David Hammond1, Jessica L Reid2, Robin Burkhalter2, Vicki L Rynard2. 1. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada dhammond@uwaterloo.ca. 2. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Abstract
BACKGROUND: Increased electronic cigarette (e-cigarette) use among young people is often attributed to industry marketing practices; however, the effectiveness of regulations that limit e-cigarette advertising and promotions has yet to be examined. New federal legislation that liberalized the Canadian e-cigarette market in May 2018, along with differences in provincial regulations, provides an opportunity to examine the impact of regulatory restrictions on e-cigarette marketing. METHODS: Repeat cross-sectional surveys of 12 004 16- to 19-year-olds in Canada, completed online in 2017, 2018, and 2019. Logistic regression models were used to examine differences over time in exposure to e-cigarette marketing and e-cigarette use, including between provinces with differing strengths of marketing restrictions. RESULTS: The percentage of youth surveyed who reported noticing e-cigarette promotions often or very often approximately doubled between 2017 and 2019 (13.6% vs 26.0%; adjusted odds ratio [AOR] = 2.24, 95% confidence interval [CI] = 1.97-2.56). Overall exposure to marketing was generally more prevalent in provinces with fewer regulatory restrictions. Respondents who reported noticing marketing often or very often were more likely to report vaping in the past 30 days (AOR = 1.41, 95% CI = 1.23-1.62), past week (AOR = 1.44, 95% CI = 1.22-1.70), and ≥20 days in the past month (AOR = 1.42, 95% CI = 1.11-1.81, P = .005). Provinces with low restrictions on marketing had higher prevalence of vaping in the past 30 days (AOR = 1.50, 95% CI = 1.25-1.80, P < .001), and in the past week (AOR = 1.65, 95% CI = 1.33-2.05, P < .001). CONCLUSIONS: Exposure to marketing and the prevalence of vaping increased among Canadian youth after the liberalization of the e-cigarette market in 2018. Comprehensive provincial restrictions on e-cigarette marketing were associated with lower levels of exposure to marketing and lower prevalence of e-cigarette use.
BACKGROUND: Increased electronic cigarette (e-cigarette) use among young people is often attributed to industry marketing practices; however, the effectiveness of regulations that limit e-cigarette advertising and promotions has yet to be examined. New federal legislation that liberalized the Canadian e-cigarette market in May 2018, along with differences in provincial regulations, provides an opportunity to examine the impact of regulatory restrictions on e-cigarette marketing. METHODS: Repeat cross-sectional surveys of 12 004 16- to 19-year-olds in Canada, completed online in 2017, 2018, and 2019. Logistic regression models were used to examine differences over time in exposure to e-cigarette marketing and e-cigarette use, including between provinces with differing strengths of marketing restrictions. RESULTS: The percentage of youth surveyed who reported noticing e-cigarette promotions often or very often approximately doubled between 2017 and 2019 (13.6% vs 26.0%; adjusted odds ratio [AOR] = 2.24, 95% confidence interval [CI] = 1.97-2.56). Overall exposure to marketing was generally more prevalent in provinces with fewer regulatory restrictions. Respondents who reported noticing marketing often or very often were more likely to report vaping in the past 30 days (AOR = 1.41, 95% CI = 1.23-1.62), past week (AOR = 1.44, 95% CI = 1.22-1.70), and ≥20 days in the past month (AOR = 1.42, 95% CI = 1.11-1.81, P = .005). Provinces with low restrictions on marketing had higher prevalence of vaping in the past 30 days (AOR = 1.50, 95% CI = 1.25-1.80, P < .001), and in the past week (AOR = 1.65, 95% CI = 1.33-2.05, P < .001). CONCLUSIONS: Exposure to marketing and the prevalence of vaping increased among Canadian youth after the liberalization of the e-cigarette market in 2018. Comprehensive provincial restrictions on e-cigarette marketing were associated with lower levels of exposure to marketing and lower prevalence of e-cigarette use.
Authors: Jennifer C Duke; Jane A Allen; Matthew E Eggers; James Nonnemaker; Matthew C Farrelly Journal: Nicotine Tob Res Date: 2015-12-26 Impact factor: 4.244
Authors: Tushar Singh; Israel T Agaku; René A Arrazola; Kristy L Marynak; Linda J Neff; Italia T Rolle; Brian A King Journal: Pediatrics Date: 2016-05 Impact factor: 7.124
Authors: Karen A Cullen; Andrea S Gentzke; Michael D Sawdey; Joanne T Chang; Gabriella M Anic; Teresa W Wang; MeLisa R Creamer; Ahmed Jamal; Bridget K Ambrose; Brian A King Journal: JAMA Date: 2019-12-03 Impact factor: 56.272
Authors: E Wadsworth; A McNeill; L Li; D Hammond; J F Thrasher; H-H Yong; K M Cummings; G T Fong; S C Hitchman Journal: Prev Med Date: 2018-04-17 Impact factor: 4.018
Authors: David Hammond; Jessica L Reid; Vicki L Rynard; Geoffrey T Fong; K Michael Cummings; Ann McNeill; Sara Hitchman; James F Thrasher; Maciej L Goniewicz; Maansi Bansal-Travers; Richard O'Connor; David Levy; Ron Borland; Christine M White Journal: BMJ Date: 2019-06-20
Authors: Samir Soneji; JaeWon Yang; Meghan Bridgid Moran; Andy S L Tan; James Sargent; Kristin E Knutzen; Kelvin Choi Journal: Nicotine Tob Res Date: 2019-06-21 Impact factor: 5.825
Authors: Victor Martinez-Loredo; Alba González-Roz; Lynne Dawkins; Desmond Singh; James G Murphy; James MacKillop Journal: Nicotine Tob Res Date: 2022-06-15 Impact factor: 5.825
Authors: David Hammond; Lana Vanderlee; Christine M White; Rachel B Acton; Martin White; Christina A Roberto; Adrian Cameron; Gary Sacks; Sharon Kirkpatrick; Joel Dubin; Jean Adams; Alejandra Jauregui; James F Thrasher Journal: J Nutr Date: 2022-06-13 Impact factor: 4.687
Authors: Matthew J Fagan; Katie M Di Sebastiano; Wei Qian; Scott T Leatherdale; Guy Faulkner Journal: Int J Environ Res Public Health Date: 2021-04-07 Impact factor: 3.390
Authors: Lorraine V Craig; Itsuro Yoshimi; Geoffrey T Fong; Gang Meng; Mi Yan; Yumiko Mochizuki; Takahiro Tabuchi; James F Thrasher; Steve S Xu; Anne C K Quah; Janine Ouimet; Genevieve Sansone; Janet Chung-Hall Journal: Int J Environ Res Public Health Date: 2020-11-13 Impact factor: 3.390
Authors: Adam G Cole; Rachel E Laxer; Karen A Patte; Scott T Leatherdale Journal: Int J Environ Res Public Health Date: 2021-03-18 Impact factor: 3.390