Does Exposure and Receptivity to E-cigarette Advertisements Relate to E-cigarette and Conventional Cigarette Use Behaviors among Youth? Results from Wave 1 of the Population Assessment of Tobacco and Health Study

Background: E-cigarettes (EC) are the most commonly used tobacco product among youth. Additionally, youth EC users are progressing to smoking conventional cigarettes (CC). Although known to target youth, there are no current restrictions in the US on EC marketing, including advertising. The purpose of this study is to evaluate the relationship between EC advertisements and youth EC and CC use behaviors. Methods: This study analyzed data from youth (12-17 years) aware of EC in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study (n=12,199). Weighted logistic regression models assessed whether exposure and receptivity to any of five randomized EC ads (two TV and three print) were associated with the outcomes of EC and CC behaviors of ever use, current (past 30 day) use, and susceptibility to future use. Additional analyses determined whether EC advertising exposure and EC and CC behaviors associations were moderated by EC advertising receptivity. All models were adjusted for sociodemographics, other combustible tobacco product use, and parent smoking. Results: EC advertisement exposure was significantly associated to ever and current EC use as well as susceptibility to EC and CC (p Conclusion: These findings demonstrate exposure to EC advertisements are particularly associated with EC use behaviors, but could play a role in future CC use as well. Youth who are receptive to EC advertisements appear particularly vulnerable. Further studies should focus on the role of receptivity to EC advertisements among youth in order to support regulatory policy targeting EC advertising