Tobacco Marketing, E-cigarette Susceptibility, and Perceptions among Adults

Objective: Understanding the impact of tobacco marketing on e-cigarette (EC) susceptibility and perceptions is essential to inform efforts to mitigate tobacco product burden on public health. Methods: Data were collected online in 2016 from 634 conventional cigarette (CC) smokers and 393 non-smokers using a convenience sample from Amazon Mechanical Turk. Logistic regression models, stratified by smoking status and adjusted for socio-demographics, examined the relationship among tobacco advertisements and coupons, EC and CC susceptibility, and EC perceptions. Results: Among non-smokers, increased exposure to tobacco advertising and receiving tobacco coupons was significantly related to measures of EC and CC susceptibility (p < .05). Older, more educated non-smokers had decreased odds of EC susceptibility (p < .05). Additionally, increased exposure to tobacco advertising was significantly associated with the perceptions of EC not containing nicotine and being less addictive than CC among smokers (p < .05). Conclusions: Increased exposure to tobacco advertising outlets could influence future EC and CC use in non-smokers and perceptions in smokers, while receiving coupons could affect EC and CC susceptibility among non-smokers. Future research is needed to determine whether policies to minimize exposure to tobacco marketing reduce EC use by decreasing susceptibility.