“There is a large body of evidence to support the notion that advertising cigarettes encourages people to start or to continue to smoke,” write the team. “While there are restrictions on advertising e-cigarettes in the UK (Committee on Advertising Practice) and in the USA (US Food and Drug Regulations) e-cigarettes are still being marketed elsewhere and there is concern that the advertisements portray e-cigarettes as being glamourous.”
They looked at vape advertising to see if they “enhanced attitudes towards cigarettes” (commonly referred to as renormalising smoking), and/or if it led to an increase in tobacco smoking attempts.
At the outset, they point out: “It is important to note that the evidence base around actual usage statistics currently suggests that e-cigarette availability does not appear to have led to regular use of either e-cigarettes or smoking among British non-smokers: the current number of UK non-smokers using an e-cigarette daily is less than 1%, and smoking prevalence rates continue to decline. A similar pattern is observed in the USA.”
Also, they highlight: “E-cigarette advertisements may represent an opportunity to promote reduced risk products as an alternative to smoking.”
The team notes an increased level of support for vaping as a tobacco harm reduction tool over time in the UK, but a growth in “negative attitudes towards the products”, due in all probability to the skewed “science” from America and media coverage, has acted as a “barrier to the uptake of e-cigarettes among smokers”.
Between 2015 and 2017, the proportion of UK smokers who believed that e-cigarettes are less harmful than cigarettes reduced from 31% to 20% (Action on Smoking and Health).
Similarly, in the USA, the percentage of smokers who perceived e-cigarettes to be equally harmful than combustible cigarettes increased from 23% in 2012 to 35% in 2015.
“E-cigarette advertising may serve to halt or reverse this decline.”
Their survey involved 964 participants at the outset, reduced to 765 – 543 from the USA and 222 from the UK.
They write: “Post exposure all smoking groups showed a decrease or no change in how socially acceptable or desirable they rated cigarettes. Paradoxically, dual users rated cigarettes as being significantly healthier after viewing the advertisement (p=0.01) while all other smoking group ratings remained the same. There was an increase or no change in how all smoking groups perceived the healthiness and desirability of e-cigarettes.”
The team concluded: “The results from this study suggest that viewing an e-cigarette advertisement is unlikely to renormalise smoking among most groups. However, we observed some evidence that e-cigarette advertisements may increase how healthy cigarettes are perceived among dual users.”
“This highlights the importance of more research with this relatively understudied group, in particular, around factors which promote the decision to transition from dual use to e-cigarette use or nicotine abstinence.”
“In terms of reducing barriers to uptake, e-cigarette advertisement may encourage smokers to quit using e-cigarettes as a smoking cessation tool. Thus, e-cigarette advertisements could be considered a viable tool to stimulate or support smoking cessation. However, where e-cigarette advertising is prevalent, careful monitoring of uptake of e-cigarettes among nicotine naïve populations is important.”
- “Survey of the effect of viewing an online e-cigarette advertisement on attitudes towards cigarette and e-cigarette use in adults located in the UK and USA: a cross-sectional study” by Booth, Albery, Cox, and Frings – [link]