO, Kim AE, Watson KA, Arnold KY, et al. Exposure to electronic cigarette television advertisements among youth and young adults. Pediatrics, 2014; 134(1):e29–36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24918224

10. Zhu S-H, Sun JY, Bonnevie E, Cummins SE, Gamst A, et al. Four hundred and sixty brands of e-cigarettes and counting: Implications for product regulation. Tobacco Control, 2014; 23(suppl 3):iii3–iii9. Available from: http://tobaccocontrol.bmj.com/content/23/suppl_3/iii3.abstract

11. Richardson A, Ganz O, Stalgaitis C, Abrams D, and Vallone D. Noncombustible tobacco product advertising: How companies are selling the new face of tobacco. Nicotine & Tobacco Research, 2013; 16(5):606–14. Available from: http://ntr.oxfordjournals.org/content/16/5/606.full

12. Grana RA and Ling PM. "Smoking revolution": A content analysis of electronic cigarette retail websites. American Journal of Preventive Medicine, 2014; 46(4):395–403. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24650842

13. Trumbo CW and Kim SJ. The effect of electronic cigarette advertising on intended use among college students. Addictive Behaviors, 2015; 46:77–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25827334

14. Villanti AC, Rath JM, Williams VF, Pearson JL, Richardson A, et al. Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in US young adults: A randomized controlled trial. Nicotine & Tobacco Research, 2016; 18(5):1331–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26574551

15. King AC, Smith LJ, Fridberg DJ, Matthews AK, McNamara PJ, et al. Exposure to electronic nicotine delivery systems (ends) visual imagery increases smoking urge and desire. Psychology of Addictive Behaviors, 2016; 30(1):106–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26618797

16. Maloney EK and Cappella JN. Does vaping in e-cigarette advertisements affect tobacco smoking urge, intentions, and perceptions in daily, intermittent, and former smokers? Health Communication, 2015:1–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25758192

17. Durkin SJ, Bayly M, and Wakefield MA. Can e-cigarette ads undermine former smokers? An experimental study. Tobacco Regulatory Science, 2016; 2(3):263–77. Available from: http://dx.doi.org/10.18001/TRS.2.3.6

18. Pepper JK, Emery SL, Ribisl KM, Southwell BG, and Brewer NT. Effects of advertisements on smokers' interest in trying e-cigarettes: The roles of product comparison and visual cues. Tobacco Control, 2014; 23 (Suppl 3):iii31–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24935896

19. Duke JC, Allen JA, Eggers ME, Nonnemaker J, and Farrelly MC. Exploring differences in youth perceptions of the effectiveness of electronic cigarette television advertisements. Nicotine & Tobacco Research, 2016; 18(5):1382–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26706908

20. Farrelly MC, Duke JC, Crankshaw EC, Eggers ME, Lee YO, et al. A randomized trial of the effect of e-cigarette tv advertisements on intentions to use e-cigarettes. American Journal of Preventive Medicine, 2015; 49(5):686–93. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26163170

21. Singh T, Agaku IT, Arrazola RA, Marynak KL, Neff LJ, et al. Exposure to advertisements and electronic cigarette use among US middle and high school students. Pediatrics, 2016; 137(5). Available from: http://www.ncbi.nlm.nih.gov/pubmed/27244815

22. Mantey DS, Cooper MR, Clendennen SL, Pasch KE, and Perry CL. E-cigarette marketing exposure is associated with e-cigarette use among US youth. The Journal of Adolescent Health, 2016; 58(6):686–90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27080732

23. Best C, Haseen F, van der Sluijs W, Ozakinci G, Currie D, et al. Relationship between e-cigarette point of sale recall and e-cigarette use in secondary school children: A cross-sectional study. BMC Public Health, 2016; 16(1):310. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27075888

24. Pu J and Zhang X. Exposure to advertising and perception, interest, and use of e-cigarettes among adolescents: Findings from the US National Youth Tobacco Survey. Perspectives in Public Health, 2017:1757913917703151. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28379069

25. Vasiljevic M, Petrescu DC, and Marteau TM. Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking among children: An experimental study. Tobacco Control, 2016; 25(e2):e107–e12. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26781305

26. Petrescu DC, Vasiljevic M, Pepper JK, Ribisl KM, and Marteau TM. What is the impact of e-cigarette adverts on children's perceptions of tobacco smoking? An experimental study. Tobacco Control, 2017; 26(4):421–7. Available from: http://tobaccocontrol.bmj.com/content/tobaccocontrol/26/4/421.full.pdf


 

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