Advertising increases likelihood of vaping

Young non-smokers at risk

21 November 2019

New research from Macquarie University, Sydney, Australia, confirms the potential for e-cigarette advertising to increase the likelihood of non-smokers and adolescents to start vaping.

The first systematic review to examine the role that social factors play in the uptake of e-cigarettes was published today in the American Journal of Preventive Medicine; based on work led by Samia Amin, a PhD candidate, with Dr Adam Dunn and Dr Liliana Laranjo, all from the Australian Institute of Health Innovation, Macquarie University.

Samia states that while many countries, including Australia, recognise the potential health risks of e-cigarettes, this is the first review to show how advertising might increase the uptake of these products among young people and non-smokers.

“We are at a critical point. Australia could experience what has happened in other countries with a dramatic and dangerous uptake of e-cigarettes among young people who have never used conventional cigarettes,” Samia warns.

The systematic review, which critically appraised the results of 43 studies, shows that when people are exposed to positive advertising or social messages about vaping in trials, the number who say they would try it increases. Most of the people included in those trials were young and non-smokers.

While e-cigarettes were designed to help people stop smoking, Samia says:

Unfortunately, advertisers have made vaping attractive to non-smokers and adolescents who may not consider or know the risks of inhaling nicotine.

“Vaping could become a major health issue with a cost to individuals and our health system that far outweighs the benefit it may deliver in helping people to stop smoking,” Samia warns.

Co-author Adam Dunn, also with the Australian Institute of Health Innovation, said people need to think about advertising, social influence, and social norms along a spectrum. “It is no longer easy to tell the difference between advertising, health information, and recommendations from the people we trust or admire,” he said.

Evidence suggests that people use social media as an avenue to obtain information about e-cigarettes and may encounter advertising without realising. Posts and videos on Facebook and Instagram may not appear to be advertising but can have a global reach. For instance, thousands of YouTube videos about vaping have been viewed hundreds of millions times per month.

Avoiding a catastrophe in Australia

Samia explains that while e-cigarettes are less harmful than cigarettes, people who use e-cigarettes are inhaling nicotine which is a known toxic substance that has addictive properties.

Samia says that to avoid a health catastrophe in Australia, policymakers should continue to impose sale and import restrictions, but they might also consider how regulations on the marketing of alcoholic beverages to young people might also be applied to e-cigarette products.

In the United States, seven people have died from vaping and a further 530 cases of lung injury have been reported. Some US states have restricted or banned the sale of e-cigarette products and limit how they can be marketed. Other countries have started to do the same.

Samia Amin, Adam G. Dunn, Liliana Laranjo (2019) Social Influence in the Uptake and Use of Electronic Cigarettes: A Systematic Review. American Journal of Preventive Medicine  https://www.ajpmonline.org/article/S0749-3797(19)30377-0/abstract

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