Skip to main content
Skip to main content

AAP Gateway

Advanced Search »

User menu

  • Login
  • Current Policy
  • Topic/Program Collections
  • Submit Manuscript
  • Alerts
  • Subscribe
  • aap.org

Menu

  • AAP Grand Rounds
  • AAP News
  • Hospital Pediatrics
  • NeoReviews
  • Pediatrics
  • Pediatrics in Review
  • Current AAP Policy
  • Journal CME
  • AAP Career Center
  • Pediatric Collections
  • AAP Journals Catalog

Sections

    • Login
    • Current Policy
    • Topic/Program Collections
    • Submit Manuscript
    • Alerts
    • Subscribe
    • aap.org

    Sign up for Insight Alerts highlighting editor-chosen studies with the greatest impact on clinical care.

    New! Video Abstracts -- brief videos summarizing key findings of new articles

    Know what's next when you read AAP Journals, view the new 2018 Catalog.
    Trainees,
    enter the SOPT Essay Contest for a chance to be published in Pediatrics!

    Advertising Disclaimer »

    Tools and Links

    Pediatrics
    July 2014, VOLUME 134 / ISSUE 1
    From the American Academy of Pediatrics
    Article

    Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults

    Jennifer C. Duke, Youn O. Lee, Annice E. Kim, Kimberly A. Watson, Kristin Y. Arnold, James M. Nonnemaker, Lauren Porter
    • Article
    • Figures & Data
    • Info & Metrics
    • Comments
    Loading
    Download PDF

    Abstract

    BACKGROUND AND OBJECTIVE: Currently, the US Food and Drug Administration does not regulate electronic cigarette (e-cigarette) marketing unless it is advertised as a smoking cessation aid. To date, the extent to which youth and young adults are exposed to e-cigarette television advertisements is unknown. The objective of this study was to analyze trends in youth and young adult exposure to e-cigarette television advertisements in the United States.

    METHODS: Nielsen data on television household audiences’ exposure to e-cigarette advertising across US markets were examined by calendar quarter, year, and sponsor.

    RESULTS: Youth exposure to television e-cigarette advertisements, measured by target rating points, increased 256% from 2011 to 2013. Young adult exposure increased 321% over the same period. More than 76% of all youth e-cigarette advertising exposure occurred on cable networks and was driven primarily by an advertising campaign for 1 e-cigarette brand.

    CONCLUSIONS: E-cigarette companies currently advertise their products to a broad audience that includes 24 million youth. The dramatic increase in youth and young adult television exposure between 2011 and 2013 was driven primarily by a large advertising campaign on national cable networks. In the absence of evidence-based public health messaging, the current e-cigarette television advertising may be promoting beliefs and behaviors that pose harm to the public health. If current trends in e-cigarette television advertising continue, awareness and use of e-cigarettes are likely to increase among youth and young adults.

    • electronic cigarettes
    • e-cigarettes
    • advertising
    • media
    • adolescents
    • smoking
    • students
  • Abbreviations:
    e-cigarette —
    electronic cigarette
    FDA —
    Food and Drug Administration
    TRP —
    target rating point
  • What’s Known on This Subject:

    Electronic cigarettes have unknown health risks and youth and young adults increasingly use them. E-cigarette companies are marketing e-cigarettes using television ads. The content of these ads may appeal to young people because they emphasize themes of independence and maturity.

    What This Study Adds:

    E-cigarette companies advertise to a broad television audience that includes 24 million youth. The reach and frequency of these ads increased dramatically between 2011 and 2013. If current trends continue, youth awareness and use of e-cigarettes are likely to increase.

    Electronic cigarettes (e-cigarettes) are battery-powered devices resembling traditional cigarettes and are designed to deliver nicotine vapor.1 US sales of e-cigarettes have doubled every year since they were introduced and reached $1 billion annually as of August 2013.2 From 2011 to 2012, youth prevalence of e-cigarette use doubled in terms of ever use (from 3.3% to 6.8%), current use (from 1.1% to 2.1%), and dual use with traditional cigarettes (from 0.8% to 1.6%). As of 2012, an estimated 1.8 million middle and high school students had ever used e-cigarettes.3 Almost 10% (9.3%) of students who have used e-cigarettes have never used traditional cigarettes.

    The rise in e-cigarette use among youth aged 12 to 17 years poses several concerns. E-cigarette use may lead to tobacco use,4 undermine social norms about tobacco,5 and delay cessation among cigarette smokers. It is unknown whether e-cigarette use increases youth risk for nicotine addiction or serves as a gateway, increasing risks that youth will transition to using other tobacco products. Social norms regarding the acceptability of smoking can influence smoking behaviors.6 Evidence suggests that policies limiting tobacco use, particularly indoor air policies and household tobacco rules, engender social norms supporting cessation, reduce tobacco use initiation by youth, and decrease adult tobacco use.7–11 Effects of these policies may be undermined if widespread acceptance of e-cigarette use increases the acceptability of tobacco use, especially among youth, who may not distinguish between products. In addition, e-cigarettes may encourage smokers to delay cigarette cessation. Some smokers use e-cigarettes to circumvent smoking restrictions,1 and adolescent smokers may use both e-cigarettes and traditional cigarettes rather than quitting. These concerns are also warranted for young adults aged 18 to 24 years, given the increasing prevalence of cigarette initiation and increasing rates of transition to regular smoking during young adulthood.12,13

    Although researchers have yet to determine the direct health effects posed by inhalation of the vaporized chemical constituents in e-cigarettes,14 studies suggest that exposure to nicotine has deleterious effects on the brain during youth and young adulthood. During adolescence, executive functions are developing, and exposing adolescents to nicotine may alter this development.15 Animal studies show evidence of deficits induced by exposure to nicotine during adolescence, including those in serial pattern learning,16 attention and impulsivity,17 and memory,18 as well as increased anxiety and depression.19–21 These findings raise serious concerns about nicotine exposure from e-cigarette use among youth and young adults.

    The 2009 Family Smoking Prevention and Tobacco Control Act gives the US Food and Drug Administration (FDA) regulatory jurisdiction over cigarettes and other tobacco products22; the FDA has the authority to extend this jurisdiction to e-cigarettes.22,23 The FDA has announced its intent to regulate e-cigarettes as tobacco products.24 An evidence base to inform regulatory decisions at the federal, state, and local levels is needed.25–28 As of October 2013, 25 states have established youth access laws prohibiting sales of e-cigarettes to minors.29 Recently, tobacco companies have entered the e-cigarette marketplace and substantially increased e-cigarette advertising expenditures. For example, after 1 major e-cigarette brand was acquired by a tobacco company in 2012, advertising expenditures of the product increased from $2 million in 2011 to >$14 million in 2012.30

    No widespread education campaigns exist to inform the public about the safety of e-cigarettes, and publicly available information is dominated by e-cigarette company marketing and popular media.4,31 Although traditional cigarette advertising has been banned from US television since 1971,32 e-cigarettes are not included in the restrictions.22,33 Historically, e-cigarettes have been advertised online,34 potentially exposing youth and young adults to many different marketing messages.35 In 2012, e-cigarette companies began airing media campaigns on television, a shift that may substantially increase the reach of messages to nearly all US households. Television remains the primary media channel through which advertisers reach US youth with messages.36,37 Although e-cigarette advertising on television may be designed to increase use and sales to adult US audiences,38 it may also result in considerable youth exposure.

    In light of the numerous concerns related to e-cigarette use during adolescence and the recent increases in advertising expenditures for e-cigarettes, studies on the type and extent of youth and young adult exposure to e-cigarette advertisements address a gap in the literature. The current study assesses the extent to which youth aged 12 to 17 years and young adults aged 18 to 24 years were exposed to US e-cigarette television advertisements.

    Methods

    Data Source

    Data on e-cigarette advertisements on US television networks were obtained from Nielsen, the leading provider of comprehensive television advertising data. The Nielsen Monitor-Plus service tracks commercial occurrence information on >100 US network and cable television networks and locally across 210 US designated market areas (“media markets” hereafter).39 Nielsen data are based on individual ratings of television programs obtained through weekly monitoring of US households. These data allow Nielsen to estimate the reach of commercial advertising occurring during television programs by viewer demographics.

    Measures

    To assess e-cigarette advertising exposure, we calculated target rating points (TRPs), the standard unit of measurement for potential television exposure, from the early appearance of e-cigarette advertising in January 2011 to the most recent data available in September 2013. TRPs are measured for a specified audience as a function of reach (the proportion of people exposed to an advertisement) and frequency (the number of times an advertisement is potentially viewed).39 TRPs, aggregated from viewership ratings for each e-cigarette commercial occurrence, were calculated by quarter, year, and sponsor. TRPs were calculated for youth aged 12 to 17 years and young adults aged 18 to 24 years. For example, an ad with 50 youth TRPs per quarter is plausibly estimated to have been viewed an average of 5 times by 10% of youth or an average of 1 time by 50% of youth over a 3-month period. Individuals may have higher or lower exposure based on their own television viewing behavior. Comparison TRPs were also summarized for adults aged 25 to 34, 35 to 54, and ≥55 years.

    TRPs were calculated for cable, network, syndicated, and spot television advertisements. Cable television ratings include 97 networks airing nationally (eg, Comedy Central, AMC). Network (broadcast) television consists of 8 networks airing nationally (eg, ABC, FOX). The number of nationally syndicated television channels includes >200 programs available to local stations (eg, Friends). Data include 73 919 spot television advertisements aired locally in US markets.39 Ratings were adjusted to account for advertisement length, so all TRPs reflect ratings for 30-second equivalents (eg, TRPs for 60-second advertisements were doubled). Of all advertisements, 64.4% were 30 seconds, whereas 17.4% were 15, 12.6% were 60, and 5.7% were 120 seconds.

    Weighting and Analysis

    TRPs for national network, cable, and syndicated television media assess exposure among all youth and young adult television households, whereas spot television TRPs measure exposure in an individual media market. To compare spot television advertising with national advertising, market-level TRPs were weighted to the national population of youth and young adults. We created population-weighted TRPs by adjusting each value to account for the percentage of the US population included in each market. TRPs were multiplied by the population of the constituent counties based on 2010 US Census data, divided by the national population, and summed to estimate national exposure.

    To examine changes in e-cigarette television advertising over time, trends in quarterly TRP data overall and by media type were summarized. The distribution of TRPs across e-cigarette brands airing over the study period were summarized. In addition, the cable networks and programs airing the largest proportion of advertising and markets in which youth were exposed to spot television advertising were examined.

    Results

    National Trends in Exposure

    Figure 1 displays quarterly trends in national e-cigarette advertising TRPs from January 2011 through September 2013 by age. Throughout most of 2011 and the first half of 2012, youth were exposed to <100 quarterly TRPs of e-cigarette television advertising. During the latter half of 2012 and the first 3 quarters of 2013, youth exposure increased substantially, peaking at 347 TRPs from April to June 2013 and declining to 275 TRPs from July to September 2013. From October 2012 through September 2013, youth were exposed to 1054 cumulative yearly TRPs. Although youth audience reach data cannot be separated from frequency data because they are proprietary to paid advertisers, TRPs can be used to estimate the average frequency of ad exposure for fixed percentages of the population. For example, based on the cumulative yearly TRPs, 50.0% of all youth in US television households were exposed to an average of 21 e-cigarette advertisements from October 2012 through September 2013. Alternatively, the same cumulative yearly TRPs could represent an exposure to an average of 105 advertisements for 10% of all US youth or an exposure to an average of 13 ads for 80% of all US youth over the 1-year period. Youth exposure to television e-cigarette advertisements increased 256.0% from 2011 to 2013.

    FIGURE 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1

    Exposure to e-cigarette television advertisements, January 2011 to September 2013.

    Over the study period, young adults were exposed to higher national TRPs than youth, and TRP patterns were similar (Fig 1). Young adults were exposed to more than 300 TRPs in each quarter from October 2012 through September 2013, peaking at 611 quarterly TRPs from April to June 2013. From October 2012 through September 2013, young adults were exposed to 1742 cumulative TRPs. Similar to youth, the TRPs for young adults can be used to estimate the average frequency of ad exposure for fixed percentages. For example, based on the cumulative TRPs, 50.0% of all young adults in US television households were exposed to an average of 35 e-cigarette advertisements from October 2012 through September 2013. Young adult exposure to television e-cigarette advertisements increased 321.0% from 2011 to 2013.

    Television Media Type and Popular Networks

    Cable television accounted for the largest proportion of all TRPs among youth and young adults (Table 1). Overall, 75.5% of U.S. e-cigarette advertising exposure to youth from January 2011 to September 2013 occurred on cable networks (75.0% for young adults). Consistent with the increasing national trend overall, e-cigarette advertising from October 2012 through September 2013 accounted for 69.9% of all youth television exposure and 73.8% of all young adult exposure during the 11 quarters examined in the study.

    View this table:
    • View inline
    • View popup
    TABLE 1

    Quarterly Television TRPs by Age and Media Type, January 2011 to September 2013

    In 2013, the cable network AMC aired the most e-cigarette advertising reaching youth audiences at 8.0%, followed by Country Music Television (6.1%), Comedy Central (5.9%), WGN America (5.4%), TV Land (5.3%), and VH1 (5.3%). E-cigarette advertisements appeared on programs (eg, The Bachelor, Big Brother, Survivor) that were among the 100 highest-rated youth programs for the 2012–2013 viewing season.

    Distribution of Advertising by Brand and Time of Day

    Increases in advertising were not equal across brands. The majority of youth and young adult exposure to advertisements was by 1 e-cigarette brand, which accounted for 81.7% of all nationally aired TRPs directed at youth and 80.4% of TRPs directed at young adults in 2013 (Table 2). The next leading brand accounted for 7.1% of exposure to youth and 6.7% of exposure to young adults in 2013.

    View this table:
    • View inline
    • View popup
    TABLE 2

    Percentage of Television E-Cigarette Advertisinga by Brand and Age, January 2013 to September 2013

    During Quarter 3 of 2013, 52.9% of TRPs for the e-cigarette brand with the majority of television advertising reaching the youth audience aired overnight (1–7 am), followed by 21.6% in prime time (8–11 pm) and 14.8% in late night (11 pm–1 am). Similarly, 55.5% of TRPs reaching the young adult audience aired overnight, followed by 19.5% in prime time and 15.3% in late night. Data on the popularity of television viewing by day part provide context for advertising reach to youth and young adults. At any given time, approximately 8% of US youth (10% of young adults) are watching programs overnight, 25% of youth (24% of young adults) are watching programs in prime time, and 16% of youth (19% of young adults) are watching in late night.

    Local Advertising and Targeted Media Markets

    In contrast to the high levels of national advertisements by 1 major brand, there was a greater variety of brands and lower level of spot television advertising. Nineteen companies aired advertisements locally over the study period. In 2011, 2 spot television campaigns aired, with a mean of 50 quarterly youth TRPs. The first brand aired in 51 media markets containing 40.4% of US youth; the second aired in 45 media markets containing 28.9% of US youth. The 8 other brands advertising in 2011 reached 4% of US youth on average. In 2013, 1 spot television campaign aired in 9 media markets containing 22.4% of US youth (mean = 41 quarterly youth TRPs). The largest nationally advertised e-cigarette brand also aired locally in media markets containing 15.7% of US youth (mean = 15 quarterly youth TRPs). The 10 other brands advertised in 2013 reached 3% of US youth on average.

    Although the overall reach of these spot television campaigns as a proportion of national television households is low, some media markets received high additional exposure beyond the large cable network advertisements during the study period (Fig 2). Youth in 5 media markets received ≥1000 TRPs over the study period.

    FIGURE 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 2

    Market-level youth exposure to e-cigarette spot television advertisements, January 2011 to September 2013. Note. Yellow-shaded markets (Youth TRPs): Greensboro-High Point-Winston Salem, NC (770); Charleston-Huntington, WV (728); Syracuse, NY (665); Lexington, KY (643); Greenville-Spartanburg, SC–Asheville, NC–Anderson, SC (582); Flint-Saginaw-Bay City, MI (563); Richmond-Petersburg, VA (551); Miami-Ft. Lauderdale, FL (538); Cedar Rapids-Waterloo-Iowa City & Dubuque, IA (530). Green-shaded markets: Las Vegas, NV (500); Cincinnati, OH (426); Dayton, OH (413); Pittsburgh, PA (405); Paducah, KY–Cape Girardeau, MO–Harrisburg, IL (402); Nashville, TN (377); Hartford and New Haven, CT (360); San Antonio, TX (358); Oklahoma City, OK (357); Louisville, KY (324); Honolulu, HI (314).

    Discussion

    Results show that e-cigarette companies have been advertising their products to a broad audience that includes 24 million youth. Youth and young adult exposure to television e-cigarette advertisements increased substantially from 2011 to 2013, with a dramatic rise from late 2012 through September 2013. In contrast to earlier research on the broader e-cigarette advertising landscape, which included more than 80 brands,30 television advertising is dominated by few advertisers. The trends in youth and young adult media exposure were driven primarily by a large advertising campaign on national cable networks for 1 e-cigarette brand in addition to small, targeted local advertising.

    Data on exposure levels for effective US antitobacco mass media campaigns suggest that the substantial rise in national television e-cigarette advertising levels may have begun influencing youth e-cigarette beliefs and behaviors since October 2012. The Centers for Disease Control and Prevention guidelines on advertising levels for antitobacco mass media campaigns recommend 800 quarterly TRPs for sustaining campaign effects.40 However, some studies indicate that advertising exposure for youth may yield effects at lower levels, starting at about 300 TRPs per quarter,41 with linear increases up to 1250 TRPs.41–43 Although TRP guidelines for antitobacco mass media campaigns may not be directly applicable for influence of e-cigarette advertising on youth, they offer a point of comparison. The sustained level of exposure to the unregulated messages about the benefits of e-cigarettes reported here is of concern and may pose public health harm to youth and young adults.

    Trends in e-cigarette television advertising suggest that recent increases in the rates of e-cigarette use may continue,3 and more research is needed to determine the effects of e-cigarette advertisements on youth and young adults. Current advertising includes celebrities and depicts e-cigarettes with vapor that is indistinguishable from cigarette smoke. Empirical evidence shows a strong association between smoking depictions in film and smoking initiation among youth and young adults.44–46 Furthermore, studies show that such visual cues can trigger urges to smoke.47,48 Additional research on the extent to which youth distinguish between e-cigarettes and traditional cigarettes could provide data on the impact of visual depictions of e-cigarette use on television.

    The most widely aired e-cigarette advertisement features a film actor exhaling e-cigarette vapor while informing viewers of numerous benefits of “smoking” the product, closing with the ad tagline, “We’re all adults here. It’s time to take back your freedom.” In her final opinion from a 2006 lawsuit between the US federal government and 2 tobacco companies, US District Court Judge Gladys Kessler determined that youth antismoking media campaigns sponsored by the tobacco industry “promote the message that smoking is an adult decision. Emphasizing that smoking is an adult activity underscores the desirability of engaging in adult behavior for adolescents who are particularly motivated to appear mature” (p. 1168).49 More than a decade after ineffective youth prevention media campaigns sponsored by the major tobacco companies50–52 were removed from television, e-cigarette advertisements with similar messages may be creating new social norms around e-cigarettes and increasing the desirability of e-cigarettes.

    This is the first study to examine youth and young adult exposure to e-cigarette advertising on television during this rapidly evolving period of e-cigarette marketing in the United States. Using systematically collected exposure data from the leading agency on television advertising, we report timely evidence of marketing reach among youth and young adults during the debut of e-cigarette advertising on US television. Findings support previous research documenting increased media expenditures for e-cigarette brands acquired by tobacco companies30 and confirms that greater expenditures lead directly to greater youth and young adult exposure to e-cigarette television advertising.

    Study limitations include the use of TRP data to measure e-cigarette advertising. TRPs represent estimates of potential exposure at the population level for each age group in the study, and individuals may receive more or less exposure depending on the frequency of and program selected for viewing. Although TRPs are an accurate indicator of exposure, they are abstract because data on reach and frequency are proprietary to e-cigarette advertisers. However, TRPs are a valid, standard metric that correlates highly with recall of advertising for antitobacco mass media campaigns.41,53,54 Results are limited to television advertising; exposure through other media (eg, online, radio, print), advertisements at the point of sale, and observations of people using e-cigarettes may affect related beliefs and behaviors.

    Conclusions

    E-cigarettes have unknown health risks and deliver nicotine, raising health concerns about youth and young adult use. E-cigarette companies advertise their products to a broad audience that includes 24 million youth, and youth and young adult television exposure has increased dramatically between 2011 and 2013. In the absence of evidence-based public health messaging, television advertising may be promoting beliefs and behaviors that pose harm to the public health. If current trends in e-cigarette television advertising continue, awareness and use of e-cigarettes are likely to increase among youth and young adults.

    Footnotes

      • Accepted April 15, 2014.
    • Address correspondence to Jennifer C. Duke, PhD, RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709. E-mail: jduke{at}rti.org.
    • Dr Duke conceptualized and designed the study and analyses and drafted the initial manuscript; Dr Lee assisted in designing the study and drafting the initial manuscript and critically reviewed and revised the manuscript; Drs Kim, Nonnemaker, and Porter assisted in designing the study and critically reviewed and revised the manuscript; Ms Watson and Ms Arnold acquired the data and conducted the analyses and critically reviewed the manuscript; and all authors approved the final manuscript as submitted.

    • FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

    • FUNDING: This work was funded under an RTI International contract with the Florida Department of Health’s Bureau of Tobacco Free Florida.

    • POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

    References

    1. ↵
      1. Pepper JK,
      2. Brewer NT
      . Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review [published online ahead of print November 20, 2013]. Tob Control. doi: 10.1136/tobaccocontrol-2013-051122pmid:doi: 10.1136/tobaccocontrol-2013-051122
      OpenUrlPubMed
    2. ↵
      Robehmed N. E-cigarette sales surpass $1 billion as big tobacco moves in. Forbes. 2013. Available at: www.forbes.com/sites/natalierobehmed/2013/09/17/e-cigarette-sales-surpass-1-billion-as-big-tobacco-moves-in/
    3. ↵
      1. Corey C,
      2. Wang B,
      3. Johnson SE,
      4. et al.,
      5. Centers for Disease Control and Prevention (CDC)
      . Notes from the field: electronic cigarette use among middle and high school students: United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2013;62(35):729–730pmid:24005229
      OpenUrlPubMed
    4. ↵
      1. Grana RA
      . Electronic cigarettes: a new nicotine gateway? J Adolesc Health. 2013;52(2):135–136pmid:23332475
      OpenUrlCrossRefPubMedWeb of Science
    5. ↵
      1. Mejia AB,
      2. Ling PM,
      3. Glantz SA
      . Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA. Tob Control. 2010;19(4):297–305pmid:20581427
      OpenUrlAbstract/FREE Full Text
    6. ↵
      1. Stokols D
      . Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996;10(4):282–298pmid:10159709
      OpenUrlCrossRefPubMedWeb of Science
    7. ↵
      1. Siegel M,
      2. Albers AB,
      3. Cheng DM,
      4. Biener L,
      5. Rigotti NA
      . Effect of local restaurant smoking regulations on progression to established smoking among youths. Tob Control. 2005;14(5):300–306pmid:16183980
      OpenUrlAbstract/FREE Full Text
      1. Siegel M,
      2. Albers AB,
      3. Cheng DM,
      4. Hamilton WL,
      5. Biener L
      . Local restaurant smoking regulations and the adolescent smoking initiation process: results of a multilevel contextual analysis among Massachusetts youth. Arch Pediatr Adolesc Med. 2008;162(5):477–483pmid:18458195
      OpenUrlCrossRefPubMedWeb of Science
      1. Hopkins DP,
      2. Razi S,
      3. Leeks KD,
      4. Priya Kalra G,
      5. Chattopadhyay SK,
      6. Soler RE,
      7. Task Force on Community Preventive Services
      . Smokefree policies to reduce tobacco use. A systematic review. Am J Prev Med. 2010;38(2 suppl):S275–S289pmid:20117612
      OpenUrlCrossRefPubMedWeb of Science
      1. Fichtenberg CM,
      2. Glantz SA
      . Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ. 2002;325(7357):188pmid:12142305
      OpenUrlAbstract/FREE Full Text
    8. ↵
      1. Zhang X,
      2. Cowling DW,
      3. Tang H
      . The impact of social norm change strategies on smokers’ quitting behaviours. Tob Control. 2010;19(suppl 1):i51–i55pmid:20382651
      OpenUrlAbstract/FREE Full Text
    9. ↵
      1. Foldes SS,
      2. An LC,
      3. Rode P,
      4. et al
      . The prevalence of unrecognized tobacco use among young adults. Am J Health Behav. 2010;34(3):309–321pmid:20001188
      OpenUrlCrossRefPubMedWeb of Science
    10. ↵
      1. Substance Abuse and Mental Health Services Administration
      . Results From the 2012 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013
    11. ↵
      1. Etter JF,
      2. Bullen C,
      3. Flouris AD,
      4. Laugesen M,
      5. Eissenberg T
      . Electronic nicotine delivery systems: a research agenda. Tob Control. 2011;20(3):243–248pmid:21415064
      OpenUrlAbstract/FREE Full Text
    12. ↵
      1. Dwyer JB,
      2. McQuown SC,
      3. Leslie FM
      . The dynamic effects of nicotine on the developing brain. Pharmacol Ther. 2009;122(2):125–139pmid:19268688
      OpenUrlCrossRefPubMedWeb of Science
    13. ↵
      1. Fountain SB,
      2. Rowan JD,
      3. Kelley BM,
      4. Willey AR,
      5. Nolley EP
      . Adolescent exposure to nicotine impairs adult serial pattern learning in rats. Exp Brain Res. 2008;187(4):651–656pmid:18478215
      OpenUrlCrossRefPubMedWeb of Science
    14. ↵
      1. Counotte DS,
      2. Spijker S,
      3. Van de Burgwal LH,
      4. et al
      . Long-lasting cognitive deficits resulting from adolescent nicotine exposure in rats. Neuropsychopharmacology. 2009;34(2):299–306pmid:18580873
      OpenUrlCrossRefPubMedWeb of Science
    15. ↵
      1. Trauth JA,
      2. Seidler FJ,
      3. Slotkin TA
      . Persistent and delayed behavioral changes after nicotine treatment in adolescent rats. Brain Res. 2000;880(1–2):167–172pmid:11033001
      OpenUrlCrossRefPubMedWeb of Science
    16. ↵
      1. Smith LN,
      2. McDonald CG,
      3. Bergstrom HC,
      4. et al
      . Long-term changes in fear conditioning and anxiety-like behavior following nicotine exposure in adult versus adolescent rats. Pharmacol Biochem Behav. 2006;85(1):91–97pmid:16919320
      OpenUrlCrossRefPubMed
      1. Slawecki CJ,
      2. Gilder A,
      3. Roth J,
      4. Ehlers CL
      . Increased anxiety-like behavior in adult rats exposed to nicotine as adolescents. Pharmacol Biochem Behav. 2003;75(2):355–361pmid:12873627
      OpenUrlCrossRefPubMedWeb of Science
    17. ↵
      1. Slawecki CJ,
      2. Thorsell AK,
      3. El Khoury A,
      4. Mathé AA,
      5. Ehlers CL
      . Increased CRF-like and NPY-like immunoreactivity in adult rats exposed to nicotine during adolescence: relation to anxiety-like and depressive-like behavior. Neuropeptides. 2005;39(4):369–377pmid:16038974
      OpenUrlCrossRefPubMedWeb of Science
    18. ↵
      1. Ashley DL,
      2. Backinger CL
      . The Food and Drug Administration’s regulation of tobacco: the Center for Tobacco Products’ Office of Science. Am J Prev Med. 2012;43(5 Suppl 3):S255–S263pmid:23079225
      OpenUrlCrossRefPubMed
    19. ↵
      US Court of Appeals Dist. of Columbia Circuit. Sottera, Inc. v. Food & Drug Administration. In: F 3d: Court of Appeals, Dist. of Columbia Circuit; 2010. p. 891
    20. ↵
      Food and Drug Administration. Regulation of e-cigarettes and other tobacco products. 2013. Available at: www.fda.gov/NewsEvents/PublicHealthFocus/ucm252360.htm. Accessed July 10, 2013
    21. ↵
      1. Freiberg MJ
      . Federal approaches to the regulation of noncigarette tobacco products. Am J Prev Med. 2012;43(5 Suppl 3):S249–S254pmid:23079224
      OpenUrlCrossRefPubMed
      1. Freiberg M.
      Options for state and local governments to regulate non-cigarette tobacco products. Ann Health Law. 2012;21(2):407–445
      OpenUrlPubMed
      1. Benowitz NL,
      2. Goniewicz ML
      . The regulatory challenge of electronic cigarettes. JAMA. 2013;310(7):685–686pmid:23856948
      OpenUrlCrossRefPubMedWeb of Science
    22. ↵
      1. Lee YO,
      2. Mukherjea A,
      3. Grana R
      . Hookah steam stones: smoking vapour expands from electronic cigarettes to waterpipes. Tob Control. 2013;22(2):136–137pmid:22863993
      OpenUrlFREE Full Text
    23. ↵
      Wilson R. Awaiting FDA, states pursue their own e-cigarette rules. The Washington Post. 2013. Available at: www.washingtonpost.com/blogs/govbeat/wp/2013/10/29/awaiting-fda-states-pursue-their-own-e-cigarette-rules/
    24. ↵
      1. Kim AE,
      2. Arnold KY,
      3. Makarenko O
      . E-cigarette advertising expenditures in the United States, 2011–2012. Am J Prev Med. 2014;46(4):409–412
      OpenUrlCrossRefPubMed
    25. ↵
      1. Grana RA,
      2. Glantz SA,
      3. Ling PM
      . Electronic nicotine delivery systems in the hands of Hollywood. Tob Control. 2011;20(6):425–426pmid:21659450
      OpenUrlFREE Full Text
    26. ↵
      1. Eckard EW
      . Competition and the cigarette TV advertising ban. Econ Inq. 1991;29(1):119–123
      OpenUrlCrossRefWeb of Science
    27. ↵
      1. Kim AE,
      2. Lee YO,
      3. Shafer P,
      4. Nonnemaker J,
      5. Makarenko O
      . Adult smokers' receptivity to a television advert for electronic nicotine delivery systems [published online ahead of print October 3, 2013]. Tob Control. doi: 10.1136/tobaccocontrol-2013-051130pmid:doi: 10.1136/tobaccocontrol-2013-051130
      OpenUrlPubMed
    28. ↵
      1. Noel JK,
      2. Rees VW,
      3. Connolly GN
      . Electronic cigarettes: a new “tobacco” industry? Tob Control. 2011;20(1):81pmid:20930060
      OpenUrlFREE Full Text
    29. ↵
      Grana R, Ling PM. “Smoking revolution?” A content analysis of online electronic cigarette marketing. In: American Public Health Association 140th Annual Meeting; October 31, 2012
    30. ↵
      The Nielsen Company. A look across media: the cross-platform report, Quarter 3, 2013. The Cross-Platform Series. 2013. Available at: www.slideshare.net/mapleaikon/crossplatform-report-june-2013-nielsen
    31. ↵
      Leibowitz J, Rosch JT, Ramirez E, Brill J, Ohlhausen M. A review of food marketing to children and adolescents. Follow-up report. Federal Trade Commission. 2012. Available at: www.ftc.gov/sites/default/files/documents/reports/review-food-marketing-children-and-adolescents-follow-report/121221foodmarketingreport.pdf
    32. ↵
      Elliot S. Campaigns for e-cigarettes borrow from tobacco’s heyday. The New York Times. 2012 December 6:B6. Available at: www.nytimes.com/2012/12/06/business/media/campaigns-for-electronic-cigarettes-borrow-from-their-tobacco-counterparts.html
    33. ↵
      Nielsen Holdings. Nielsen Monitor-Plus methodology by medium. 2013. Available at: http://en-us.nielsen.com/sitelets/cls/documents/adviews/AdViews-Methodology-by-Medium-InfoKit.pdf
    34. ↵
      1. Centers for Disease Control and Prevention
      . Best Practices for Comprehensive Tobacco Control Programs—2007. Atlanta, GA: U.S. Department of Health and Human Services; 2007
    35. ↵
      1. Emery S,
      2. Wakefield MA,
      3. Terry-McElrath Y,
      4. et al
      . Televised state-sponsored antitobacco advertising and youth smoking beliefs and behavior in the United States, 1999–2000. Arch Pediatr Adolesc Med. 2005;159(7):639–645pmid:15996997
      OpenUrlCrossRefPubMedWeb of Science
      1. Terry-McElrath YM,
      2. Wakefield MA,
      3. Emery S,
      4. et al
      . State anti-tobacco advertising and smoking outcomes by gender and race/ethnicity. Ethn Health. 2007;12(4):339–362pmid:17701761
      OpenUrlCrossRefPubMedWeb of Science
    36. ↵
      1. Farrelly MC,
      2. Davis KC,
      3. Haviland ML,
      4. Messeri P,
      5. Healton CG
      . Evidence of a dose-response relationship between “truth” antismoking ads and youth smoking prevalence. Am J Public Health. 2005;95(3):425–431pmid:15727971
      OpenUrlCrossRefPubMedWeb of Science
    37. ↵
      1. Sargent JD,
      2. Stoolmiller M,
      3. Worth KA,
      4. et al
      . Exposure to smoking depictions in movies: its association with established adolescent smoking. Arch Pediatr Adolesc Med. 2007;161(9):849–856pmid:17768284
      OpenUrlCrossRefPubMedWeb of Science
      1. Heatherton TF,
      2. Sargent JD
      . Does watching smoking in movies promote teenage smoking? Curr Dir Psychol Sci. 2009;18(2):63–67pmid:20160916
      OpenUrlAbstract/FREE Full Text
    38. ↵
      1. Morgenstern M,
      2. Sargent JD,
      3. Engels RC,
      4. et al
      . Smoking in movies and adolescent smoking initiation: longitudinal study in six European countries. Am J Prev Med. 2013;44(4):339–344pmid:23498098
      OpenUrlCrossRefPubMed
    39. ↵
      1. Sargent JD,
      2. Morgenstern M,
      3. Isensee B,
      4. Hanewinkel R
      . Movie smoking and urge to smoke among adult smokers. Nicotine Tob Res. 2009;11(9):1042–1046pmid:19542516
      OpenUrlAbstract/FREE Full Text
    40. ↵
      1. Hagger MS,
      2. Leaver E,
      3. Esser K,
      4. et al
      . Cue-induced smoking urges deplete cigarette smokers’ self-control resources. Ann Behav Med. 2013;46(3):394–400pmid:23720186
      OpenUrlCrossRefPubMed
    41. ↵
      United States v. Philip Morris USA, Inc., 449 F Supp 2d 1, 1168 (D.D.C. 2006)
    42. ↵
      1. Farrelly MC,
      2. Davis KC,
      3. Duke J,
      4. Messeri P
      . Sustaining “truth”: changes in youth tobacco attitudes and smoking intentions after 3 years of a national antismoking campaign. Health Educ Res. 2009;24(1):42–48pmid:18203679
      OpenUrlAbstract/FREE Full Text
      1. Wakefield M,
      2. Terry-McElrath Y,
      3. Emery S,
      4. et al
      . Effect of televised, tobacco company-funded smoking prevention advertising on youth smoking-related beliefs, intentions, and behavior. Am J Public Health. 2006;96(12):2154–2160pmid:17077405
      OpenUrlCrossRefPubMedWeb of Science
    43. ↵
      1. National Cancer Institute
      . Role of entertainment media in promoting or discouraging tobacco use. In: Davis RM, Gilpin EE, Loken B, Viswanath K, Wakefield MA, eds. The Role of the Media in Promoting and Reducing Tobacco Use. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2009:357–428
    44. ↵
      1. Southwell BG,
      2. Barmada CH,
      3. Hornik RC,
      4. Maklan DM
      . Can we measure encoded exposure? Validation evidence from a national campaign. J Health Commun. 2002;7(5):445–453pmid:12455763
      OpenUrlCrossRefPubMedWeb of Science
    45. ↵
      1. Niederdeppe J
      . Assessing the validity of confirmed AD recall measures for public health communication campaign evaluation. J Health Commun. 2005;10(7):635–650pmid:16278200
      OpenUrlCrossRefPubMedWeb of Science
    • Copyright © 2014 by the American Academy of Pediatrics
    View Abstract
    PreviousNext

     

    Advertising Disclaimer »

    View this article with LENS
    PreviousNext
    Email

    Thank you for your interest in spreading the word on Pediatrics.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults
    (Your Name) has sent you a message from Pediatrics
    (Your Name) thought you would like to see the Pediatrics web site.

    Alerts
    Sign In to Email Alerts with your Email Address
    Citation Tools
    Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults
    Jennifer C. Duke, Youn O. Lee, Annice E. Kim, Kimberly A. Watson, Kristin Y. Arnold, James M. Nonnemaker, Lauren Porter
    Pediatrics Jul 2014, 134 (1) e29-e36; DOI: 10.1542/peds.2014-0269

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
    Share
    Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults
    Jennifer C. Duke, Youn O. Lee, Annice E. Kim, Kimberly A. Watson, Kristin Y. Arnold, James M. Nonnemaker, Lauren Porter
    Pediatrics Jul 2014, 134 (1) e29-e36; DOI: 10.1542/peds.2014-0269
    del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
    Print
    PDF
    Insight Alerts
    • Table of Contents
    • Current Policy
    • Early Release
    • Current Issue
    • Past Issues
    • Editorial Board
    • Editorial Policies
    • Overview
    • Open Access
    • Pediatric Collections
    • Video Abstracts
    • Author Guidelines
    • Reviewer Guidelines
    • Submit My Manuscript

    Subjects

    • Public Health
      • Public Health
    • Substance Use
      • Smoking
    • Media
      • Media
    Back to top

                

    Copyright (c) 2018 by American Academy of Pediatrics

    International Access »           

    Terms of Use
    Privacy Statement
    FAQ

    AAP Pediatrics