Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among US adults, 2021

Introduction: Little is known about the influence of e -cigarette marketing on cannabis vaping behaviors. This study examined the associations between e -cigarette marketing exposure and nicotine and cannabis vaping among adults. Methods: This cross-sectional study included a U.S. nationally representative sample of adults from the Wave 6 survey of the Population Assessment of Tobacco and Health Study. We used multinomial logistic regressions to examine the associations between past 30 -day e -cigarette marketing exposure and past 30 -day vaping behavior (sole- and dual-vaping of nicotine and cannabis) overall and stratified by age. Results: Overall, 52.0 % of respondents reported e -cigarette marketing exposure, and 89.8 %, 5.6 %, 3.2 %, and 1.4 % reported no vaping, sole -nicotine vaping, sole -cannabis vaping, and dual-vaping, respectively. E -cigarette marketing exposure was associated with increased odds of reporting sole -cannabis vaping versus no vaping (adjusted risk ratio [aRR], 1.31; 95 % confidence interval [CI], 1.09-1.57) and dual-vaping versus no vaping (aRR, 1.26; 95 % CI, 1.01-1.57). This association was found among those aged 18-24 and 25-34 years. It was also associated with increased odds of reporting sole -cannabis vaping versus sole -nicotine vaping (aRR, 1.28; 95 % CI, 1.04-1.58). This association was found among those aged 18-24 years. Discussion: E -cigarette marketing exposure was associated with sole -cannabis vaping and dual-vaping, not solenicotine vaping among U.S. adults. Such associations were mainly driven by young adults aged 18-24 and 25-34 years. Greater restrictions on tobacco marketing may have reduced the influence of e -cigarette marketing on nicotine vaping, while gaps in marketing restrictions for cannabis may contribute to e -cigarette marketing influence on cannabis vaping.