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Report: More and More Teens Seeing E-Cigarette Ads

MMWR infographic of student exposure to e-cigarette ads

The US Centers for Disease Control and Prevention (CDC) reports that middle school and high school students are being exposed to more advertising for electronic cigarettes than ever before. The March 16th issue of the CDC’s Morbidity and Mortality Weekly Report states that nearly 4 out of 5 middle and high school students were exposed to e-cigarette ads from at least one source in 2016. This is a 12% increase from 2014.

E-cigarettes are the most commonly used tobacco product among this age group. According to the CDC, exposure to e-cigarette advertising is linked to the chances that young people will go on to use e-cigarettes, just as exposure to traditional tobacco advertising is linked to the chances that young people will try regular cigarettes or other traditional tobacco products. The CDC says regulating e-cigarette advertising should be part of comprehensive youth tobacco prevention efforts.

The CDC used data from the 2014, 2015, and 2016 National Youth Tobacco Surveys to determine the numbers of middle and high school students who were exposed to e-cigarette advertising from retail stores (convenience stores, supermarkets, or gas stations), the internet, TV/movies, and newspapers/magazines.

Key findings

  • In 2016, 20.5 million US middle and high school students were exposed to e-cigarette advertisements from at least one source. That’s 78.2%, or nearly 4 out of 5 students.
  • Youth exposure to e-cigarette advertisements from at least one source has increased each year between 2014 and 2016. (2014: 68.9%, 18.3 million; 2015: 73.0%, 19.2 million; 2016: 78.2%, 20.5 million)
  • The biggest source of e-cigarette advertising to youth is retail stores. In 2016, 68% of middle and high school students were exposed to e-cigarette advertising in retail stores, compared with the internet: 40.6%, TV/movies: 37.7%, and newspapers/magazines: 23.9%.

How tobacco ads appeal to youth

According to the US Surgeon General, e-cigarette advertising uses marketing strategies that appeal to youth, similar to those of traditional tobacco product advertising. These tactics include:

  • Themes of romance, freedom, and rebellion
  • Celebrity endorsements
  • Health claims
  • Product design features

In addition, e-cigarettes are marketed and promoted using strategies that are not legal for regular cigarette advertising, such as TV, sports, and music event sponsorships; in-store self-service displays; and ads placed outside brick-and-mortar businesses at children’s eye level. In August 2016, the Food and Drug Administration began enforcing restrictions on e-cigarette sales to minors, including those online.

According to the report, students who currently used e-cigarettes or other tobacco products were more likely than non-users to see e-cigarette advertising. The report’s authors say this means prevention of youth exposure to e-cigarette advertising might be important for preventing young people’s use of any tobacco product.

Youth tobacco prevention efforts

The CDC calls for specific approaches to help reduce tobacco use by young people. They include:

  • Regulation of marketing electronic and traditional tobacco products directed toward youth
  • Restricting e-cigarettes sales to adult-only facilities
  • Limiting the number of stores selling tobacco products in a specific area, and/or limiting how close they can be to schools
  • Banning self-service displays, such as vending machines
  • Requiring in-person transactions for all e-cigarette purchases
  • Launching education campaigns that warn young people about the dangers of using any tobacco products, including e-cigarettes

How e-cigarettes impact youth

E-cigarettes contain heated nicotine extracted from tobacco, as well as a variety of flavorings and other additives. Because e-cigarettes are a relatively new product, not much is known about the health effects of their long-term use.

However, nicotine – highly addictive at any age – is especially dangerous for children, teenagers, and young adults because their brains are still developing. Most users, including youth, prefer to use flavored e-cigarettes. Many flavors appear to be aimed at children, with names such as Cherry Crush and Cotton Candy.

Young people use e-cigarettes more than any other tobacco product. And research has found a strong association between youth using e-cigarettes and their likelihood of trying conventional cigarettes.

The American Cancer Society recommends not using any tobacco products at all. If you use tobacco or know someone who does, and want information about quitting, visit us online or call us at 1-800-227-2345 for tips and resources.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Exposure to Electronic Cigarette Advertising Among Middle and High School Students — United States, 2014–2016. Published in the March 16, 2018 issue of Morbidity and Mortality Weekly Report. First author Kristy Marynak, MPP, US Centers for Disease Control and Prevention, Atlanta, Ga.