Association between E-Cigarette Advertising Exposure and Use of E-Cigarettes among a Cohort of U.S. Youth and Young Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Outcome Variable
2.3. Primary Advertising Exposure and Covariate Variables
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics and E-Cigarette Advertisement Exposures at Baseline
3.2. Bivariate Association between Participant Characteristics and Any Advertisement Exposure
3.3. Associations between Baseline E-Cigarette Marketing Exposure and Past 30-Day E-Cigarette Use at Follow-Up: Youth
3.4. Associations between Baseline E-Cigarette Marketing Exposure and Past 30-Day E-Cigarette Use at Follow-Up: Young Adults
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Youths (13–20) n = 1490 | Young Adults (21–24) n = 814 | |||
---|---|---|---|---|
Baseline sample characteristics: | n (wt.%) | 95% CI | n (wt.%) | 95% CI |
Sex | ||||
Male | 702 (49.2) | 45.2, 53.1 | 286 (45.7) | 41.1, 50.3 |
Female | 787 (50.8) | 46.9, 54.8 | 528 (54.3) | 49.7, 58.9 |
Race/Ethnicity | ||||
White, NH | 871 (55.8) | 51.9, 59.6 | 316 (56.7) | 52.3, 61.1 |
Black, NH | 186 (13.2) | 10.8, 16.1 | 182 (14.0) | 11.4, 17.2 |
Other/2 +races, NH | 96 (6.9) | 5.0, 9.3 | 63 (6.4) | 4.6, 8.8 |
Hispanic | 266 (20.5) | 17.5, 23.9 | 185 (20.0) | 16.8, 23.6 |
Asian, NH | 71 (3.6) | 2.7, 4.9 | 68 (2.9) | 1.9, 4.5 |
Household Income | ||||
<USD 25,000 | 255 (19.9) | 16.6, 23.6 | 278 (30.3) | 26.3, 34.5 |
USD 25,000–USD 49,999 | 294 (19.7) | 16.7, 23.2 | 208 (25.5) | 21.7, 29.7 |
USD 50,000–USD 99,999 | 534 (31.9) | 28.5, 35.5 | 194 (24.7) | 21.0, 28.8 |
USD 100,000+ | 407 (28.5) | 25.3, 32.0 | 134 (19.5) | 16.1, 23.5 |
Region | ||||
Northeast | 247 (18.0) | 14.9, 21.5 | 121 (14.5) | 11.6, 17.9 |
Midwest | 397 (23.6) | 20.6, 26.9 | 143 (21.5) | 18.0, 25.4 |
South | 544 (35.6) | 32.0, 39.5 | 376 (38.4) | 34.1, 42.8 |
West | 302 (22.8) | 19.7, 26.2 | 174 (25.7) | 21.8, 30.0 |
Ever used e-cigarettes | 57 (7.6) | 5.5, 10.6 | 134 (12.8) | 10.1, 15.9 |
Current cigarette smoker | 28 (3.5) | 2.1, 5.8 | 49 (6.8) | 4.5, 10.1 |
E-cigarette user at follow-up | 119 (7.9) | 6.0, 10.2 | 97 (11.1) | 8.4, 14.5 |
Exposure to any TV, retail or online/social media ads or content at baseline | 917 (63.7) | 59.8, 67.4 | 547 (58.3) | 53.6, 62.8 |
TV advertising | 376 (24.3) | 21.1, 27.8 | 229 (22.5) | 19.0, 26.4 |
Retail store advertising | 695 (52.2) | 48.2, 56.3 | 445 (53.4) | 48.6, 58.2 |
Online/social media advertising/content | 545 (42.9) | 38.7, 47.2 | 361 (43.2) | 38.4, 48.1 |
Any Exposure to TV, Retail, Online/Social Media Ad/Content | No Exposure to TV, Retail, Online/Social Media Ad/Content | ||||||
---|---|---|---|---|---|---|---|
n | Wt.% | 95% CI | n | Wt.% | 95% CI | p * | |
E-cigarette use at follow-up | <0.001 | ||||||
No | 1273 | 87.8 | 85.0, 90.1 | 760 | 95.9 | 93.3, 97.5 | |
Yes | 188 | 12.2 | 10.0, 15.0 | 27 | 4.1 | 2.5, 6.7 | |
Baseline Characteristics: | |||||||
Cigarette smoker | 0.07 | ||||||
No | 1392 | 94.0 | 91.5, 95.8 | 775 | 97.1 | 94.0, 98.6 | |
Yes | 65 | 6.0 | 4.2, 8.5 | 11 | 2.9 | 1.4, 6.0 | |
E-cigarette ever user | 0.002 | ||||||
No | 1305 | 87.7 | 84.7, 90.2 | 761 | 94.3 | 91.2, 96.4 | |
Yes | 159 | 12.3 | 9.8, 15.3 | 30 | 5.7 | 3.6, 8.8 | |
Sex | 0.83 | ||||||
Male | 624 | 47.3 | 43.5, 51.2 | 344 | 48.0 | 43.0, 53.0 | |
Female | 839 | 52.7 | 48.9, 56.5 | 447 | 52.1 | 47.0, 57.0 | |
Age groups | 0.08 | ||||||
13–20 | 917 | 65.1 | 61.6, 68.5 | 539 | 59.8 | 54.9, 64.6 | |
21–24 | 547 | 34.9 | 31.5, 38.4 | 252 | 40.2 | 35.4, 45.1 | |
Race/Ethnicity | <0.001 | ||||||
White, NH | 679 | 50.1 | 46.3, 53.9 | 469 | 63.7 | 59.0, 68.2 | |
Black, NH | 287 | 17.0 | 14.3, 20.1 | 78 | 8.6 | 6.4, 11.5 | |
Other/2+ races, NH | 97 | 6.5 | 4.8, 8.8 | 61 | 7.5 | 5.2, 10.6 | |
Hispanic | 297 | 22.0 | 19.0, 25.5 | 149 | 18.2 | 15.0, 22.0 | |
Asian, NH | 104 | 4.4 | 3.2, 5.9 | 34 | 2.0 | 1.3, 3.1 | |
Household Income | 0.52 | ||||||
<USD 25,000 | 374 | 25.7 | 22.3, 29.4 | 155 | 22.2 | 18.2, 26.8 | |
USD 25,000–USD 49,999 | 337 | 22.1 | 19.3, 25.2 | 158 | 21.1 | 16.9, 26.0 | |
USD 50,000–USD 99,999 | 433 | 28.6 | 25.3, 32.1 | 281 | 30.7 | 26.6, 35.1 | |
USD 100,000+ | 320 | 23.7 | 20.7, 27.0 | 197 | 26.1 | 22.1, 30.6 | |
Region | 0.26 | ||||||
Northeast | 242 | 17.0 | 14.3, 20.0 | 121 | 17.2 | 13.2, 22.1 | |
Midwest | 309 | 20.6 | 17.8, 23.7 | 212 | 24.9 | 21.0, 29.2 | |
South | 621 | 39.1 | 35.5, 42.9 | 287 | 33.6 | 29.2, 38.3 | |
West | 292 | 23.3 | 20.2, 26.8 | 171 | 24.3 | 20.4, 28.8 |
Model 1 (1447) | Model 2 (1400) | Model 3 (1363) | Model 4 (1247) | |
---|---|---|---|---|
Any exposure to TV, retail, or online/social media ads or content | ||||
No (Reference group) | 1.00 | |||
Yes | 2.77 (1.23, 6.24) * | |||
Exposure to e-cigarette product Ads through TV- programming channels | ||||
No (Reference group) | 1.00 | |||
Yes | 3.08 (1.78, 5.33) *** | |||
Exposure to e-cigarette product Ads through Point-of-sale channels | ||||
No (Reference group) | 1.00 | |||
Yes | 2.22 (1.18, 4.18) * | |||
Exposure to e-cigarette product Ads through online or social media channels | ||||
No (Reference group) | 1.00 | |||
Yes | 2.33 (1.24, 4.39) ** | |||
Current use cigarettes at baseline | ||||
No (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 7.01 (1.86, 26.41) ** | 7.88 (2.11, 29.34) ** | 6.63 (1.74, 25.31) ** | 17.23 (4.67, 63.60) *** |
Ever use of e-cigarette at baseline | ||||
No (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 2.87 (1.14, 7.23) * | 3.61 (1.46, 8.94) ** | 2.68 (1.05, 6.81) * | 3.58 (1.51, 8.47) ** |
Sex | ||||
Male (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Female | 0.87 (0.47, 1.62) | 0.93 (0.50, 1.72) | 0.87 (0.47, 1.61) | 0.83 (0.43, 1.61) |
Race/Ethnicity | ||||
White, NH (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
Black, NH | 1.74 (0.51, 5.92) | 1.47 (0.46, 4.75) | 1.76 (0.53, 5.83) | 1.59 (0.45, 5.69) |
Other/2+ races, NH | 1.40 (0.50, 3.89) | 1.55 (0.57, 4.21) | 1.38 (0.50, 3.85) | 1.63 (0.60, 4.43) |
Hispanic | 1.55 (0.74, 3.24) | 1.61 (0.79, 3.31) | 1.52 (0.73, 3.18) | 1.35 (0.62, 2.93) |
Asian, NH | 0.69 (0.20, 2.35) | 0.57 (0.17, 1.99) | 0.86 (0.26, 2.84) | 0.34 (0.10, 1.17) |
Household Income | ||||
<USD 25,000 (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
USD 25,000–USD 49,999 | 2.41 (0.99, 5.86) | 2.77 (1.13, 6.79) * | 2.33 (0.96, 5.65) | 2.50 (0.95, 6.55) |
USD 50,000–USD 99,999 | 1.73 (0.64, 4.68) | 2.15 (0.84, 5.54) | 1.77 (0.66, 4.74) | 2.36 (0.85, 6.61) |
USD 100,000+ | 2.38 (0.88, 6.47) | 2.64 (0.99, 7.07) | 2.38 (0.89, 6.40) | 2.22 (0.72, 6.86) |
Region | ||||
Northeast (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
Midwest | 0.43 (0.19, 0.97) * | 0.42 (0.18, 0.97) * | 0.43 (0.19, 0.97) * | 0.39 (0.16, 0.94) * |
South | 0.57 (0.22, 1.46) | 0.54 (0.21, 1.42) | 0.58 (0.23, 1.50) | 0.59 (0.22, 1.55) |
West | 0.56 (0.24, 1.33) | 0.55 (0.23, 1.32) | 0.57 (0.24, 1.36) | 0.52 (0.20, 1.35) |
Model 1 (791) | Model 2 (776) | Model 3 (735) | Model 4 (690) | |
---|---|---|---|---|
Any exposure to TV, retail, or online/social media ads or content | ||||
No (Reference group) | 1.00 | |||
Yes | 2.34 (1.08, 5.11) * | |||
Exposure to e-cigarette product Ads through TV-programming channels | ||||
No (Reference group) | 1.00 | |||
Yes | 2.48 (1.29, 4.80) ** | |||
Exposure to e-cigarette product Ads through Point-of-sale channels | ||||
No (Reference group) | 1.00 | |||
Yes | 2.02 (1.00, 4.10) * | |||
Exposure to e-cigarette product Ads through online or social media channels | ||||
No (Reference group) | 1.00 | |||
Yes | 2.18 (1.10, 4.32) * | |||
Current use cigarettes at baseline | ||||
No (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 4.77 (1.62, 14.05) ** | 5.62 (2.08, 15.23) ** | 5.05 (1.77, 14.47) ** | 6.76 (2.35, 19.40) *** |
Ever use of e-cigarette at baseline | ||||
No (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Yes | 2.15 (0.98, 4.70) | 2.70 (1.22, 5.97) * | 2.21 (0.98, 4.97) | 1.64 (0.70, 3.82) |
Sex | ||||
Male (Reference group) | 1.00 | 1.00 | 1.00 | 1.00 |
Female | 0.48 (0.25, 0.90) * | 0.44 (0.23, 0.84) * | 0.44 (0.22, 0.86) * | 0.43 (0.21, 0.86) * |
Race/Ethnicity | ||||
White, NH (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
Black, NH | 2.82 (1.18, 6.77) * | 2.41 (0.99, 5.84) | 3.30 (1.26, 8.61) * | 3.06 (1.12, 8.32) * |
Other/2+ races, NH | 0.84 (0.27, 2.67) | 0.70 (0.21, 2.26) | 0.91 (0.27, 3.08) | 0.91 (0.24, 3.42) |
Hispanic | 2.38 (1.05, 5.40) * | 2.39 (1.00, 5.72) | 3.00 (1.18, 7.58) * | 2.57 (0.97, 6.81) |
Asian, NH | 1.85 (0.65, 5.32) | 1.52 (0.51, 4.48) | 2.38 (0.78, 7.27) | 2.35 (0.76, 7.27) |
Household Income | ||||
<USD 25,000 (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
USD 25,000–USD 49,999 | 0.45 (0.20, 1.03) | 0.44 (0.19, 1.05) | 0.43 (0.18, 1.03) | 0.42 (0.17, 1.01) |
USD 50,000–USD 99,999 | 1.08 (0.51, 2.28) | 1.03 (0.48, 2.20) | 0.89 (0.41, 1.92) | 0.88 (0.40, 1.93) |
USD 100,000+ | 0.19 (0.05, 0.70) * | 0.16 (0.04, 0.61) ** | 0.11 (0.02, 0.51) ** | 0.04 (0.01, 0.12) *** |
Region | ||||
Northeast (Reference) | 1.00 | 1.00 | 1.00 | 1.00 |
Midwest | 1.00 (0.35, 2.87) | 0.66 (0.25, 1.76) | 0.95 (0.31, 2.94) | 0.59 (0.18, 1.89) |
South | 0.91 (0.38, 2.19) | 0.61 (0.27, 1.38) | 0.93 (0.37, 2.35) | 0.86 (0.35, 2.12) |
West | 0.99 (0.37, 2.62) | 0.66 (0.26, 1.70) | 0.93 (0.33, 2.64) | 0.83 (0.29, 2.40) |
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Do, V.V.; Nyman, A.L.; Kim, Y.; Emery, S.L.; Weaver, S.R.; Huang, J. Association between E-Cigarette Advertising Exposure and Use of E-Cigarettes among a Cohort of U.S. Youth and Young Adults. Int. J. Environ. Res. Public Health 2022, 19, 12640. https://doi.org/10.3390/ijerph191912640
Do VV, Nyman AL, Kim Y, Emery SL, Weaver SR, Huang J. Association between E-Cigarette Advertising Exposure and Use of E-Cigarettes among a Cohort of U.S. Youth and Young Adults. International Journal of Environmental Research and Public Health. 2022; 19(19):12640. https://doi.org/10.3390/ijerph191912640
Chicago/Turabian StyleDo, Vuong V., Amy L. Nyman, Yoonsang Kim, Sherry L. Emery, Scott R. Weaver, and Jidong Huang. 2022. "Association between E-Cigarette Advertising Exposure and Use of E-Cigarettes among a Cohort of U.S. Youth and Young Adults" International Journal of Environmental Research and Public Health 19, no. 19: 12640. https://doi.org/10.3390/ijerph191912640