Advertising of traditional cigarettes has been banned from US television since 1971, and advertising of tobacco products that targets youth has been prohibited since 1998. However, the marketing of electronic cigarettes, or e-cigarettes, is not yet regulated by the FDA, and this absence of restrictions has allowed the growing e-cigarette industry to aggressively advertise its products on television to viewers, which include substantial numbers of young people.
Just how much young people are exposed to e-cigarette advertising on television is revealed in a new study released in Pediatrics today. The study, which is reportedly the first to quantify the exposure to e-cigarette advertising on television among youths and young adults, shows an alarming increase in such exposure from 2011 to 2013.
To calculate exposure to e-cigarette television advertising from January 2011 through September 2013 for youth aged 12 to 17 years and young adults aged 18 to 24 years, researchers used the Nielsen Monitor-Plus service, the standard and most comprehensive source of television advertising data. They found that among youth, for most of 2011 through 2012, the target rating point (TRP, estimate of average frequency of advertising exposure for a certain percentage of the population over a certain period) was less than 100, compared with 2013, when the TRP peaked at 347 from April through June and then decreased slightly to 275 from July through September.
To put these numbers in perspective, a quarterly TRP of 100 means that over a period of 3 months, potentially 50% of the US television audience of 24 million youths (that is, 12 million youths) viewed an e-cigarette commercial an average of 2 times (TRP = 50 × 2 = 100). Alternatively, potentially 10% of the television audience (2.4 million youths) viewed such an ad an average 10 times over 3 months (TRP = 10 × 10 = 100). Overall, these numbers translated to a 256% increase in television advertisement exposure among youth from 2011 to 2013.
Results for young adults showed a similar trend, with higher absolute numbers, starting at around 150 TRPs in 2011, with TRP peaking at 611 in April through June 2013, and decreasing slightly to 458 in July through September 2013. Overall, this represented a 321% increase in exposure among young adults over the study period.
The authors performed further analyses that showed that the majority of advertisements were aired on cable television, with the network AMC airing the highest amount of advertising, and 1 particular brand, blu eCigs, accounting for more than 80% of the advertisements. The most widely aired commercial featured a film actor exhaling e-cigarette vapor while stating, “We’re all adults here. It’s time to take back your freedom.”
This trend may signify potential harms to public health, the authors said. They noted that although e-cigarettes have been marketed toward adults as a smoking cessation aid, among youth, these products may instead serve as a gateway to nicotine addiction, undermining current societal norms about the acceptability of smoking, especially among young people who may not be able to distinguish between e-cigarettes and regular cigarettes. In light of the increasing prevalence of e-cigarette use among youth, the authors stated that future e-cigarette advertising toward this demographic should be closely monitored.
More information about e-cigarettes is available in a recent JAMA Patient Page and an article from The Medical Letter. A interactive timeline of tobacco-related events, with several examples of tobacco advertising over the past century, can be viewed here.