A research team from the University of Cambridge, Behaviour and Health Research, has tested the hypothesis that the marketing of e-cigarettes may increase the appeal of tobacco smoking in children . Their conclusions deserve further studies regarding the impact of flavoured e-cigarette adverts on the youth but confirm that advertising for the e-cigarette doesn’t appeal to tobacco. The prevention of the youth from nicotine products is the main concern when dealing with flavored e-cigarettes or e-liquids, with a dual aspect of nicotine regarded as a toxic substance for brain development and an addictive compound.
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British teenagers 11-16 years screened
English school children (11-16 years old, non-smoking and not using e-cigarettes) have been exposed to three types of adverts in an experiment: a control without any e-cigarette, flavoured e-cigarette ads and non-flavour ones. The children and teenagers were subsequently asked by the Dr. Vasiljevic and her team for their feelings regarding smoking and trying e-cigarettes. Other questions addressed their perception of the risks associated to electronic and tobacco cigarettes.
Exposure to e-cigarette adverts doesn’t increased the appeal for tobacco products
After answering several questions, the researchers found that 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. The perceived harm of tobacco smoking remained high and did not decrease after adverts were shown.
Candy-flavored e-cigarettes may raise teenagers’ interest in the product
The questions asked to the British young participants also aimed at investigating whether non-flavored or candy-flavored e-cigarettes would be more appealing. The researchers identified a potential threat for the youth with candy-flavored e-cigarette advertisements. As expected, the youngest would be more likely to try or buy candy-flavored e-cigarettes than non-flavoured ones, which deserves in a first time further studies and, if confirmed, to adapt the forthcoming regulation on these products.
The results also indicate that 21% of the tested population (127 kids answered yes to the first two questions) was smoking or using e-cigarettes, which is worrying but in an overall agreement with country-wise studies of larger smoking patterns. The short-term interest versus long-term use is under concern, here, and more specifically the way to deal with the attractiveness of the product for the kids.
The fear of a gateway to tobacco remains unjustified
The authors are nevertheless cautious with this optimistic result and recognize that “further studies replicating and extending the current research are needed to elucidate the impact of candy-like flavoured and non-flavoured e-cigarette adverts”. They consider investigating this topic more specifically by including the children who reported being smokers or e-cigarette users and probably more “susceptible to” compared to the overall population. However, as also suggested by the ASH that monitors the changing smoking behavior in the UK, the fear of a gateway to tobacco remains unjustified.
European regulation and flavored e-liquids in the UK?
In the UK, the sale of e-cigarettes is prohibited to the under-18s but adverts are allowed on TV, in magazines and on the internet. Some vaping products may be prescribed by physicians in order to help smokers quit. In the framework of the forthcoming regulation of the tobacco product market in the European Union by the transposition of the EU TPD Article 20, the questions of whether vaping and more specifically candy-flavored products might be regulated is clearly addressed.
A recent leak of the forthcoming provisions suggests a blanket ban on the advertising of all vaping products which may potentially shut down any issue related to advertising in the UK. The EU TPD also requests manufacturers and importers to file notification forms that may heavily weigh on the market, and even more if they have to pay to MHRA notification fees in addition to the cost for introducing EU notification (if any?). The flavor of e-liquids, potentially as diverse as 8 000 according to the authors, characterizes e-cigarettes and their attractiveness among adults. However, given the more strictness that will be applied to vaping products in the UK, the offer may drastically decrease in a close future.
E-cigarette ads and Youth in the US
In the US, the CDC is currently campaigning against e-cigarettes adverts. Youth vulnerability to e-cigarette adverts is stated by considering the parallel increase of the budget for e-cigarette advertising and the relative number of the youth having used an e-cigarette in the last 30 days of the survey.
The CDC takes this societal problem very seriously and proposes actions at the different levels of the society. Starting within the family circle, CDC suggests parents to have a better control on children‘s access to un-appropriate media for their age, and to promote family debates on the topic. At a higher level, health professionals are recommended to include e-cigarette use in their inquiries and prevention on nicotine use, since many kids are not aware of the presence of nicotine in e-liquids. At the State level, a regulation on the sales of vaping product is addressed. More specifically, CDC recommends face-to-face transactions so that the vendors may comply with age limitations. Besides this, the CDC advises a broad information effort and calls the Federal government, the states, the communities and the individual for more funds to support their campaigns.
 Vasiljevic, M., Petrescu, D. C., & Marteau, T. M. (2015). Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking amongst children: an experimental study. doi:10.1136/tobacco control-2015-052593