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Receptivity to tobacco ads linked to eventual product use

Tristan Manalac
06 Apr 2018
The purchase, use and possession of electronic nicotine delivery systems, such as e-cigarettes and vaporisers, will be banned in Singapore, starting early next year.

Receptivity to any tobacco advertising is high among adolescents, and e-cigarette advertising is the most effective, reports a recent US study, which also shows that receptivity to advertising is associated with progression to use.

“In this population-based study including 10,989 participants, receptivity to tobacco advertising at wave 1 was significantly associated with committed never tobacco users aged 12–17 years progressing to susceptibility and tobacco product use at 1-year follow-up in wave 2,” said researchers.

“Our study reinforces that tobacco product marketing continues to be an important contributor to tobacco use among young people,” they added.

The proportion of participants with any level of receptivity to any tobacco advertising varied across the different age groups and peaked in those aged 18–21 years at 68.7 percent. Analysis based on product category showed that e-cigarette advertisements were most effective, followed by cigarette, smokeless tobacco and cigar ads. [JAMA Pediatr 2018;doi:10.1001/jamapediatrics.2017.5756]

Notably, moderate or high receptivity to any tobacco advertisement was almost three times as likely in the 18–21-year age group than their 12–14-year counterparts (27.5 percent vs 9.7 percent).

While susceptibility to any tobacco product at wave 1 was significantly associated with progression to use for all product categories considered, tobacco advertising still seemed to have a significant effect on committed never users.

For instance, committed never users who were receptive to cigarette advertising at wave 1 (n=1,378; 20.4 percent) showed significantly higher odds of ever use (adjusted odds ratio [OR], 1.54; 95 percent CI, 1.03–2.32) or any progression (adjusted OR, 1.43; 1.23–1.65) at wave 2.

The trend for higher ever use and any progression among committed never users remained significant for e-cigarette (adjusted OR, 1.45; 1.19–1.75 and adjusted OR, 1.62; 1.41–1.85, respectively) and cigar (adjusted OR, 2.07; 1.26–3.40 and adjusted OR, 2.01; 1.62–2.49, respectively) advertisements.

In contrast, receptivity to smokeless tobacco advertisement at wave 1 did not seem to significantly increase use (adjusted OR, 1.35; 0.68–2.70) or any progression (adjusted OR, 1.21; 0.96–1.52) at wave 2 in both sexes.

Interestingly, receptivity to e-cigarette, but not conventional cigarette, ads at wave 1 was significantly associated with ever use of conventional cigarettes at wave 2 (adjusted OR, 1.60; 1.08–2.38).

“These findings suggest a hypothesis that initial exposure to nicotine can lead individuals to look for a more efficient product that provides satisfaction,” explained researchers.

“Our study of never tobacco users suggests a role for an environmental influence in that the effectiveness of e-cigarette advertising contributes to the association between e-cigarette use and conventional cigarette smoking,” they added.

In the study, susceptibility to future tobacco use was measured in committed never users and was assessed through knowledge of the product, curiosity to try the product and willingness to engage in product use.

To evaluate receptivity to tobacco advertising, participants were shown 20 randomly sampled ads and were asked if they remembered seeing the ad in the past 12 months and whether they liked, disliked or were neutral to the advertisement.

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