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Adult smokers’ receptivity to a television advert for electronic nicotine delivery systems
  1. Annice E Kim,
  2. Youn Ok Lee,
  3. Paul Shafer,
  4. James Nonnemaker,
  5. Olga Makarenko
  1. RTI International, Research Triangle Park, North Carolina, USA
  1. Correspondence to
    Dr Annice E Kim, RTI International, 3040 Cornwallis Road, Durham, North Carolina 27709, USA; akim{at}rti.org

Abstract

Objective The aim of the present work was to examine adult smokers’ awareness of and receptivity to an electronic nicotine delivery system (ENDS) television advert, and whether viewing the advert influenced urge to smoke and intention to try ENDS.

Methods A television advert for ENDS brand blu eCigs was shown to an online convenience sample of 519 Florida adult smokers. We measured current smokers’ awareness of and receptivity to the advert, and whether seeing the advert influenced their thoughts about smoking or quitting, urge to smoke and intention to try ENDS. Results were stratified by prior ENDS use.

Results Approximately 62.3% of current smokers were aware of the advert. Smokers found the advert informative (73.8%), attention grabbing (67.5%) and innovative (64.5%), with prior ENDS users rating the advert more favourably than non-users. Seeing the advert elicited an urge to smoke (mean 42.1, SD=1.9) and thoughts about smoking cigarettes (75.8%) as well as quitting (74.6%). Prior END users were significantly more likely than non-users to report thinking about smoking cigarettes after seeing the advert (P<0.05). Most smokers said ENDS were ‘made for people like them’ (88.6%) and they would try ENDS in the future (66.0%).

Conclusions Smokers are receptive to ENDS television adverts and report intention to try ENDS after viewing the advert. Future studies should monitor ENDS advertising and examine how exposure to ENDS adverts influences smokers’ use of ENDS, dual use with cigarettes and cessation behaviour.

  • Advertising and Promotion
  • Electronic nicotine delivery devices
  • Media
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Introduction

Electronic nicotine delivery system (ENDS) devices (also referred to as electronic cigarettes or e-cigarettes) have grown in popularity in the USA, with sales projected to reach US$1 billion in 2013.1 ,2 Consumer interest in ENDS is on the rise.3–7 US adults’ awareness of ENDS increased from 32.2%6 to 40.2%5 in 2010, to 57.9%8 in 2011, with awareness significantly higher among current smokers than former smokers and never smokers.5 ,6 Ever use of ENDS among US adults also increased from 2010 (2.7%6 to 3.4%5) to 2011 (6.2%8) and was highest among current smokers (11.4%5 to 18.2%6 in 2010, to 21.2%8 in 2011).

To date, ENDS companies have primarily marketed online.9 However, towards the end of 2012, two leading ENDS companies—blu eCigs and NJOY—began airing advertisements on US television cable networks.2 This shift to television marketing signals that ENDS companies are making an aggressive push to attract new users on a national scale. Cigarette advertising has been banned from US television since 1971,10 but the ban does not cover ENDS because they are not tobacco products and are not currently regulated by the US Food and Drug Administration (FDA).11 In light of this longstanding ban, consumers may perceive televised adverts for ENDS as adding legitimacy and veracity to the claims made in the advert. The blu eCigs television advert portrays an actor smoking an ENDS in places where smoking is banned (eg, work, restaurant), prominently features visual cues (eg, actor exhaling vapour) that may elicit a viewer's urge to smoke,12 and frames ENDS as a ‘smarter’ alternative to cigarettes. As a result, these adverts may increase use of ENDS among smokers, which could encourage dual use, undermine quit attempts and influence relapse among those trying to quit. Furthermore, using ENDS in public places may undermine clean indoor air laws and increase interest in ENDS among youth and adult non-smokers.

It is unknown whether ENDS television advertisements appeal to smokers and increase their desire to use ENDS. As part of an annual online survey, we assessed adult smokers’ awareness of and receptivity to the blu eCigs television advert and whether the advert influenced smokers’ urge to smoke, thoughts about smoking or quitting and intention to try ENDS. We examined these measures because studies show that smokers’ receptivity to adverts is a short-term outcome that influences knowledge, attitudes and beliefs about smoking and cessation,13 and visual cues such as smoking can trigger urges to smoke.14

Methods

Data source

In January 2013 we conducted an online survey of Florida adult (aged 18 or older) smokers and recent quitters (past 12 months) recruited from comScore's internet panel. comScore emailed invitations to panellists; of the 1313 panellists who completed the screener questions, 620 met the eligibility criteria and completed the survey (47% response rate). Because 84.7% of the respondents were current smokers, we restricted our analysis to these 519 current smokers. Participants gave informed consent and the study was approved by RTI International's Institutional Review Board.

Measures

Participants viewed a video clip of the blu eCigs television advert (http://www.youtube.com/watch?v=tHPU2gR_RiI). Immediately after viewing the advert, we assessed participants’ awareness of and receptivity to the advert, including how often the participant had seen the advert or one similar to it in the past 6 months and whether the advert made them think about smoking cigarettes or quitting smoking (never, rarely, sometimes, often, or always); urge to smoke following the advert (0=no urge to 100=strongest urge I have ever experienced)14 ,15; extent to which the advert grabbed their attention, was memorable, innovative, or exciting (four-point scale from strongly disagree to strongly agree); and likelihood of trying ENDS after seeing the advert (four-point scale from very unlikely to very likely). We also measured cessation behaviour (quit attempt in past 12 months), prior (past 12 months) and current ENDS use, and demographic characteristics.

Analysis

We ran descriptive statistics and stratified the analysis by ENDS use in the past 12 months (yes/no) because receptivity to the blu eCigs television advert and intention to try may differ by prior ENDS use. Pearson's χ2 tests and t tests were used to test for statistical significance. Data were weighted to the population of Florida adult smokers using 2011 Florida Behavioral Risk Factor Surveillance System data.

Results

Most respondents were white (64.2%), male (55.2%), aged 25–64 (83.4%), with a household income of US$25 000 or more (71.3%) (table 1). Approximately 34.4% of smokers had used ENDS in the past year and 23.2% were currently using ENDS. Approximately 49.5% had made a quit attempt in the past year.

Table 1

Demographic characteristics of survey respondents: Florida adult current smokers (N=519)

Table 2 summarises respondents’ awareness of and receptivity to the blu eCigs television advert. Over 60% of respondents had seen the advert in the past 6 months, with exposure significantly higher among prior ENDS users (70.8%) than non-users (58.3%) (p<0.05). Seeing the advert made respondents think about smoking cigarettes (75.8%) with rates significantly higher among prior ENDS users (82.7%) than non-users (72.2%) (p<0.05). Respondents experienced an urge to smoke after seeing the advert (mean=42.1, SD=1.9); prior ENDS users (mean=45.6, SD=3.0) experienced stronger urge to smoke than non-users (mean=40.3, SD=2.4), but this difference was not statistically significant. Seeing the advert made 74.6% of respondents think about quitting smoking but no significant difference between prior e-cigarette users and non-users was observed.

Table 2

ENDS television advert: awareness, receptivity and perceptions among current smokers (N=519)

Prior ENDS users were significantly more receptive to the blu e-Cig advert than non-users, finding the adverts to be worth remembering (72.8% vs 56.3%, p<0.01), attention grabbing (76.6% vs 62.7%, p<0.01), exciting (46.2% vs 34.8%, p<0.05), innovative (74.0% vs 59.5%, p<0.01), informative (80.4% vs 70.3%, p<0.05) and convincing (73.0% vs 53.4%, p<0.01). Most respondents (88.6%) believed the ENDS depicted in the advert was ‘made for people like me’. Among non-current ENDS users, 66.0% intended to try ENDS after viewing the advert.

Discussion

In summary, we find that current smokers are aware of and receptive to the blu eCigs television advert. Prior ENDS users held significantly more favourable views of the advert than non-users, but even non-users were fairly receptive to the advert. Interestingly, we found that viewing the advert elicited thoughts about smoking cigarettes and urge to smoke as well as thoughts about quitting smoking. We believe that the prominent visual cues in the advert may have triggered thoughts about smoking cigarettes and smoking urges; the actor was ‘vaping’ (the ENDS equivalent term to smoking) his blu eCigs (which look like traditional cigarettes) in common daily situations (eg, in a car) and exhaling vapour that looks very similar to cigarette smoke. Studies show that such visual cues can trigger urges to smoke.14 Additionally, smokers who are trying to quit smoking and suppressing their cravings end up thinking about smoking cigarettes more, pay more attention to smoking cues in their environment,16 and may even smoke more.17 These prior studies focused on cigarette smoking cues, but we believe they may also be relevant to ENDS because they are designed to look and function like cigarettes. The advert may have triggered thoughts about quitting because it noted that blu eCigs are a ‘smarter alternative to cigarettes’. To date, ENDS have largely been touted as a way to quit smoking cigarettes, and this is the primary reason smokers cite for initiating ENDS use.18 Our findings warrant further research on whether ENDS visual cues trigger smokers’ urges to smoke cigarettes or ENDS and whether smokers are substituting ENDS for cigarettes when they cannot smoke. In other studies smokers report using ENDS to circumvent smoking bans and to reduce cigarette smoking and associated harms.19 More research is needed on whether ENDS use encourages dual use with cigarettes, decreases cigarette consumption, and/or undermines cessation.

Currently, the FDA does not regulate ENDS marketing and labelling unless ENDS are advertised as a smoking cessation aid.20 Meanwhile, ENDS companies have been aggressively advertising their products across media channels (eg, magazines, internet), and advert expenditures are likely to increase2 as tobacco companies enter the ENDS marketplace.21 blu eCigs was acquired by Lorillard in April 2012 and generated US$114 million in net sales from January to June 2013.22 Altria's MarkTen and RJR's Vuse brand ENDS devices will be introduced in test markets in 2013.23

Our study has several limitations. First, although we attempted to account for the non-probability-based sample by using post-stratification weights, these results may not be generalisable to other populations of adult smokers. Indeed, rates of ENDS use reported in our survey are higher than those reported in previous studies using nationally representative samples,8 but it is unclear whether this is due to differences in sampling or the rapid increase in ENDS use in recent years. Second, we examined a single blu eCigs television advert so results are not generalisable to all ENDS television adverts. Third, the urge to smoke and thoughts about quitting smoking items did not specify a product, so we cannot determine whether respondents were referring to cigarettes or ENDS devices.

In conclusion, we find that smokers are receptive to a blu eCigs television advert and report intention to try ENDS devices after viewing the advert. Future studies should examine how exposure to ENDS adverts influences smokers’ use of ENDS devices, dual use with cigarettes, cessation behaviour and ENDS initiation among non-smokers and youth. Finally, researchers should continue monitoring ENDS advertising and its impact on consumer perceptions and behaviours.

What this paper adds

  • Electronic nicotine delivery system (ENDS) devices are growing in popularity in the US. Towards the end of 2012, ENDS advertisements began airing on US television, which was unprecedented since cigarette television adverts have been banned in the US since 1971.

  • This study finds that adult current smokers are receptive to the ENDS television advert and report intention to try ENDS after viewing the advert.

  • Viewing the ENDS television advert elicited thoughts about smoking cigarettes and quitting smoking, likely due to the prominent visual cues in the advert and ENDS being framed as a smarter alternative to cigarettes.

  • Future studies should monitor ENDS advertising and examine how exposure to ENDS adverts influences smokers’ use of ENDS, dual use with cigarettes and cessation behaviour.

References

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Footnotes

  • Contributors AK conceptualised the study and led the study implementation, analysis, and drafting and revising of the manuscript. YOL contributed to the survey design, oversaw data collection, and contributed to drafting and revising the manuscript. PS conducted the analysis and contributed to drafting and revising the manuscript. JN contributed to analysis and drafting and revising the manuscript. OM assisted with data collection and drafting of manuscript.

  • Funding This work was funded under RTI International's evaluation of the Bureau of Tobacco Free Florida's tobacco prevention and control programme.

  • Competing interests None.

  • Ethics approval RTI International IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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