Background Electronic nicotine delivery systems (ENDS) are growing in awareness and use in the USA. They are currently unregulated as the Food and Drug Administration has yet to assert jurisdiction under its tobacco authority over these products, and a US Court of Appeals held they cannot be regulated as drugs/delivery devices if they are not marketed for a therapeutic purpose. Observation of the current online marketplace suggests ENDS, like some nutraceutical products, are being promoted using affiliate marketing techniques using claims concerning purported health benefits.
Objective This study performed a forensic analysis to characterise the relationships between online ENDS affiliate advertisements and ENDS sellers, and evaluated descriptive content on advertisements and websites to inform future policy and regulatory efforts.
Methods A purposive sampling strategy was used to identify three forms of ENDS advertising. Web proxy software recorded identifiable objects and their ties to each other. Network analysis of these ties followed, as well as analysis of descriptive content on advertisements and websites identified.
Results The forensic analysis included four ENDS advertisements, two linked affiliate websites, and two linked seller websites, and demonstrated a multilevel relationship between advertisements and sellers with multiple layers of redirection. Descriptive analysis indicated that advertisements and affiliates, but not linked sellers, included smoking cessation claims. Results suggest that ENDS sellers may be trying to distance marketing efforts containing unsubstantiated claims from sales. A separate descriptive analysis of 20 ENDS seller web pages indicated that the use of affiliate marketing by sellers may be widespread.
Conclusions These findings support increased monitoring and regulation of ENDS marketing to prevent deceptive marketing tactics and ensure consumer safety.
- Electronic nicotine delivery devices
- Harm Reduction
- Advertising and Promotion
- Tobacco industry
Statistics from Altmetric.com
- Electronic nicotine delivery devices
- Harm Reduction
- Advertising and Promotion
- Tobacco industry
Electronic cigarettes, or electronic nicotine delivery systems (ENDS), are increasingly popular devices1 composed of a battery, heating element, and a chamber for a humectant carrying liquid nicotine. In 2010, the US Court of Appeals for the District of Columbia Circuit held that the Food and Drug Administration (FDA) may only regulate ENDS under its tobacco authority but not as drugs or medical devices unless they are marketed for a therapeutic purpose (eg, smoking cessation).2 Following this decision, the FDA stated it did not plan to seek further litigation concerning this specific case but planned to assert jurisdiction pursuant to its existing statutory authority to cover all categories of tobacco products including ENDS.3 Unless and until FDA asserts jurisdiction, however, ENDS are not subject to any FDA requirements as long as they are marketed without therapeutic claims. Other legal requirements, such as prohibitions on deceptive advertising, do apply. One primary channel of ENDs marketing and sales is via the internet.4 ,5 Indices of online searching and sales for ENDS products show considerable interest6 ,7 as well as the use of a particular means of advertising often associated with duplicitous tactics, affiliate marketing.4 ,5
Online affiliate marketing consists of commercial networks where ‘affiliates’ run content websites that ultimately direct viewers to vendors (‘sellers’), usually resulting in a payment from the seller back to the affiliate. Individuals may be directed to the affiliate content sites by search engines, banner advertising, or direct marketing outreach, including spam messages. Typically, third party software tracks consumers at each step via intermediary links and cookies from advertisements to affiliate websites to sellers where products are ultimately purchased. Despite being nearly invisible to most internet users, this marketing strategy is growing in use particularly in the USA and UK8; one research analyst group reported ‘US affiliate marketing spending will reach $4 billion by 2014’.9 This method of marketing has been used for dietary supplements and nutraceuticals, with several marketing networks having been sued by the Federal Trade Commission (FTC) for promoting their products via websites that appear to be unbiased third party news reports.10–13 In 2012, one case was settled between the FTC and an advertising network called ‘Ads4Dough’ that acted as intermediaries between fake news sites making therapeutic claims about acai-based products (touted as a ‘superfood’ and weight loss aid) and sellers where the products were purchased.12 ,13 Little is known concerning the use of affiliate marketing for tobacco/nicotine products, although two reports have noted the presence of these affiliate ‘schemes’ available for ENDS.4 ,5 Starting with directly observed online advertising, the current study sought to better characterise the relationships between online ENDS affiliate advertisements and ENDS sellers and to evaluate descriptive content on these advertisements and websites to inform future policy and regulatory efforts.
We performed a forensic analysis of the online relationships between ENDS affiliate advertisements and sellers and supplemented this with descriptive analysis of the incidence of these techniques in the real world. The forensic technique borrows methods from computer and network forensics which are designed to detect patterns, communications or information in websites and their supporting infrastructure that may indicate an intent to deceive. To examine the affiliate-based networks, we used a purposive sampling strategy to identify three forms of ENDS advertising during August 2012–January 2013: text message spam (n=1), email spam (n=1), and banner advertisements (n=2). Advertisements were noted and recorded during normal browsing sessions, while all spam messages were received by investigators or family members without solicitation. The web proxy software Charles (V.3.7, XK72 Limited) was run in the background to log browsing sessions to record all identifiable objects (eg, web pages, source files, servers) and their ties to each other via links, redirection or shared physical resources. For text messages, associated links were manually entered into a browser. The network analysis software ORA (V.2.4.6, Center for Computational Analysis of Social and Organizational Systems) was used to graphically examine network links between affiliate advertisements, affiliate websites, and seller websites.
Descriptive analyses of each advertisement and linked web pages included sale of nicotine-containing liquid, text containing smoking cessation claims, text containing health or toxicant exposure claims, and was performed by two researchers with discrepancies resolved via discussion. To assess for the incidence of affiliate marketing by other ENDS online sellers, we also performed a supplementary descriptive analysis using http://www.google.com to identify sites. On 11 January 2013, four keywords were searched (electronic cigarette, e-cigarette, e-cig, and ecig), and for the first two pages of results, the first web page visible after clicking each link was assessed. Websites that were noted to sell ENDS were coded as above, as well as whether they had an affiliate marketing programme available and age verification mechanism.
Forensic analysis of four identified advertisements revealed two affiliate websites and two linked seller websites. Figure 1 displays the relationship between one banner advertisement (figure 1A), affiliate website (figure 1B) and linked seller website (figure 1C). Data indicate a multilevel relationship between consumers who received advertising and the seller, with logs demonstrating multiple layers of redirection (see figure 2). Descriptive analysis of the content on these networks indicated that advertisements and affiliate websites, but not linked seller websites, included smoking cessation claims. Specifically, two out of four advertisements contained smoking cessation claims: ‘You can finally quit smoking, & still satisfy your cravings!’ (email spam). Both affiliate websites had text suggestive of smoking cessation and health/toxicant exposure claims: ‘…when she tried electronic cigarettes she was able to become cigarette free two days later.’, ‘…the electronic cigarette has quickly become the #1 choice for smokers looking to lead a healthier lifestyle.’ (thesmartstyleliving.com). Neither seller website (first page visible was coded) contained smoking cessation claims, and only pages from ecigsbrand.com made claims concerning health/toxicant exposure: ‘Reduce some health risks’; ‘…without the side effects that come with smoking you don’t want like second hand smoke, bad breath, tar, carcinogens and butts.’ Sale of nicotine-containing liquid was evident on one advertisement, both affiliate websites, and both seller websites. One seller product (No Flame E-Cigarette Inc.; figure 1 figure 1C) linked from an affiliate using a spam text message was purchased by one of the authors (NKC) for $4.95 using a one-use credit card; as of 20 March 2013 the Better Business Bureau (BBB) reported 146 complaints against the company in the past 12 months for poorly disclosed additional charges—a second charge of $109.67 2 weeks later, followed by $69.62 in monthly subscription fees.14 At the time of our purchase, the additional charges were mentioned only within the dense text of a linked page titled ‘Terms and Conditions’.
The supplementary descriptive analysis search resulted in 20 unique ENDS seller websites; over half (12) offered an affiliate program, but none of these overlapped with those identified in the forensic analysis. Less than one-third (6) had age restrictions for the web page accessed, over half (11) made health/toxicant exposure claims, and four (4) made cessation claims, while all sold nicotine-containing liquid.
Forensic analysis demonstrated that individual ENDS sellers may be using a network of affiliates to distance marketing efforts making cessation claims from actual sales sites that do not. Unambiguous claims concerning smoking cessation and health benefits related to ENDS were present in both ENDS advertisements and affiliate websites but not their linked seller websites, despite FDA limits on cessation claims and the limited empirical evidence for efficacy.15–17 To date, no large-scale clinical trials of ENDS effectiveness for smoking cessation or toxicant exposure reduction have been published, although results from one such study for smoking cessation appear to be forthcoming.18 Correspondingly, information on the FDA website states the following: ‘As the safety and efficacy of e-cigarettes have not been fully studied, consumers of e-cigarette products currently have no way of knowing … if there are any benefits associated with using these products.’19 Manufacturers of some dietary supplements have used ‘third party’ sources (eg, fake news websites) to distance themselves from unsubstantiated claims about their products,10 ,12 and a similar strategy may be in use here to make misleading health claims about ENDS. These practices may be influencing public perceptions of ENDS. A recent US-based survey among Midwestern young adults in 2010–2011 indicated that 45% of those aware of ENDS believed the devices help people quit smoking,20 and in a nationally representative survey of US adults in 2010, 71% of smokers aware of ENDS reported they were less harmful than regular cigarettes.21 Additionally, reports from the BBB indicate that some ENDS sellers may be misleading customers concerning actual product costs and charges incurred, an issue that has also received attention by the FTC.22 ,23 While we found that 12 of 20 sampled sellers offer affiliate programs, the present findings do not indicate that online ENDS affiliate marketing is always deceptive, nor do they provide any estimate of how prevalent the use of deceptive marketing for ENDS might be. A larger-scale study to examine marketing strategies, primary and affiliate, as well as messages used to promote these products is needed. Results from this examination should be examined with care as only a small number of sites and advertisements were investigated, and the online marketplace is rapidly changing and evolving. While ‘big tobacco’ companies (consisting of the heavily consolidated manufacturers of cigarettes) are rapidly entering the ENDS marketplace,24 ,25 the ENDS industry has been dominated by small manufacturers and sellers,26 each with unique marketing strategies. With ENDS sales and prevalence continuing to rise in the USA,1 ,7 ,21 ,26 it is imperative that marketing efforts for these products are monitored, and regulatory efforts from the FTC and FDA are strengthened to prevent deceptive marketing tactics and ensure consumer safety.
What is already known
Electronic nicotine delivery systems (ENDS) are growing in popularity, but remain unregulated in the USA.
Unlike traditional tobacco products, these devices are heavily marketed online, but little is known about the mechanisms.
Other products making health claims have used online affiliate marketing.
What this paper adds
This work represents the first forensic analysis of online marketing tactics for ENDS.
Results highlight how potentially misleading smoking cessation and health/toxicant exposure claims are being used on online ENDS advertisements, affiliate websites and seller websites.
Portions of this work were presented at the 19th annual meeting of the Society for Research on Nicotine and Tobacco. The authors would like to thank Megan Jacobs for her assistance in data coding, and Vaughan Rees for providing comments on an earlier version of this manuscript.
Portions of this work were presented at the 19th annual meeting of the Society for Research on Nicotine and Tobacco.
Contributors NKC developed the idea for the study. NKC, JB and COC contributed to the collection, analysis and interpretation of the data. COC wrote the first draft of the paper and NKC and JB provided critical revision. All authors gave final approval of the manuscript.
Funding All work was funded internally by Legacy.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data collected are included in the manuscript except for some additional web pages coded, and are available by request.
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