Effect of internet and conventional advertisement exposure on electronic cigarette use among adolescents: findings from the National Youth Tobacco Survey

Thumbnail Image
Journal Title
Journal ISSN
Volume Title
University of Alabama Libraries

Background: The use of e-cigarettes has increased dramatically among American adolescents since 2011 and has become a major public health concern. About 2.4 million middle and high students were current (past 30 days) users of electronic cigarettes or e-cigarettes in 2014 (CDC, 2017a). Exposure to e-cigarette advertisements may be a contributing factor to the sharp rise in e-cigarette use among adolescents, as 69% of middle and high school students reported to have exposure to e-cigarette advertisements on the Internet, in convenience stores, in magazine or newspapers, and on television (CDC, 2017a). Purpose: To examine the impact of Internet and conventional advertisement exposure on use of e-cigarettes among American adolescents. To investigate the individual, interpersonal, community and policy factors associated with e-cigarette use. Methods: This study is a secondary data analysis of data originating from the 2017 National Youth Tobacco Survey (NYTS). This database is an annual, school-based, cross-sectional survey that collects information on major tobacco use indicators from middle school (grade 6-8) to high school (from grade 9 to 12) students. Results: Out of the 17,872 adolescents included in the analysis, most participants were White (44.1%). A sample of racial and ethnic minority youths also participated: 25.8% Hispanic, 16.7% African American, and 10.9% other. Approximately 20% of the youths in the study reported e-cigarette use. The relationships between e-cigarette use and current cigarette smoking status, age, race, grade in school, perceived harmfulness, perceived addictiveness, presence of tobacco user in household, Internet advertisement exposure, access to tobacco products and warning label exposure were all significant (p<0.001). Specifically, Internet advertisement exposure was significantly associated with e-cigarette use (p<0.001). Participants who were “always” exposed to Internet e-cigarette advertisements were 2.15 times more likely to use e-cigarettes than those who were never exposed (OR=2.15; 95% CI [1.72, 2.70]; p<0.001). Conclusion: Internet advertisement exposure exerts a greater impact on e-cigarette use than other conventional advertisement methods. Health educators and health professionals should educate the target population about the harms of e-cigarette use at an early stage of adolescence, and serve as advocates for policy changes regarding tighter regulations on e-cigarette advertisements, especially on the Internet.

Electronic Thesis or Dissertation
Health sciences, Health education, Public health