Exposure to E-Cigarette Advertisements or Reviews and E-Cigarette Use Progression: A Longitudinal Examination of Short-Term and Long-Term Associations among US Young Adults

Abstract

Limited research has investigated the impact of e-cigarette advertising and reviews on the progression of e-cigarette use among young adults in the US. This study utilized five-wave longitudinal data (2018–2020) with 3006 young adults aged 18–34, reporting exposure to e-cigarette advertisements or reviews at Wave 1 (W1) and W3. Generalized estimating equations (GEE) were used to examine the prospective associations between frequent exposure to e-cigarette advertisements or reviews and e-cigarette use progression in four groups: never users (n = 1271 at W1), former users (previously used but quit ≥ 6 months ago, n = 422 at W1), recent former users (used in the past 6 months but not in the past month, n = 186 at W1), and current users (used in the past month, n = 1127 at W1). Among baseline former users, frequent exposure to e-cigarette reviews was associated with current use at 6-month follow-up (aOR = 4.40, 95%CI = 1.46–13.29). Among baseline current users, frequent exposure to e-cigarette reviews was associated with increased days of use at 6-month follow-up (IRR = 1.20, 95%CI = 1.07–1.34) and 12-month follow-up (IRR = 1.18, 95%CI = 1.03–1.35). E-cigarette reviews may contribute to relapse among recent former users and increased usage frequency among current users, highlighting the need for enhanced e-cigarette promotional activity regulation.