Exposure to Electronic Cigarette Advertising Among Middle and High School Students - United States, 2014-2016

Abstract

Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among U.S. middle and high school students (1). Exposure to e-cigarette advertisements is associated with higher odds of current e-cigarette use among middle and high school students (2-4). To assess patterns of self-reported exposure to four e-cigarette advertising sources (retail stores, the Internet, television, and newspapers and magazines), CDC analyzed data from the 2014, 2015, and 2016 National Youth Tobacco Surveys (NYTSs). Overall, exposure to e-cigarette advertising from at least one source increased each year during 2014-2016 (2014: 68.9%, 18.3 million; 2015: 73.0%, 19.2 million; 2016: 78.2%, 20.5 million). 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. A comprehensive strategy to prevent and reduce youth use of e-cigarettes and other tobacco products includes efforts to reduce 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 (5).

FIGURE 1

Percentage of U.S. middle and high school students exposed to e-cigarette advertisements through any source, retail stores, the Internet, television/movies, and newspapers and magazines — National Youth Tobacco Survey, United States, 2014–2016 * Between-year differences in the percentage of students exposed to each advertisement source during 2014–2016 were assessed using the Wald F test and posthoc corrections for multiple hypothesis testing (p<0.0167). ^† Statistically significant increases occurred during 2014–2015, 2015–2016, and 2014–2016. ^§ Statistically significant increases occurred during 2014–2015, 2015–2016, and 2014–2016. ^¶ Statistically significant increase occurred during 2014–2015. ** Statistically significant increase occurred during 2014–2015; statistically significant decrease occurred during 2015–2016. Movies were removed as an exposure source after 2014. ^†† Statistically significant decreases occurred during 2015–2016 and 2014–2016.

FIGURE 2

Percentage of U.S. middle and high school students who were exposed to e-cigarette advertising, by number of exposure sources— National Youth Tobacco Survey, United States, 2014–2016 * The four exposure sources were retail stores, the Internet, television/movies, and newspapers and magazines. Movies were removed as an advertising source after 2014.