Did You Know? Receptivity to Tobacco Advertising Is Associated With Progression Toward Use In Adolescents


A newly published study investigated whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking. For that purpose, researchers analyzed data from the Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) which was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10,989).

Findings included:

  • Receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years but highest for those aged 18 to 21 years.
  • E-Cigarette advertising had the highest receptivity among all age groups.
  • For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products.
  • Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2.

 The researchers concluded that receptivity to tobacco advertising was significantly associated with progression toward use in adolescents. Receptivity was highest for e-cigarette advertising and was associated with trying a cigarette.


Source: Pierce et al. (2018). Association Between Receptivity to Tobacco Advertising and Progression to Tobacco Use in Youth and Young Adults in the PATH Study. JAMA Pediatrics, Mar 26. doi: 10.1001/jamapediatrics.2017.5756. [Epub ahead of print]



Did You Know? A Quarter Of Youth Who Have Never Used Tobacco Products Are Open To Using E-Cigarettes

A newly published study examined how e-cigarette harm perceptions and advertising exposure are associated with openness and curiosity among tobacco naive youth. Findings from the 2015 National Youth Tobacco Survey were analyzed.

Findings included:

  • Among respondents who never used tobacco products, 24% were open to using e-cigarettes and 25% were curious.
  • Respondents that perceived e-cigarettes to cause a lot of harm had lower odds of both openness and curiosity about e-cigarettes compared to those with lower harm perception.
  • Respondents who reported high exposure to e-cigarette advertising in stores had greater odds of being open to e-cigarette use and highly curious compared to those not highly exposed.


The researchers concluded that youth exposed to e-cigarette advertising are open and curious to e-cigarette use. These findings could help public health practitioners better understand the interplay of advertising exposure and harm perceptions with curiosity and openness to e-cigarette use in a rapidly changing marketplace.

Source: Margolis et al. (2018). E-cigarette openness, curiosity, harm perceptions and advertising exposure among U.S. middle and high school students. Preventive Medicine, Apr 17, 112:119-125. doi: 10.1016/j.ypmed.2018.04.017. [Epub ahead of print]

Did You Know? Youth Exposure to E-Cigarette Advertising is Highest in Retail Stores

smoking kids

A newly published Morbidity and Mortality Report (CDC, March 2018) focused on the exposure to electronic cigarette advertising among middle and high school students. To assess patterns of self-reported exposure to four e-cigarette advertising sources (retail stores, the Internet, television, and newspapers and magazines), CDC researchers analyzed data from the 2014, 2015, and 2016 National Youth Tobacco Surveys (NYTSs).

Findings included:

  • Overall, exposure to e-cigarette advertising from at least one source increased each year during 2014-2016 (2014: 68.9%; 2015: 73.0%; 2016: 78.2%).
  • In 2016, exposure was highest for retail stores (68.0%), followed by the Internet (40.6%), television (37.7%), and newspapers and magazines (23.9%).
  • During 2014-2016, youth exposure to e-cigarette advertising increased for retail stores (54.8% to 68.0%), decreased for newspapers and magazines (30.4% to 23.9%), and did not significantly change for the Internet or television.


Recommendations include reducing youth exposure to e-cigarette advertising from a range of sources, including retail stores, television, the Internet, and print media such as newspapers and magazines.

Source: Marynak et al. (2018). Exposure to Electronic Cigarette Advertising Among Middle and High School Students – United States, 2014-2016. MMWR Morb Mortal Wkly Rep. 2018 Mar16, 67(10), 294-299.

Did You Know? Hookah Smoking is Common Among College Students

hookah 2
A recently published study reported on the first nicotine product used among undergraduates who had ever tried tobacco, and explores correlates of hookah as that first product. Participants included a convenience sample of undergraduate students (n = 1538) at four universities in upstate New York during fall 2013. 
Findings included: 
  • Among the 832 students who reported ever use of any nicotine product, 25.4% reported hookah as their first product smoked; only combustible cigarettes (39.5%) were reported more frequently. 
  • Among students who ever smoked cigarettes, most reported cigarettes as their introductory product. 
  • Among students who never smoked cigarettes, nearly half reported hookah as their introductory product. 
  • Among ever nicotine users, current hookah smoking was common (34.9%), and greater than current e-cigarette (25.9%) and current combustible cigarette (26.4%) use. 
  • Never users of cigarettes, females, and non-Hispanic African Americans, had higher adjusted odds of reporting hookah as their introductory product.
The researchers’ recommendations include broadening prevention efforts beyond a focus on combustible cigarettes.
Source: Kulak et al. (2018). Examining Hookah as an Introduction to Nicotine Products among College Students. Substance Use & Misuse, Mar 13:1-9. doi: 10.1080/10826084.2018.1441308. [Epub ahead of print]

Lack of Public Health Messages About Hookah Use Maybe Interpreted As Sign That Hookah Use is Safe

The rate of Hookah use among college students during the last decade is about 30%. Presently, the US Food and Drug Administration (FDA) has little regulation for the manufacture, distribution, or sale of hookah. A recently published review of the scientific literature assessed hookah use while focusing on the consequences for regulatory policy.
Findings included:
  • Hookah use may initiate smoking among tobacconaïve college students.
  • College students who use hookah are generally not aware of the increased risks for tobacco related diseases as it relates to their behavior.
  • Few public health messages target college-age adults with anti-hookah messages.
  • A lack of information regarding the dangers and potential harms of hookah use may be misinterpreted as a sign of “safety” which inadvertently may imply a suggestion of no need for safety measures.
Source: Fevrier et al. (2018). Policy Implications and Research Recommendations: A Review of Hookah Use Among US College Students. Journal of Community Health, Mar 30. doi: 10.1007/s10900-018-0502-4. [Epub ahead of print]

Did You Know? Among California Youth, Prevalence of E-Cigarette Use is Highest Among Non-Hispanic White Boys and Asian Girls


A newly published study sought to determine e-cigarette use prevalence and its relation to alcohol use as a potential gateway drug, and how this may differ by sex and ethnicity in a multi-ethnic sample of California adolescents. The researchers analyzed data from 1806 adolescents aged 12-17 in the 2014 and 2015 California Health Interview Survey (CHIS) cycles.

Findings included:

  • The prevalence of e-cigarette use was 9.1% overall in California adolescents but highest in boys among non-Hispanic Whites (15.1%) and in Asian girls (13.3%).
  • Among e-cigarette users, 61.3% of boys and 71.0% of girls reported using alcohol as well.

The researchers concluded that attention needs to be paid to the high prevalence of e-cigarette smoking, as well as its potential as a gateway drug for alcohol drinking in adolescents.

Source: Wong & Fan, (2018). Ethnic and sex differences in E-cigarette use and relation to alcohol use in California adolescents: the California Health Interview Survey. Public Health, Mar 7;157:147-152. doi: 10.1016/j.puhe.2018.01.019. [Epub ahead of print]

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Literature Review Of Characteristics Of Adolescent E-Cigarette Users
A newly published article reviewed the existing e-cigarette literature for the characteristics of adolescents most likely to become e-cigarette users. A total of 100 articles were found, and 25 were finally included in the present review. The researchers found that older age, male gender, conventional smokers, peer influence, daily smoking, and heavier smoking are the most common characteristics of adolescent e-cigarette users. Since e-cigarette use is increasing and considering that the long-term health effects are still under investigation, targeted interventions towards more susceptible individuals may be an effective prevention strategy.
Source: Perikleous et al. (2018). E-Cigarette Use Among Adolescents: An Overview of the Literature and Future Perspectives. Frontiers in Public Health, Mar 26;6:86. doi: 10.3389/fpubh.2018.00086.
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Did You Know? Majority of Youth who Use Electronic Vaping Products Use Advanced Models that Deliver Nicotine More Effectively

Advanced models of electronic vaping products (EVPs) likely pose a greater risk to adolescent health than basic or intermediate models because advanced models deliver nicotine more effectively and heat e-liquid to higher temperatures, producing more harmful chemical emissions. A newly published study (Nicotine & Tobacco Research, December 2017) examined adolescents’ risk factors for using different device types. Researchers used social media to recruit an online sample of 1,508 U.S. adolescents aged 15-17 who reported past 30-day use of e-cigarettes. The study assessed tobacco use, beliefs and knowledge about EVPs, and EVP use behavior, including the device type participantsuse most frequently. 
Findings included:
  • Most respondents usually used modifiable advanced devices (56.8%) rather than basic “cigalike” (14.5%) or pen-style intermediate (28.7%) devices.
  • Use of multiple device types was common, particularly among those who primarily used basic devices.
  • Younger age and less frequent vaping were associated with mainly using basic devices.
  • Adolescents who were older, male, personally bought their main device, and had ever mixed e-liquids were at elevated risk for usually using advanced devices.
The researchers concluded that adolescents who primarily use basic devices may be newer users who are experimenting with multiple devices. Future research should examine which adolescents are most likely to transition to advanced devices in order to develop targeted interventions. Recommendations include that regulators should consider strategies to reduce access to all types of EVPs, such as better enforcement of the current ban on sales to minors.
Source: Pepper et al. (2017). Adolescents’ Use of Basic, Intermediate, and Advanced Device Types for Vaping. Nicotine & Tobacco Research, Dec 23, [Epub ahead of print]

Did You Know That African Americans, Compared To Whites And Hispanics, Are Less Likely To View E-Cigarettes As Addictive?

A recently published study examined racial/ethnic differences in e-cigarette knowledge, risk perceptions, and social norms among current and former smokers.

Findings included:

  • White participants scored significantly higher on e-cigarette knowledge, compared to both Hispanics and African Americans/Blacks.
  • Knowledge was lower among African Americans/Blacks compared to Hispanics.
  • Compared to both Whites and Hispanics, African American/Black participants held lower perceptions regarding e-cigarette health risks and were less likely to view e-cigarettes as addictive.
  • Normative beliefs did not differ by race/ethnicity.

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Did You Know A Recent Study Found A Large Increase In Past Month E-Cigarette Use By Adolescents Between 2011 and 2015?

A recent study evaluated trends from 2011-2015 in electronic cigarette (e-cigarette) use among U.S. adolescents, including prevalence and associations with past month use of cigarettes and other tobacco products, cigarette smoking intensity, quit attempts, and quit contemplation. National Youth Tobacco Survey data (N = 101,011) were analyzed.

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Did You Know That Point-Of-Sale E-Cigarette Advertising Is Related To Neighborhood Characteristics?

A recent study examined neighborhood characteristics of point-of-sale (POS) e-cigarette advertising among tobacco stores. The purpose of this study was to examine socio-demographic characteristics of POS e-cigarette advertising among tobacco stores in the Omaha metropolitan area of Nebraska. Between April and June 2014, trained fieldworkers completed marketing audits of all stores that sell tobacco (n = 463) in the Omaha metropolitan area and collected comprehensive e-cigarette advertising data of these stores.

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