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Study: Teens more likely to vape after seeing store ads :

August 26, 2019

Adolescents exposed to e-cigarette ads in retail stores are twice as likely to start vaping within several years, according to a new study.

E-cigarette use has been skyrocketing among teens despite evidence they are addictive, harmful to developing brains and contain toxic chemicals. In recent weeks, they also have been linked to 193 reports of severe pulmonary illness.

Researchers from the University of Texas and University of North Texas set out to look at the impact of e-cigarette advertising, which is unregulated. They used data on 2,288 adolescents ages 12-17 and 2,423 young adults ages 18-29 in Texas who had never used e-cigarettes. At the start of the study, participants were asked about e-cigarette ads they had seen or heard on TV, radio, billboards, retail stores and the internet and how frequently they had seen or heard them. Over the course of 2.5 years, they were asked about their e-cigarette use. The results are reported in “Electronic Nicotine Delivery Systems Marketing and Initiation among Youth and Young Adults,” (Loukas A, et al. Pediatrics. Aug. 26, 2019,

About 58% of adolescents said they had seen e-cigarette ads in retail stores and 44% had seen them on TV. Other types of ads were less common. Over the course of the study, 14% started vaping. Adolescents were twice as likely to use e-cigarettes if they had seen ads in retail stores. Other channels were not significantly linked to use.

Young adults were most likely to recall seeing e-cigarette ads on the internet (57%) and in retail stores (56%). About 25% of this group started vaping during the study. Having viewed ads in retail stores or on TV was associated with 1.3 times higher odds of starting to vape.

Authors noted the impact of retail stores, saying they “often display marketing near checkout counters, simultaneously marketing ENDS (electronic nicotine delivery system) products and providing direct access to them.”

Trying to explain the association between TV ads and e-cigarette use among young adults but not adolescents, authors cited previous research showing the messages, such as comparing e-cigarettes to traditional cigarettes, don’t always resonate with younger groups.

Researchers called for federal and state authorities to regulate e-cigarette ads, especially in retail stores.

“Given the increasing popularity of ENDS products among young people, limiting ENDS marketing at retail stores is of paramount importance,” they wrote.

The AAP has been unwavering in its efforts to keep e-cigarettes out of children’s hands, urging lawmakers to restrict sales to anyone under 21 years and to ban flavored products. It also has been pushing for faster premarket review by the Food and Drug Administration.

Last month, Jonathan P. Winickoff, M.D., M.P.H., FAAP, represented the Academy at a hearing held by a U.S. House of Representatives oversight subcommittee and called for JUUL pods to be removed from the market. The pods have the same amount of nicotine as 20 cigarettes. The Academy also helped launch a series of advertisements to call attention to the harmful effects of JUUL.

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