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 nonsmokers. Future research is needed to determine whether policies to minimize exposure to tobacco marketing reduce EC use by decreasing susceptibility.