Article Text

Download PDFPDF

Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking among children: an experimental study
  1. Milica Vasiljevic,
  2. Dragos C Petrescu,
  3. Theresa M Marteau
  1. Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
  1. Correspondence to Professor Theresa M Marteau, Behaviour and Health Research Unit, University of Cambridge, Forvie Site, Addenbrooke's Hospital, Cambridge CB2 0SR, UK; tm388{at}


Background There are concerns that the marketing of e-cigarettes may increase the appeal of tobacco smoking in children. We examined this concern by assessing the impact on appeal of tobacco smoking after exposure to advertisements for e-cigarettes with and without candy-like flavours, such as, bubble gum and milk chocolate.

Methods We assigned 598 English school children (aged 11–16 years) to 1 of 3 different conditions corresponding to the adverts to which they were exposed: adverts for flavoured e-cigarettes, adverts for non-flavoured e-cigarettes or a control condition in which no adverts were shown. The primary endpoint was appeal of tobacco smoking. Secondary endpoints were: appeal of using e-cigarettes, susceptibility to tobacco smoking, perceived harm of tobacco, appeal of e-cigarette adverts and interest in buying and trying e-cigarettes.

Results Tobacco smokers and e-cigarette users were excluded from analyses (final sample=471). Exposure to either set of adverts did not increase the appeal of tobacco smoking, the appeal of using e-cigarettes, or susceptibility to tobacco smoking. Also, it did not reduce the perceived harm of tobacco smoking, which was high. Flavoured e-cigarette adverts were, however, more appealing than adverts for non-flavoured e-cigarettes and elicited greater interest in buying and trying e-cigarettes.

Conclusions Exposure to adverts for e-cigarettes does not seem to increase the appeal of tobacco smoking in children. Flavoured, compared with non-flavoured, e-cigarette adverts did, however, elicit greater appeal and interest in buying and trying e-cigarettes. Further studies extending the current research are needed to elucidate the impact of flavoured and non-flavoured e-cigarette adverts.

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

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors MV, DCP and TMM designed the study. MV supervised the study and oversaw the acquisition of data. MV, DCP and TMM were responsible for the analysis and interpretation of data. MV drafted the manuscript, DCP and TMM were responsible for critical revision of the manuscript. All authors gave final approval of the manuscript.

  • Disclaimer The Department of Health had no role in the study design, data collection, analysis or interpretation. The research was conducted independently of the funders, and the views expressed in this paper are those of the authors and not necessarily those of the Department of Health in England. The final version of the report and ultimate decision to submit for publication was determined by the authors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The experiment was conducted in accordance with APA standards for the ethical treatment of human participants, and gained the prior approval by the Psychology Research Ethics Committee of the University of Cambridge (reference number: Pre.2014.101).

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

  • Data sharing statement We are willing to make all data available to any interested parties. Please contact the corresponding author for more information.