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Health claims made in vape shops: an observational study and content analysis
  1. Kimberly G Wagoner1,
  2. Micah Berman2,
  3. Shyanika W Rose3,
  4. Eunyoung Song1,
  5. Jennifer Cornacchione Ross1,
  6. Elizabeth G Klein4,
  7. Dannielle E Kelley5,
  8. Jessica L King1,
  9. Mark Wolfson1,
  10. Erin L Sutfin1
  1. 1 Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
  2. 2 Health Services Management and Policy, The Ohio State University College of Public Health and Moritz College of Law, Columbus, Ohio, USA
  3. 3 Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, USA
  4. 4 Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA
  5. 5 School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to WagonerKimberly G, Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; kwagoner{at}


Background Prior to the final deeming rule, federal law in the USA prohibited electronic cigarettes (e-cigarettes) from being marketed as smoking cessation products; for other therapeutic purposes and in ways that conveyed Food and Drug Administration (FDA) approval/endorsement. After August 2016, additional federal prohibitions were added including false/misleading and unauthorised modified risk tobacco product (MRTP) claims. No systematic investigation of e-cigarette health claims has been conducted in the retail environment. We sought to document and characterise claims made in vape shops.

Methods Between November 2015 and February 2016, before final deeming rule implementation, two trained data collectors conducted unannounced observational assessments of 46 vape shops in North Carolina. Data collectors used wearable imaging technology to document health claims about e-cigarettes. Photos were coded for five claim types: (1) cessation device; (2) drug effect/device; (3) FDA-approved/endorsed; (4) false/misleading and (5) MRTP. Photos were double coded; differences between coders were adjudicated and reviewed by an expert panel.

Results At least one health claim was displayed in 41.3% (n=19) of retailers, ranging from 0 to 27 claims per retailer. All claim types were found. Cessation device claims were the most prevalent (62.2%, n=84), followed by MRTP (27.4%, n=37), drug effect/device (8.1%, n=11), false/misleading (1.5%, n=2), and FDA approved/endorsed (0.7%, n=1). Retail chains made the majority of claims compared with independent shops (88.9% vs 11.1%).

Conclusions Many vape shops displayed e-cigarette health claims, which are all now FDA prohibited. These claims could mislead consumers and influence behaviour. Findings highlight the need for retailer education, continued surveillance, enforcement specific to advertising and research on consumer perceptions of claims.

  • electronic nicotine delivery systems (ENDS)
  • surveillance and monitoring
  • advertising and promotion

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  • Collaborators The following are members of the E-cigarette Claims Work Group: KGW (Wake Forest School of Medicine); MB (The Ohio State University College of Public Health and Moritz College of Law); SR (Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies); ES (Wake Forest School of Medicine); JCR (Wake Forest School of Medicine); EGK (The Ohio State University College of Public Health); DEK (University of North Carolina at Chapel Hill); JLK (Wake Forest School of Medicine); MW (Wake Forest School of Medicine); ELS (Wake Forest School of Medicine).

  • Contributors KGW and ELS designed the study. KGW, MB, SR, ES, JCR, MW and ELS contributed to the implementation of the study. MB performed the legal analysis. MB, EGK, DEK, SR, MW, JCR and ELS made up the expert panel for the content analysis. KW and JLK wrote the manuscript. All authors contributed to revising the manuscript.

  • Funding This work was supported by grant number P50CA180907 from the National Cancer Institute and the FDA Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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