18B.2 Advertising and promotion of e-cigarettes

Last updated: July 2021

Suggested citation: Greenhalgh, EM, & Scollo, MM. InDepth 18B: Electronic cigarettes (e-cigarettes). In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from:  http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18b-e-cigarettes

 

A robust body of research1, 2 has concluded that tobacco companies have engaged in widespread marketing activity that exerts an influence on young people; exposure to such marketing and other portrayals of smoking in the media and popular culture causes smoking uptake.2 A growing body of research has been documenting similarly extensive marketing of e-cigarette products and exploring how it might affect use of e-cigarettes, particularly among young people and never smokers.

18B.2.1 Exposure to e-cigarette promotion

Even prior to major promotion by tobacco companies, a large proportion of people in the US were aware of the existence of e-cigarettes.3 Between 2009 and 2010, awareness doubled from 16.4% to 32.2%,4 and has continued to increase over time.5 Respondents in a study published in 2013 named television, word of mouth, and the Internet as their top three sources of information.3 E-cigarettes are widely promoted using a range of channels, including online through banner and video adverts and social media, print media, television, and in shops.6 Globally there were 75 news stories per day on the topic of e-cigarettes in 2018, compared with eight stories per day in 2013.7

Awareness of e-cigarette promotion has been particularly strong among young people. 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%.8 Approximately seven in 10 US middle and high school students were exposed to e-cigarette advertisements in 2014.9 In 2016 in the US, exposure to e-cigarette advertising through various channels was highest for retail stores (68.0%), followed by the internet (40.6%), television (37.7%), and newspapers and magazines.10 One analysis highlighted a resurgence in e-cigarette TV advertising in the US since early 2019, following a lull in the two years prior, driven entirely by three major brands: blu (manufactured by Lorillard), JUUL (part-owned by Altria), and Vuse (manufactured by RJ Reynolds).11 Another study in the US found that adolescents and young adults had higher odds than older adults of exposure through television and digital marketing.12 Among US adults, common sources of awareness of JUUL were advertisements, news, and word-of-mouth.13

Research in the EU found that in 2014, about two in five EU citizens aged 15+ reported past year exposure to e-cigarette advertising. Exposure was higher among e-cigarette ever-users, current smokers and those with frequent access to the internet.14 In 2017, the ITC project found that most young people reported exposure to e-cigarette ads (Canada = 74%, England = 83%, US = 81%).15 In Canada, the percentage of youth surveyed who reported noticing e-cigarette promotions often or very often approximately doubled between 2017 and 2019.16

A small Australian study using a convenience sample found that in 2019, more than half (56%) of respondents reported exposure to e-cigarette advertisements on social media platforms. Although exposure was more likely among users of e-cigarettes, almost one-third of non-users reported exposure to e-cigarette advertising.17

18B.2.2 Expenditure on e-cigarette promotion

E-cigarette promotional spending has varied over time.18 Revenue spent on advertising of e-cigarettes in the US was estimated to have trebled between 2011 and 2012 (from $US6.4 million to $18.3 million) and reached $88.1 million in 2014.19 Almost 40% of this expenditure was attributed to Altria’s promotion of Markten.20  Vuse (R. J. Reynolds) spending on television marketing alone in 2015 and 2016 exceeded US$16 million. On the other hand, marketing expenditure for JUUL between 2015 and 2017 was relatively moderate, with its enormous growth attributed to a range of innovative and engaging campaigns on social media.21 Another analysis of e-cigarette advertising spending in the US found that it increased from $US59 million in 2013 to $US91 million in 2014, followed by a sharp decline to $US37 million in 2015. Spending shifted over time in terms of media channels and messaging, and also differed depending on the brands’ affiliations with the tobacco industry.22

Companies’ use of social media for promotion allows for lower costs and wide reach, particularly to young people.21, 23 Other strategies for reaching young people include advertising on youth-focused media channels. Following its launch in 2015, JUUL reportedly bought online advertisements on teen-focused websites for Nickelodeon, Cartoon Network and Seventeen magazine.24 In 2019, Philip Morris International reportedly signed a $US6.5M sponsored content deal with Vice Media, which focuses on the 18- to 34-year-old market, to promote e-cigarettes.25

Other expenditure has focused on countering growing restrictions and combatting negative perceptions of e-cigarettes. In Canada in 2020, Imperial Tobacco Canada launched a campaign in major newspapers, and on billboards and websites that downplayed the risks of vaping and accused the media and anti-tobacco groups of intentionally spreading false information.26, 27 Also in 2020 it was reported that Philip Morris International paid News Corp Australia tens of thousands of dollars to run four online articles that were designed to look like science features, as part of an international campaign to lobby for weaker regulation.28 In response to public health concerns, JUUL announced a $30 million investment in 2018 to combat underage use. An analysis of this expenditure concluded that the campaign did not appear to be designed to educate or reach parents; rather, it targeted cities in the US where health organisations and legislative officials were launching investigations into JUUL.29

18B.2.3 Messages in e-cigarette advertising

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.30 Mass media campaigns sponsored by Public Health England early in 2019 have specifically referred to e-cigarettes as a useful cessation tool.31

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.’32 An analysis of radio ads in the US found that references to ‘taste’ were the most popular, followed by highlighting benefits of using e-cigarettes, presence of music, and comparison to other brands.33 

Marketing efforts aimed at capturing a younger market involve promotion of innovative flavouring and highlighting the public performance of vaping.34 Celebrity endorsements, cartoons, flavours, and implications of increased social status may be particularly appealing to young people,35-39 and such forms of advertising have been likened to traditional cigarette advertising.36, 40-42 Adverts promote perceptions among children that e-cigarettes are fun, cool, healthier/safer than tobacco cigarettes, and can be used to circumvent smokefree policies.43, 44 Flavoured e-cigarette adverts may elicit greater appeal and interest in buying and trying e-cigarettes than ads for non-flavoured products.45 

18B.2.4 Forms of advertising and promotion

18B.2.4.1 Online advertising

The increasing popularity of e-cigarettes has been largely attributed to aggressive promotion over the Internet.46 E-cigarette Internet vendors have been actively engaged in various promotional activities to increase the appeal and presence of their products online. Regulation of this environment is particularly challenging, and has led to calls for targeted policy-making including robust age verification and restrictions on marketing and promotion.47 Researchers in the US have called for detailed reporting by e-cigarette marketers on e-cigarette marketing expenditure and sales in order to better understand skyrocketing popularity among young people.48, 49 Some have suggested that online sales of e-cigarettes be banned until there are adequate checks in place to prevent sales to minors.50

While cigarette websites generally require age-verified accounts for entry, one study found that the majority of e-cigarette websites required accounts only for making purchases.51 Several studies in New Zealand have also shown the large majority of online vendors do not require proof of age, and many do not mention health effects or addiction.52, 53 A survey in Melbourne found that 87 per cent of parents were worried that those under the age of 18 can easily buy e-cigarettes and liquids online.54 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.35 Such sites generally lack adequate information regarding nicotine and addiction, or potential health risks of using the products.52

18B.2.4.1.1 Social media and the use of social influencers

As with tobacco cigarettes (see Section 11.11), social media serves as a low-cost way for e-cigarette companies to target current and potential users. The promotion of products on social media is less expensive than traditional advertising venues, and can be difficult to monitor and regulate.21, 23 Recent years have seen a proliferation of e-cigarette advertisements and related content on YouTube,55 Facebook,56 Twitter,57 Instagram,58, 59 TikTok,60 Reddit,61 and Tinder.62 A recent analysis found that among 35 of the leading e-cigarette brands in the US, most had pages on at least two social media platforms. Brand pages rarely used age gating, did not display health warnings, and many showed images of young people and mentioned flavours.63 While exposure to e-cigarette marketing at the point of sale tends to reflect country-specific policies (i.e., is lower in countries that have stricter policies), exposure to e-cigarette advertisements on websites or social media does not appear to follow country-specific policies, highlighting the difficulty in regulating online marketing.64 An experiment in Australia found that, contrary to Facebook’s advertising policy, mock ads containing e-cigarettes were approved for targeted advertisement to 13-17-year-old users.65 Greater use of social media—where e-cigarette advertising is often focused—is associated with a greater risk for e-cigarette use among adolescents.66, 67

A review of e-cigarette messaging on social media found that the products were being promoted as safer, as a useful cessation aid, and for use where smoking is prohibited. Novel flavouring and the public performance of vaping were also common themes.34 A study of the promotional strategies employed on Twitter found that most Tweets emphasised the  relative affordability of e-cigarettes, and portrayed the products as ‘cool’.68 One analysis of YouTube ads found that messages likely to be appealing to young people, such as those promoting flavours and technological improvement, were present in about two-fifths of the videos,69 while another found that vape trick videos on YouTube (many of which were industry-sponsored) could be accessed by children.70 Similarly, e-cigarette marketing on Facebook can often be accessed by underage youth.56 Sales can also take place on social media, even in countries where the products are banned.71 One report found that retailers were using TikTok to advertise at no cost and to sell e-cigarettes to young people.72

An analysis of Twitter found that almost all tweets were commercial tweets, which largely promoted products and flavours.57 Several studies have found that most tweets about vaping are put out by robots,73-75 and that such tweets often promote misinformation about nicotine and e-cigarettes.74 In Australia, while the advertising of e-cigarettes is largely prohibited, several studies of Australian Twitter content have found that it largely does not reflect Australia’s precautionary stance. Instead, tweets often endorse and encourage e-cigarette use, minimise health risks, and call for less restrictive laws,76, 77 as well as portray the products as effective smoking cessation aids.78 One Australian study found that one in five tweets were business listings, and many posts were explicitly used to promote or sell the products.76 

Along with being a platform for e-cigarette advertisements from manufacturers and retailers,79 much of the social media content related to e-cigarettes is generated by e-cigarette users.80 While not necessarily endorsed by manufacturers, this content nevertheless provides free advertising for brands. Despite not having official brand accounts, as of August 2020, videos tagged #juulgang (content related to JUUL) had 548.9 million views, a 7% increase compared with three months earlier; #puffbar (related to Puff Bar) had 258.1 million views, a 136% increase; and #vuse (related to Vuse) had 1.3 million views, a 76% increase.60 Another study of ten of the most popular videos on TikTok portraying Puff Bars found that they had received millions of views. Most videos featured nicotine or addiction-related content and flavour, two included sale or promotional content, and two clearly portrayed underage youth.81 A study in 2018 noted the growing popularity of “smoking selfies” — photos posted on social media by models, actors and influencers of themselves smoking or vaping.82 People with large social media followings may also be paid to promote products under the guise of an objective review.83

JUUL’s enormous rise in sales worldwide since its launch in 2015 has been largely attributed to its efficient, low-cost marketing through Twitter, YouTube, Instagram and Snapchat.84 Recent years have seen a proliferation of JUUL-related posts on Instagram, many of which appeal to young people.58 One study found most JUUL followers on Twitter were predicted to be younger than the legal age to purchase e-cigarette products.85 JUUL-related content continued to increase even after US FDA's multiple interventions to curb promotions targeting minors.86 An investigation into JUUL Labs Inc.’s role in the ‘youth nicotine addiction epidemic’ found that JUUL recruited thousands of online ‘influencers’ to market to teens and had deliberately targeted children in order to become America’s largest seller of e-cigarettes.87, 88 Other companies have similarly used celebrities, models and influencers to promote their products.89 "Tagging" social media influencers and other companies or their products were popular promotional strategies used by KandyPen on Instagram.90 British American Tobacco (BAT),91-94 Imperial Brands,95 and Philip Morris International (PMI)96 have all marketed their e-cigarettes and heated tobacco products on social media using models and social influencers. In 2019, PMI suspended a global social media marketing campaign following a Reuters investigation into the company’s use of influencers.96 Four e-cigarette manufacturers, including BAT, have had Instagram posts promoting e-cigarettes using models and celebrities banned by the UK Advertising Standards Authority.97

18B.2.4.2 Product placement

Product placement in film, television and music videos offers enormous reach for e-cigarette companies, particularly to young people, and can serve to normalise and glamorise e-cigarette use and associate it with aspirational celebrities. One study found that several official music videos from the Billboard Hot 100 featured e-cigarette product placement and imagery. Although such placement appeared in a relatively low number of videos, they had collectively received billions of views. Hip Hop videos were the most likely genre to include e-cigarette product placement, while the predominant theme of videos was Image/Lifestyle/Sociability.98 There are also many examples of characters in television shows99, 100 and movies101 using e-cigarettes.

Research in California found that young adults exposed to e-cigarette product placement or imagery in music videos were more likely to report ever and current use of e-cigarettes.102

18B.2.4.3 Discounts and giveaways

E-cigarette companies have utilised a range of giveaways, promotions and discounts in order to promote their products. A number of reports have detailed instances of e-cigarette companies offering free samples of their products to children.103, 104 In 2020, Vype (an e-cigarette owned by R. J. Reynolds) had 30 days of giveaways on its Instagram page, including prizes such as headphones, trainers and sunglasses.105 At a concert in Madrid in 2020, the front rows comprised influencers there to promote Glo, BAT’s heated tobacco product, as well as people who had won tickets via a lottery on Glo’s Instagram account.103 E-cigarette retailers have also reportedly offered college scholarships, which results in their brands being listed on university websites.106 NHS staff in the UK were reportedly ­offered vouchers for e-cigarettes by VPZ, which is partly funded by PMI and is the largest vape retailer in the UK.107 There are also reports of incentives for using e-cigarettes. Reviti life insurance – a subsidiary of PMI – offers discounts to smokers who switch to IQOS or e-cigarettes.108

E-cigarette vaping conventions provide opportunities for promotion of products and social networking among users. Attendance is generally free or low-cost, and can include: free food, drink, prizes, parties, and contests, as well as free samples of products. They also provide the opportunity for attendees to try a wide range of products before purchasing, and facilitate social interaction among e-cigarette users.109 Vapour cloud competitions and vaping trick shows (usually sponsored by e-cigarette manufacturers or industry associations) were often included in the conventions.110, 111

As with tobacco cigarettes, the pricing of e-cigarettes appears to play an important role in uptake and use (see Section 13.1). From 2012 through 2016, e-cigarette unit sales in the US generally increased as product prices decreased.112 Products have also been made more affordable to young people through the sale of disposable e-cigarettes.113 Another pricing strategy whereby pod devices such as JUUL and Vuse are provided cheaply or for free, but require ongoing purchasing of disposable device-specific pods, may have contributed to increased e-cigarette use among youth.114

18B.2.4.4 Sponsorships

An investigation into BAT found that it has been sponsoring music and sporting events around the world, including an F1 e-sports tournament that was streamed live on YouTube and could be watched by children.103 BAT has also sponsored a number of other car racing tournaments, promoting its ‘reduced risk’ products.115, 116 In 2019, the Victorian Government implemented a ban on advertisements for e-cigarettes ahead of Australian Motorcycle Grand Prix at Phillip Island. The ban followed revelations that PMI and BAT had signed deals with Ferrari and McLaren to advertise e-cigarettes and other products at the Grand Prix and other motor sport events.117

18B.2.4.5 Product features

18B.2.4.5.1 Flavours that appeal to youth

The wide range of sweet flavours is one of the most commonly cited reasons for experimentation with e-cigarettes among children, along with curiosity.118-122 Young adults similarly cite curiosity123 and flavours124 as common reasons for initiating e-cigarette use. Flavoured e-cigarette adverts appear to elicit greater appeal and interest in buying and trying e-cigarettes than ads for non-flavoured products.45 The presence of flavouring and/or nicotine at the first e-cigarette exposure is associated with progression to current and more frequent e-cigarette use among adolescents,125-127 and can also decrease perceptions of harm.128, 129 Non-tobacco flavours may be particularly appealing to never smokers compared with smokers.130 Although such flavours have largely been banned in conventional cigarettes in Australia131-136 and the US137 mostly due to their appeal to children, and despite the high levels of toxic compounds found in flavoured e-cigarettes,138, 139 it was estimated in 2014 that there were over 7500 different flavours of e-liquid available.140 Given that flavours play an important role in increasing the appeal of products, limiting the availability and marketing of flavours may reduce appeal.141-143 

18B.2.4.5.2 Product designs and packaging

Along with advertising that appeals to children, e-cigarette manufacturers have been criticised for creating child-friendly packaging for e-cigarette products and liquids. In 2018, the FDA issued warnings to companies that had created nicotine-containing e-liquids that resembled juice boxes, lollies, and cookies. Many products also had cartoon characters on their labelling. Along with increasing the appeal of these products for use among adolescents, the FDA notes that many could be mistaken for food or beverage products by younger children, leading to increased poisonings.144 Recently there has also been a growth in products that facilitate inconspicuous e-cigarette use (known as ‘stealth vaping’), which aim to conceal the products and/or the exhaled vapour. Researchers have expressed concern that these products could appeal to adolescents as a way to hide e-cigarettes from their parents and teachers.145

Although nicotine-containing e-cigarette products are banned in Australia, there have been similar reports of non-nicotine e-liquids being sold in packaging that includes cartoon imagery and fruit and lolly flavours. Experts have called for stricter regulations on the marketing and sale of e-cigarette products, particularly online.146

Figure 18B.2.1 E-cigarette liquids purchased in NSW, Australia
Source: NSW Health

 

18B.2.4.6 Retail promotion and access

Like conventional cigarettes, the majority of in-person e-cigarette retailers are supermarkets, convenience stores and service stations. However, the number of specialist e-cigarette shops (’vape shops’) has grown in the US and UK, and in France, Belgium, and Switzerland vape shops serve as the main retail channel. Following the tobacco retail display ban in the UK, there were reports that some shop owners replaced closed tobacco cabinets with vaping stands.147 Following a ban on menthol cigarettes in the UK, PMI reportedly encouraged retailers to stock menthol HEETS – a heated tobacco alternative that was unaffected by the ban.148 In New Zealand, a 2017 analysis found that among e-cigarette retailers, products were visible at point of sale in almost all (89%) stores, including 15% with self-service displays and 15% with displays adjacent to children's products. Advertising was present in 31% of the outlets.149 A study in Israel found that heated tobacco products were placed near youth-oriented merchandise and in prominent locations easily seen by youth.150 Perceptions that e-cigarettes are easy to purchase predict use among young people.151

In Australia, there are a smaller number of speciality vape shops, and such stores are prohibited from selling nicotine products (see Section 18B.8). Some states have also included e-cigarettes in their tobacco retail licencing schemes, or introduced separate restrictions regarding the sale of e-cigarettes (see Table 2, Section 11.9). An evaluation of an e-cigarette retail licensing policy in Pennsylvania found that it was associated with a reduction in e-cigarette use among adolescents.152 

18B.2.5 Effects of e-cigarette advertising and promotion

There is increasing evidence of the effects of e-cigarette marketing on interest, trialling and regular use of e-cigarette products.

18B.2.5.1 Increases curiosity, appeal and intentions to use e-cigarettes

Young people exposed to e-cigarette adverts report more positive attitudes toward, greater curiosity about and higher intention to use the products,43, 44, 66, 153-156 as well as reductions in their perceptions of health risks of e-cigarette use.157, 158 Adverts promote perceptions among children that e-cigarettes are fun, cool, healthier/safer than tobacco cigarettes, and can be used to circumvent smokefree policies.43, 44 Outside of Australia (where such displays are banned), exposure to tobacco marketing in retail outlets may also increase adolescents’ willingness to use e-cigarettes.159-161 A study in the US found that exposure to e-cigarette ads at point-of-sale were associated with having greater odds of susceptibility toward and curiosity about e-cigarette use.162 Higher internet163 and social media66 use is associated with increased risk of using e-cigarettes among youth. The more likeable young people find advertisements the more likely they are to be willing to try e-cigarettes.164

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.165, 166 Among smokers, e-cigarette advertising appears to increase desire both to use e-cigarettes and tobacco cigarettes,167-169 and among ex-smokers, exposure to e-cigarette adverts can increase desire to smoke and weaken confidence in abstaining.170 Ads that imply that e-cigarette use can enhance one’s social life or self-image promote positive attitudes toward the products among young adult non-smokers.171

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.172

18B.2.5.2 Increases use of e-cigarettes

Correlational160, 173-181 and longitudinal182-189 studies have also found an association between e-cigarette marketing exposure and greater use of e-cigarettes. Receptivity190 and exposure179 to tobacco and e-cigarette marketing is also correlated with dual use (i.e., use of multiple tobacco/e-cigarette products) among US adolescents.179

A study examining mediators of this relationship found that e-cigarette content on social media that promotes e-cigarettes as useful for improving mood and reducing stress may encourage experimentation. Content that promotes flavours and e-cigarettes as cleaner and more socially acceptable than cigarettes may escalate e-cigarette use among experimenters.191 

18B.2.5.3 Effects on use and perceptions of tobacco cigarettes

Some studies have not found evidence that exposure to e-cigarette adverts increases the appeal of tobacco smoking among children,45, 192 although such exposure may reduce the perceived harms of occasional tobacco smoking.192, 193 A longitudinal study in the US found that receptivity to e-cigarette marketing was associated with later conventional cigarette smoking,194 while research in Germany found that exposure to e-cigarette advertisements may increase the likelihood of initial use of e-cigarettes, cigarettes, and hookahs.195 Another US study found that e-cigarette advertising in addition to existing traditional tobacco advertising appears to be associated with the use of tobacco and nicotine products among adolescents.196 More frequent exposure to e-cigarette commercials may be associated with increased use of e-cigarettes and cigarettes among young people.185

18B.2.5.4 Targeting high-risk groups

Along with their marketing that targets youth, there have been reports of e-cigarette manufacturers explicitly targeting their marketing and promotion to other vulnerable groups. JUUL has allegedly directly marketed its products and offered discounts to Native American tribes.197, 198 Similarly, there is evidence in New Zealand that Philip Morris has targeted Māori199 and people living in poverty200 with its ‘reduced risk’ products. JUUL has also targeted its marketing to the US military and veteran population.201, 202

Research in the US found that uptake of e-cigarettes was associated with exposure to e-cigarette advertising among minority youth.203 Another US study found that Black and Asian people were far more likely than White people to trust e-cigarette companies with information about the health effects of e-cigarettes, highlighting the importance of considering racial and ethnic minorities in the development of public education campaigns.204    

18B.2.6 Effectiveness of advertising bans

E-cigarette manufacturers claim that advertising is necessary for providing information and supporting people who smoke to quit.205, 206 However, research suggests that exposure to any sort of e-cigarette advertising likely increases young people’s intent to initiate e-cigarette use,207 and that all advertisements contained at least some features attractive to youth.208

Thousands of lawsuits have been filed in the US alleging that JUUL and other companies deliberately marketed e-cigarettes to teenagers. In response to concerns regarding the effects of e-cigarette advertising, particularly on young people, several countries have introduced bans on advertising and promotion (see Section 18B.9). Following the implementation of a ban on e-cigarette advertisements by retailers (apart from specialty shops) in Ontario, Canada, in 2020, there was a large reduction in the number of ads surrounding schools.209 However, e-cigarette advertising can be difficult to monitor and regulate, particularly as much of it occurs online. One study in the EU found that in member states with more comprehensive advertising bans, exposure to e-cigarettes advertisements was similar to member states without such bans.14 Another study in the EU found that following the implementation of the Tobacco Products Directive, exposure to e-cigarette advertising tended to decline for some channels, particularly television and radio, but tended to increase in some unregulated channels, such as at points of sale.210 In Mexico, where the sales and marketing of e-cigarettes is largely banned, half of middle school students were aware of the products in 2015.211 Violations of e-cigarette advertising restrictions can be common.212-214

Following warning letters, in 2018 the US FDA banned e-liquids made by 17 different manufacturers that came in packaging strongly resembling candies, cookies and other snacks.215, 216 The FDA requires warnings on e-cigarette advertisements, and studies show this should also apply to social media.217 However, the prevalence of FDA-mandated warning statements in e-cigarette related YouTube videos has been found to be low.218 The FDA also ruled that JUUL misrepresented its products by selling or distributing them as modified risk tobacco products without an appropriate FDA order.219

18B.2.7 Public support for regulations on e-cigarette promotion

In light of ongoing debates about e-cigarettes, researchers have examined the level of public support for policies that would restrict marketing and promotion of the products. Reactions to proposals for regulation tend to be predominantly negative on Twitter,220 and one study found that greater engagement with online tobacco content was associated with lower levels of support for e-cigarette policies.221 However, surveys in the US suggest that the majority of adults support the prohibition of e-cigarette sales and marketing to youth,222, 223 as well as banning flavours.223-225 Similarly, most Canadians support restrictions on e-cigarette advertising in order to reduce use among youth.226 Research in the EU found that in 2018, support for a ban on e-cigarette promotion ranged from 33% in Spain to 57% in Poland.227

Among a sample of parents in Melbourne, Australia the overwhelming majority (87%) supported banning marketing and advertising that targets teenagers.54 A survey of Australian e-cigarette users found that just over one-third supported e-cigarettes being regulated in the same way as tobacco cigarettes, which would include a ban on advertising and promotion.228 A survey of pharmacy customers in Brisbane, Australia found that most non-smokers (87%) felt that nicotine-containing e-cigarettes should be regulated either as a medicinal product or completely banned. Twelve per cent thought they should be regulated in line with tobacco products. Among smokers, 62% thought nicotine e-cigarettes should be regulated as tobacco products.229

Public health experts and commentators have been calling for bans on promotion of e-cigarettes since 2015 in Australia230 and New Zealand.231 Researchers232-234 and public health bodies235-238 have also called for stronger regulations on the products, particularly restrictions that would limit exposure to and use by teenagers.

 

Relevant news and research

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13.   Moran MB, Chen-Sankey JC, Tan AS, Soneji S, Lee SJ, et al. Sources of awareness of JUUL e-cigarettes in 2 surveys of adults in the United States. American Journal of Health Behavior, 2019; 43(2):279-86. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30808468

14.   Filippidis FT, Laverty AA, Fernandez E, Mons U, Tigova O, et al. Correlates of self-reported exposure to advertising of tobacco products and electronic cigarettes across 28 European union member states. Tobacco Control, 2017; 26(e2):e130-e3. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28607098

15.   Cho YJ, Thrasher JF, Reid JL, Hitchman S, and Hammond D. Youth self-reported exposure to and perceptions of vaping advertisements: Findings from the 2017 international tobacco control youth tobacco and vaping survey. Preventive Medicine, 2019; 126:105775. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31323286

16.   Hammond D, Reid JL, Burkhalter R, and Rynard VL. E-cigarette marketing regulations and youth vaping: Cross-sectional surveys, 2017-2019. Pediatrics, 2020; 146(1). Available from: https://www.ncbi.nlm.nih.gov/pubmed/32601126

17.   Amin S, Dunn AG, and Laranjo L. Exposure to e-cigarette information and advertising in social media and e-cigarette use in Australia: A mixed methods study. Drug and Alcohol Dependence, 2020; 213:108112. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32574981

18.   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

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

20.   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):e16-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26530219

21.   Huang J, Duan Z, Kwok J, Binns S, Vera LE, et al. Vaping versus JUULing: How the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market. Tobacco Control, 2019; 28(2):146-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29853561

22.   Haardorfer R, Cahn Z, Lewis M, Kothari S, Sarmah R, et al. The advertising strategies of early e-cigarette brand leaders in the United States. Tobacco Regulatory Science, 2017; 3(2):222-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29392167

23.   Ali FRM, Marynak KL, Kim Y, Binns S, Emery SL, et al. E-cigarette advertising expenditures in the USA, 2014-2018. Tobacco Control, 2020; 29(e1):e124-e6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32108086

24.   No authors listed. Juul bought advertising space on children’s websites, including cartoon network Reuters,  2020. Available from: https://uk.reuters.com/article/uk-juul-vaping-lawsuit/juul-bought-ad-space-on-kids-websites-including-cartoon-network-lawsuit-idUKKBN2062TJ

25.   McCauley K. Philip Morris international vapes with vice media. OdwyerPR,  2019. Available from: https://www.odwyerpr.com/story/public/12234/2019-03-21/philip-morris-international-vapes-with-vice-media.html

26.   Miller A. 'A desperate act': Imperial tobacco Canada under fire for 'misinformation' ad campaign. CBC,  2020. Available from: https://www.cbc.ca/news/health/imperial-tobacco-canada-vaping-ad-misinformation-1.5480516

27.   The Canadian Press. Health Canada, quebec investigating imperial tobacco vaping ad campaign. CBC,  2020. Available from: https://www.cbc.ca/news/health/health-canada-investigating-vaping-ad-imperial-tobacco-1.5454578

28.   Meade A. Philip Morris-sponsored articles in the Australian could breach tobacco advertising laws.  2020. Available from: https://www.theguardian.com/media/2020/nov/19/philip-morris-sponsored-articles-in-the-australian-could-breach-tobacco-advertising-laws

29.   Kostygina G, Szczypka G, Czaplicki L, Borowiecki M, Ahn R, et al. Promoting corporate image or preventing underage use? Analysis of the advertising strategy and expenditures of the JUUL parent education for youth vaping prevention campaign. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34059551

30.   Zhu SH, 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(suppl 3):iii3-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24935895

31.   Flint SW and Jones AW. The irresponsible promotion of e-cigarettes and swaptober. The Lancet Respiratory Medicine, 2018; 6(1):e3-e4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29217461

32.   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

33.   Nicksic NE, Brosnan PG, Chowdhury N, Barnes AJ, and Cobb CO. "Think it. Mix it. Vape it.": A content analysis on e-cigarette radio advertisements. Substance Use and Misuse, 2019; 54(8):1355-64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30860933

34.   McCausland K, Maycock B, Leaver T, and Jancey J. The messages presented in electronic cigarette-related social media promotions and discussion: Scoping review. Journal of Medical Internet Research, 2019; 21(2):e11953. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30720440

35.   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: https://www.ncbi.nlm.nih.gov/pubmed/24650842

36.   Allem JP, Cruz TB, Unger JB, Toruno R, Herrera J, et al. Return of cartoon to market e-cigarette-related products. Tobacco Control, 2019; 28(5):555-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30049688

37.   Knutzen KE, Moran MB, and Soneji S. Combustible and electronic tobacco and marijuana products in hip-hop music videos, 2013-2017. JAMA Internal Medicine, 2018; 178(12):1608-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30326017

38.   Kirkpatrick MG, Cruz TB, Unger JB, Herrera J, Schiff S, et al. Cartoon-based e-cigarette marketing: Associations with susceptibility to use and perceived expectations of use. Drug and Alcohol Dependence, 2019; 201:109-14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31207451

39.   Seitz CM, Orsini MM, Jung G, and Butler K. Cartoon images on e-juice labels: A descriptive analysis. Nicotine & Tobacco Research, 2020; 22(10):1909-11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31996912

40.   Ben Taleb Z and Ebrahimi Kalan M. World vapor expo 2017: E-cigarette marketing tactics. Tobacco Control, 2018; 27(e1):e81-e2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29540557

41.   Stanford University Research into the Impact of Tobacco Advertising. Cigs vs ecigs JUUL advertising images. SRITA,  2018. Available from: http://tobacco.stanford.edu/tobacco_main/images-comp.php?token2=fm_tn_st328.php&token1=fm_tn_img10799.php&theme_file=fm_tn_mt035.php&theme_name=Cigs%20vs.%20eCigs&subtheme_name=Cigs%20vs%20eCigs%20JUUL

42.   Hoek J and Freeman B. BAT(nz) draws on cigarette marketing tactics to launch vype in New Zealand. Tobacco Control, 2019; 28(e2):e162-e3. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31315965

43.   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

44.   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

45.   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

46.   Rom O, Pecorelli A, Valacchi G, and Reznick AZ. Are e-cigarettes a safe and good alternative to cigarette smoking? Annals of the New York Academy of Sciences, 2015; 1340:65-74. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25557889

47.   Mackey TK, Miner A, and Cuomo RE. Exploring the e-cigarette e-commerce marketplace: Identifying internet e-cigarette marketing characteristics and regulatory gaps. Drug and Alcohol Dependence, 2015; 156:97-103. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26431794

48.   Glantz S. Ftc should collect and release detailed information on e-cigarette marketing and promotions.  2015. Available from: https://tobacco.ucsf.edu/ftc-should-collect-and-release-detailed-information-e-cigarette-marketing-and-promotions.

49.   Lempert LK, Chaffee BW, Popova L, Felsher B, Halpern K, et al. Detailed information and reports on electronic cigarette marketing and sales is essential for understanding the skyrocketing popularity and use of various electronic cigarette products among youth and young adults.  2015. Available from: https://tobacco.ucsf.edu/sites/tobacco.ucsf.edu/files/u9/FTC%20comment%20-%2027Dec2015-00032.pdf.

50.   No authors listed. 5 things FDA should do about JUUL e-cigarettes. Truth Initiative,  2018. Available from: https://truthinitiative.org/news/5-things-fda-should-do-about-juul-e-cigarettes

51.   O'Brien EK, Navarro MA, and Hoffman L. Mobile website characteristics of leading tobacco product brands: Cigarettes, smokeless tobacco, e-cigarettes, hookah and cigars. Tobacco Control, 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30166427

52.   Gurram N, Thomson G, Wilson N, and Hoek J. Electronic cigarette online marketing by New Zealand vendors. New Zealand Medical Journal, 2019; 132(1506):20-33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31778369

53.   Hardie L, McCool J, and Freeman B. Online retail promotion of e-cigarettes in New Zealand: A content analysis of e-cigarette retailers in a regulatory void. Health Promotion Journal of Australia, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33565666

54.   The Royal Children's Hospital. E-cigarettes, vaping and teens: Do parents know the dangers? ,  2020. Available from: https://www.rchpoll.org.au/polls/e-cigarettes-vaping-and-teens-do-parents-know-the-dangers/.

55.   Huang J, Kornfield R, and Emery SL. 100 million views of electronic cigarette YouTube videos and counting: Quantification, content evaluation, and engagement levels of videos. Journal of Medical Internet Research, 2016; 18(3):e67. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26993213

56.   Kong G, Kuguru KE, Bhatti H, Sen I, and Morean ME. Marketing content on e-cigarette brand-sponsored Facebook profile pages. Substance Use and Misuse, 2021; 56(4):442-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33596764

57.   Sun L, Tao C, Xie Z, and Li D. Promotion of disposable electronic cigarette flavors and topics on Twitter. International Journal of Environmental Research and Public Health, 2020; 17(24). Available from: https://www.ncbi.nlm.nih.gov/pubmed/33321714

58.   Czaplicki L, Kostygina G, Kim Y, Perks SN, Szczypka G, et al. Characterising JUUL-related posts on instagram. Tobacco Control, 2020; 29(6):612-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31266903

59.   Alpert JM, Chen H, Riddell H, Chung YJ, and Mu YA. Vaping and instagram: A content analysis of e-cigarette posts using the content appealing to youth (cay) index. Substance Use and Misuse, 2021; 56(6):879-87. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33749515

60.   Marynak KL and Moran M. Ad watch: 'Unstoppable' vuse alto tv spot closely mirrors 'nicotine addiction checks' on tiktok. Tobacco Control, 2020. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33093188

61.   Zhan Y, Liu R, Li Q, Leischow SJ, and Zeng DD. Identifying topics for e-cigarette user-generated contents: A case study from multiple social media platforms. Journal of Medical Internet Research, 2017; 19(1):e24. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28108428

62.   McKenzie P. Big tobacco’s stake in the nz dating scene Newsroom,  2019. Available from: https://www.newsroom.co.nz/2019/09/10/798296/big-tobaccos-stake-in-the-nz-dating-scene#

63.   O'Brien EK, Hoffman L, Navarro MA, and Ganz O. Social media use by leading US e-cigarette, cigarette, smokeless tobacco, cigar and hookah brands. Tobacco Control, 2020; 29(e1):e87-e97. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32217772

64.   Cho YJ, Thrasher J, Cummings M, Yong HH, Hitchman SC, et al. Cross-country comparison of cigarette and vaping product marketing exposure and use: Findings from 2016 ITC four country smoking and vaping survey. Tobacco Control, 2020; 29(3):295-304. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31152116

65.   Williams D, McIntosh A, and Farthing R. Profiling children for advertising: Facebook’s monetisation of young people’s personal data. Reset Australia Policy Memo: Reset Australia, 2021. Available from: https://au.reset.tech/uploads/resettechaustralia_profiling-children-for-advertising-1.pdf.

66.   Vogel EA, Ramo DE, Rubinstein ML, Delucchi KL, Darrow SM, et al. Effects of social media on adolescents' willingness and intention to use e-cigarettes: An experimental investigation. Nicotine & Tobacco Research, 2021; 23(4):694-701. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31912147

67.   Lee J, Tan ASL, Porter L, Young-Wolff KC, Carter-Harris L, et al. Association between social media use and vaping among florida adolescents, 2019. Preventing Chronic Disease, 2021; 18:E49. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33988495

68.   Alpert JM, Jaisle A, and Chen H. A content analysis of the promotional strategies employed by e-cigarette brands on Twitter. Health Mark Q, 2019; 36(4):307-21. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31696789

69.   Scaioli G, Bert F, Martorana M, Gili R, Thomas R, et al. Advertisement of electronic cigarettes in italy: Characteristics of online videos and the most popular promotional messages. Health Education Research, 2018; 33(6):473-80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30247572

70.   Kong G, LaVallee H, Rams A, Ramamurthi D, and Krishnan-Sarin S. Promotion of vape tricks on YouTube: Content analysis. Journal of Medical Internet Research, 2019; 21(6):e12709. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31215510

71.   No authors listed. Ministry of health sounds alarm over e-cigarettes. Vietnam Plus,  2020. Available from: https://en.vietnamplus.vn/ministry-of-health-sounds-alarm-over-ecigarettes/180133.vnp

72.   Perez S. Tiktok is being used by vape sellers marketing to US teens. Televisor,  2021. Available from: https://www.televisor.co.uk/social/tiktok-is-being-used-by-vape-sellers-marketing-to-teens/012616

73.   Martinez LS, Hughes S, Walsh-Buhi ER, and Tsou MH. "Okay, we get it. You vape": An analysis of geocoded content, context, and sentiment regarding e-cigarettes on Twitter. J Health Commun, 2018; 23(6):550-62. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29979920

74.   The Nicholson Foundation and The Public Good Projects. Over half of tweets about ecigs might come from bots.  2019. Available from: https://thenicholsonfoundation.org/sites/default/files/PGP-TNFBot_Detection_Report.pdf.

75.   Clark EM, Jones CA, Williams JR, Kurti AN, Norotsky MC, et al. Vaporous marketing: Uncovering pervasive electronic cigarette advertisements on Twitter. PLoS One, 2016; 11(7):e0157304. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27410031

76.   McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, et al. E-cigarette advocates on Twitter: Content analysis of vaping-related tweets. JMIR Public Health Surveill, 2020; 6(4):e17543. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33052130

77.   Jongenelis MI, Jongenelis G, Alexander E, Kennington K, Phillips F, et al. A content analysis of the tweets of e-cigarette proponents in Australia. Health Promotion Journal of Australia, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34143553

78.   McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, et al. E-cigarette promotion on Twitter in Australia: Content analysis of tweets. JMIR Public Health Surveill, 2020; 6(4):e15577. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33151159

79.   Kim AE, Hopper T, Simpson S, Nonnemaker J, Lieberman AJ, et al. Using Twitter data to gain insights into e-cigarette marketing and locations of use: An infoveillance study. Journal of Medical Internet Research, 2015; 17(11):e251. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26545927

80.   Majmundar A, Kirkpatrick M, Cruz TB, Unger JB, and Allem JP. Characterising kandypens-related posts to instagram: Implications for nicotine and cannabis use. Tobacco Control, 2020; 29(4):472-4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31147484

81.   Tan ASL and Weinreich E. #puffbar: How do top videos on tiktok portray puff bars? Tobacco Control, 2020. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32934090

82.   Cortese DK, Szczypka G, Emery S, Wang S, Hair E, et al. Smoking selfies: Using instagram to explore young women’s smoking behaviors. Social Media + Society, 2018; 4(3):2056305118790762. Available from: https://journals.sagepub.com/doi/abs/10.1177/2056305118790762

83.   Conti A. This 21-year-old is making thousands a month vaping on YouTube. Vice.com,  2018. Available from: https://www.vice.com/en_us/article/8xvjmk/this-21-year-old-is-making-thousands-a-month-vaping-on-youtube

84.   Packer A. Social media may be creating a new generation of smokers. Georgia State Signal,  2018. Available from: http://georgiastatesignal.com/social-media-may-be-creating-a-new-generation-of-smokers/

85.   Kim AE, Chew R, Wenger M, Cress M, Bukowski T, et al. Estimated ages of JUUL Twitter followers. JAMA Pediatrics, 2019; 173(7):690-2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31107511

86.   Kim Y, Emery SL, Vera L, David B, and Huang J. At the speed of Juul: Measuring the Twitter conversation related to ends and Juul across space and time (2017-2018). Tobacco Control, 2021; 30(2):137-46. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32198278

87.   House Committee on Oversight and Reform. Examining juul’s role in the youth nicotine epidemic: Part ii.  2019. Available from: https://oversight.house.gov/legislation/hearings/examining-juul-s-role-in-the-youth-nicotine-epidemic-part-ii

88.   House Committee on Oversight and Reform. Examining juul’s role in the youth nicotine epidemic: Part i.  2019. Available from: https://oversight.house.gov/legislation/hearings/examining-juul-s-role-in-the-youth-nicotine-epidemic-part-i

89.   No authors listed. Blu introduces ‘something better’ campaign. Convenience Store Decisions,  2017. Available from: https://www.cstoredecisions.com/2017/10/02/blu-introduces-something-better-campaign/#_

90.   Spillane TE, Wong BA, and Giovenco DP. Content analysis of instagram posts by leading cannabis vaporizer brands. Drug and Alcohol Dependence, 2021; 218:108353. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33109462

91.   Marsh S. British American tobacco circumventing ad ban, experts say The guardian,  2020. Available from: https://www.theguardian.com/business/2020/mar/17/british-american-tobacco-circumventing-ad-ban-experts-say

92.   Shukman H. British American tobacco used young instagram stars in its ads. The Times,  2019. Available from: https://www.thetimes.co.uk/article/british-american-tobacco-used-young-instagram-stars-in-its-ads-hs6wgf5z2

93.   Gali K, Fuchs H, and Prochaska JJ. 'Do both': Glo events and promotion in Germany. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33479030

94.   Yi J, Kim J, and Lee S. British American tobacco's 'Glo sens' promotion with k-pop. Tobacco Control, 2020. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32769211

95.   Meddings S. Interview: Imperial brands’ alison cooper sees light at the end of tobacco road. The Times,  2019. Available from: https://www.thetimes.co.uk/article/interview-imperial-brands-alison-cooper-sees-light-at-the-end-of-tobacco-road-5lmm3g2g8

96.   Dyer O. E-cigarette makers under fire for marketing to young people. British Medical Journal, 2019; 365:l2261. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31101616

97.   Wakefield J. Instagram e-cigarette posts banned by ad watchdog. BBC News,  2019. Available from: https://www.bbc.com/news/technology-50821476

98.   Escobedo P, Rosenthal EL, Saucier CJ, Unger JB, Cruz TB, et al. E-cigarette product placement and imagery in popular music videos. Nicotine & Tobacco Research, 2020. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33367917

99.   Farley R. Is JUULing, the cool kid accessory of choice, going to make it to television? Refinery29,  2018. Available from: https://www.refinery29.com/en-us/2018/10/213641/juul-vape-teen-tv-netflix-shows

100. Freeman B and Watts C. Smoke screens: Vaping on film looks less glamorous than the hollywood smoking of yesteryear. The Conversation, 2021. Available from: https://theconversation.com/smoke-screens-vaping-on-film-looks-less-glamorous-than-the-hollywood-smoking-of-yesteryear-163359

101. Lee WB. E-cigarette marketing targeted to youth in South Korea. Tobacco Control, 2017; 26(e2):e140-e4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28062581

102. Majmundar A, Unger JB, Cruz TB, Kirkpatrick MG, and Allem JP. Exposure to e-cigarette product placement in music videos is associated with vaping among young adults. Health Education & Behavior, 2021:10901981211003867. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33821689

103. Chapman M. New products, old tricks? Concerns big tobacco is targeting youngsters. The Bureau of Investigative Journalism,  2021. Available from: https://www.thebureauinvestigates.com/stories/2021-02-21/new-products-old-tricks-concerns-big-tobacco-is-targeting-youngsters

104. Doward J. Legal loophole allows children to get free vape samples. The Guardian,  2020. Available from: https://www.theguardian.com/society/2020/oct/25/legal-loophole-allows-children-to-get-free-vape-samples

105. Vype. Vype celebrates 30 days of summer with 30 prize draws. Cision PR Newswire,  2020. Available from: https://www.prnewswire.com/news-releases/vype-celebrates-30-days-of-summer-with-30-prize-draws-301108091.html

106. No authors listed. E-cigarette sellers start offering scholarships up to $5,000 with essay writing contests about the benefits of vaping. Daily Mail,  2018. Available from: http://www.mailonsunday.co.uk/news/article-5819893/E-cigarette-sellers-turn-scholarships-promote-brands.html

107. Selby A. Vape firm says thank you to frontline nhs staff with vouchers for e-cigs. Mirror,  2020. Available from: https://www.mirror.co.uk/news/uk-news/vape-firm-says-thank-you-22504039

108. Prochaska JJ and Henriksen L. Pmi reduced-risk claims and upselling of IQOS via reviti life insurance. Tobacco Control, 2020; 29(e1):e136-e7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31366704

109. Williams RS. Vapecons: E-cigarette user conventions. J Public Health Policy, 2015; 36(4):440-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26424201

110. Jiang N, Ho SY, and Lam TH. Electronic cigarette marketing tactics in mainland China. Tobacco Control, 2017; 26(2):230-2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27071732

111. Crowe K. The road to vaping. CBC News,  2019. Available from: https://newsinteractives.cbc.ca/longform/the-road-to-vaping

112. Wang TW, Coats EM, Gammon DG, Loomis BR, Kuiper NM, et al. National and state-specific unit sales and prices for electronic cigarettes, United States, 2012-2016. Preventing Chronic Disease, 2018; 15:E99. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30073948

113. St Claire S, Fayokun R, Commar A, Schotte K, and Prasad VM. The world health organization's world no tobacco day 2020 campaign exposes tobacco and related industry tactics to manipulate children and young people and hook a new generation of users. The Journal of Adolescent Health, 2020; 67(3):334-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32682598

114. Tattan-Birch H, Brown J, and Jackson SE. 'Give 'em the vape, sell 'em the pods': Razor-and-blades methods of pod e-cigarette pricing. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33766938

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