OBJECTIVE: To examine how exposure to advertising channels is associated with e-cigarette use among youth in the United States.
METHODS: This study included 161,700 middle and high school students aged 9–18 years from the 2014–2022 National Youth Tobacco Survey data. Multivariate logistic regressions estimated adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) for the association between exposure to advertising channels and ever e-cigarette use. Annual percent change (APC) for ever e-cigarette use and exposure to each advertising channel were analyzed using Joinpoint regression. Data for 2014–2018 and 2019–2022 were analyzed separately due to the change in survey format and weighting procedure.
RESULTS: Ever e-cigarette use prevalence increased (APC = + 2.78: 95 % CI -13.65, 21.38) between 2014 and 2018, then declined (APC = -18.20 %: 95 % CI –27.11, 8.36) between 2019 and 2022. Exposure to retail (2014–2018 aOR = 1.36: 95 % CI 1.29, 1.43; 2019–2022 aOR = 1.46: 95 % CI 1.38, 1.54) and internet advertising (2014–2018 aOR = 1.43: 95 % CI 1.35, 1.51; 2019–2022 aOR = 1.19: 95 % CI 1.13, 1.25) were associated with higher odds of ever e-cigarette use.
CONCLUSIONS: Exposure to retail and internet marketing increased the likelihood of ever-use of e-cigarettes among youth in the US. Additional regulations for point-of-sale and internet advertisements should be implemented.
Differential association of exposure to advertising channels with ever e-cigarette use among youth in the United States: 2014-2022
Preventive Medicine Reports, 61, 103332. doi: 10.1016/j.pmedr.2025.103332. PMCID: PMC12723290.