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Gaiha SM, Lempert LK, Lung H, Vescia F, Halpern-Felsher B. Appealing characteristics of E-cigarette marketing in the retail environment among adolescents. Prev Med Rep 2024; 43:102769. [PMID: 38883928 PMCID: PMC11177049 DOI: 10.1016/j.pmedr.2024.102769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Background Nearly 3 million U.S. adolescents use e-cigarettes. E-cigarette marketing is associated with adolescent e-cigarette use; however, studies have not asked adolescents their perceptions about whether and which e-cigarette marketing in retail stores influences purchase and use. Methods Eleven 90-minute focus groups with 12-19-year-olds (mean age 15.7, 46.6 % female) from 11 U.S. states (n = 58) recruited through Instagram and schools (May 2021-Aug 2022). Photographs of e-cigarette marketing in and around retail stores were used to aid discussion. Thematic analysis identified themes related to appealing marketing characteristics. Results Adolescents indicated that e-cigarette marketing in and around retail stores arouses their curiosity, reminds them to buy, and normalizes using e-cigarettes. Adolescents identified specific e-cigarette marketing characteristics that they believed influence their decision to purchase and use e-cigarettes including the Tobacco Power Wall, free samples and flavor smelling samples, price incentives such as discounts and starter-kits, e-cigarette displays near checkout encouraging grab-and-go, displays near food, snacks or candy, and e-cigarette advertising through posters on store windows and stickers at checkout. Adolescents reported combining online and social media strategies to bypass age verification in retail stores (e.g., buying gift cards online and using them in stores). Adolescents suggested adding warning images on negative health effects of e-cigarettes, increasing prominence of minimum-age-of-tobacco-sale signs, and developing marketing education as counter-marketing strategies. Conclusions Adolescents indicate that specific e-cigarette marketing characteristics in retail stores influence their purchase and use decisions. Addressing such e-cigarette marketing exposures in retail stores through counter-marketing messages may bolster adolescent e-cigarette prevention efforts.
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Affiliation(s)
- Shivani Mathur Gaiha
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, CA, USA
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, USA
- Faculty of Pediatrics, Harvard Medical School, USA
| | - Lauren Kass Lempert
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, CA, USA
| | - Holly Lung
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, CA, USA
| | - Francesca Vescia
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, CA, USA
| | - Bonnie Halpern-Felsher
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, CA, USA
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Sanjeevi N. Food insecurity and use of electronic vapor products among high school students. Nutr Health 2024:2601060241258578. [PMID: 38807513 DOI: 10.1177/02601060241258578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Background: Studies have shown that food insecurity is associated with electronic vapor products (EVP) use in adults; however, an understanding of this relationship in adolescents is needed to inform prevention efforts in this age group. Aim: Examine the relationship of food insecurity with EVP use patterns, frequency and source of acquisition in high school students. Methods: This cross-sectional study used Youth Risk Behavior Survey (YRBS) 2019 data from states that incorporated the YRBS' optional food insecurity question. The data included 42,154 high school students with complete information on food insecurity and two EVP-related questions. Responses to EVP-related questions identified "ever users," "current users," "former users," "current dual EVP-cigarette users," and assessed "frequency of EVP use among current users" and "source of EVP acquisition." Logistic regression examined associations of food insecurity with EVP-related outcomes. Results: The proportion of high school students who ever used EVP was 48.3% and the proportion of food-insecure students was about 12%. Food security status significantly differed by race/ethnicity of students, such that the proportion of food insecure students classified as "non-Hispanic White" was lower than the proportion of food secure students classified as "non-Hispanic White." Food insecurity was significantly associated with greater odds of ever EVP use (odds ratio (OR) = 1.75; 95% confidence interval (CI) = (1.55, 1.96)), current EVP use (OR = 2.07; 95% CI = (1.80, 2.37); using never users as reference category) and current dual use of EVP and cigarettes (OR = 2.91; 95% CI = (2.38, 3.55)). Food insecurity also was associated with greater odds of current EVP use (OR = 1.54; 95% CI = (1.28, 1.84)) when former users were used as reference category. In current users, food insecurity was related to greater odds of daily EVP use (OR = 1.40; 95% CI = (1.14, 1.70)) compared to occasional use. Conclusions: Study findings imply that efforts targeting prevention/cessation of EVP use should consider reducing food insecurity in high school students.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutrition and Exercise Physiology, Washington State University - Spokane, Spokane, WA, USA
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Do EK, Diaz MC, Bertrand A, Liu S(M, Hair EC. E-Cigarette Brand Trends in the United States: An Investigation of Data From a Youth and Young Adult Sample and the E-Cigarette Retail Market (2022). Tob Use Insights 2024; 17:1179173X241237216. [PMID: 38455141 PMCID: PMC10916459 DOI: 10.1177/1179173x241237216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
Background Electronic cigarettes (e-cigarettes) remain the most used tobacco product among young people in the United States (US). Given the need for current data on popular e-cigarette products, the current study leverages data from a rapid surveillance survey of young people and examines whether the top e-cigarette brands identified from this source align with US market data. Methodology Data were obtained from current e-cigarette users (N = 4145) participating in the Truth Continuous Tracker Online (CTO; a cross-sectional tracking survey of 15-24 year-olds sourced from the national Dynata panel) and NielsenIQ retail scanner data, collected in 2022 and aggregated by quarter (Q1, Q2, and Q3). The top 15 e-cigarette brands were determined from respondents' endorsement in the Truth CTO and ranked total sales in NielsenIQ in nominal dollars. Results Overall, 58% of e-cigarette brands overlapped across the Truth CTO and NielsenIQ data (60% for Q1, 47% for Q2 and 67% for Q3). Pod-based (JUUL; VUSE) and disposable (Hyde; Breeze Smoke) brands appeared as top brands in both datasets. Top brands were fairly consistent within and across quarters; though, more variability was found in the Truth CTO, relative to NielsenIQ. Many top brands were disposable. Conclusions Results suggest that data from rapid surveillance and retail data can be used complementarily to characterize the popular e-cigarette brands currently on the US market. Many of these popular e-cigarette brands have yet to receive marketing granted orders under the US Food and Drug Administration, suggesting the need to continue monitoring e-cigarette brands among young people.
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Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Megan C. Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | | | - Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
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Roberson A, Cummings KM, Reid JL, Burkhalter R, Gravely S, East K, Thrasher JF, Hammond D. Trends in E-Cigarette and Tobacco Cigarette Purchasing Behaviors by Youth in the United States, Canada, and England, 2017-2022. Int J Public Health 2023; 68:1606234. [PMID: 38033762 PMCID: PMC10682085 DOI: 10.3389/ijph.2023.1606234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives: This paper describes trends in youth e-cigarette (EC) and tobacco cigarette (TC) purchasing behaviors in Canada, England, and the United States (US) in relationship to changing minimum legal age (MLA) laws. Methods: Data are from eight cross-sectional online surveys among national samples of 16- to 19-year-olds in Canada, England, and the US conducted from 2017 to 2022 (N = 104,467). Average wave percentage change in EC and TC purchasing prevalence and purchase locations were estimated using Joinpoint regressions. Results: EC purchasing increased between 2017 and 2022, although the pattern of change differed by country. EC purchasing plateaued in 2019 for the US and in 2020 for Canada, while increasing through 2022 for England. TC purchasing declined sharply in the US, with purchasing from traditional retail locations declining, while purchasing from social sources increased. Vape shops were the most common location for EC purchasing, although declining in England and the US. Conclusion: Trends in EC and TC purchasing trends in the US are consistent with the expected impact of the federal MLA law increasing the legal age to 21 years in December 2019.
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Affiliation(s)
- Avery Roberson
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Katherine East
- National Addiction Centre, Institute of Psychiatry and Neuroscience, King's College London, London, England
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Tashakkori NA, Park-Lee E, Roh EJ, Christensen CH. Multiple Tobacco Product Use Among Youth E-Cigarette Users: National Youth Tobacco Survey, 2020. J Adolesc Health 2023; 73:769-775. [PMID: 37410002 DOI: 10.1016/j.jadohealth.2023.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/24/2023] [Accepted: 05/24/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Limited information exists on multiple tobacco product use, particularly among youth. This study assessed the prevalence of current youth use of e-cigarettes with other tobacco products and their associated characteristics using 2020 National Youth Tobacco Survey data. METHODS Prevalence estimates were calculated for current e-cigarette users, by multiple tobacco product use status and product combination. Demographic characteristics, e-cigarette use behaviors, age at first combustible tobacco use, and tobacco dependence symptoms were compared between current users of both e-cigarettes and combustible tobacco (dual users) and current exclusive e-cigarette users. RESULTS In 2020, 61.1% of all current e-cigarette users reported exclusive e-cigarette use, and 38.9% used e-cigarettes with other tobacco products. Among those who used e-cigarettes with other tobacco products, 85.0% used combustible tobacco, with cigarettes being the most commonly used other tobacco product. Compared with current exclusive e-cigarette users, higher proportions of dual users reported the following: frequent e-cigarette use; obtaining e-cigarettes from gas stations, persons other than a family member/friend, vape shops, or the internet; and having any tobacco dependence symptoms. Among dual users, 31.2% reported first combustible product use after e-cigarette initiation, and 34.3% reported first combustible product use prior to e-cigarette initiation. DISCUSSION Approximately four in 10 youth current e-cigarette users reported using multiple tobacco products, with a majority using combustible tobacco. Frequent e-cigarette use and tobacco dependence symptoms were more prevalent among dual users of e-cigarettes and combustible tobacco.
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Affiliation(s)
- Nicole A Tashakkori
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Eunice Park-Lee
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Esther J Roh
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Carol H Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
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Do EK, Aarvig K, Donovan EM, Barrington-Trimis JL, Vallone DM, Hair EC. E-cigarette Device Type, Source, and Use Behaviors of Youth and Young Adults: Findings from the Truth Longitudinal Cohort (2020-2021). Subst Use Misuse 2023; 58:796-803. [PMID: 36924188 PMCID: PMC10361006 DOI: 10.1080/10826084.2023.2188555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: E-cigarette device types vary in the amount of nicotine delivered to users. Given that youth and young adults are using pod-based and disposable e-cigarettes with high nicotine concentrations, it is important to determine how e-cigarette use behaviors associated with nicotine dependence may differ across e-cigarette device type. Methods: Baseline information was collected from September 2020 to March 2021 and follow-up information was collected from July to October 2021 from the Truth Longitudinal Cohort. The final analytic sample included respondents (aged 15-24) who reported current use of e-cigarettes at either baseline or follow-up and provided information on the 4-item E-cigarette Dependence Scale (EDS). Differences in endorsement of items from the EDS by e-cigarette device type (pod-based, disposable, or tank) were assessed using chi-square tests. Results: Participants (N = 308) were evenly split on age (15-20, 21+) and gender. Most 15-20-year-olds used disposable e-cigarettes, while those 21+ years primarily used tank devices. Although EDS score did not differ by e-cigarette device type, positive endorsement of two items from the EDS significantly differed by e-cigarette device type. More tank users endorsed reaching for a device without thinking about it (tank: 92.6%; pod-based: 79.0%; disposables: 79.9%, p = 0.04) and vaping more before going into a situation where vaping is not allowed (tank: 92.9%; pod-based: 71.0%; disposables: 73.0%, p < 0.01). Conclusions: Findings have the potential to inform policy implementation by providing evidence for specific targets for regulatory action that can help to reduce the burdens of e-cigarette use among youth and young adults, as results suggest that tank device users are more likely to endorse use behaviors associated with nicotine dependence.
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Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna M Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
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