E-cigarette adverts and children's perceptions of tobacco smoking harms: an experimental study and meta-analysis

Vasiljevic, M.; St John Wallis, A.; Codling, S.; Couturier, D.-L.; Sutton, S.; Marteau, T.M.

Abstract

Objectives: Children exposed to electronic cigarette (e-cigarette) adverts may perceive occasional tobacco smoking as less harmful than children not exposed to e-cigarette adverts. Given the potential cross-cueing effects of e-cigarette adverts on tobacco smoking, there is an urgent need to establish whether the effect found in prior research is robust and replicable using a larger sample and a stronger control condition. Design: A between-subjects experiment with one independent factor of two levels corresponding to the advertisements to which participants were exposed: glamorous adverts for e-cigarettes, or adverts for objects unrelated to smoking or vaping. Participants: English school children aged 11–16 (n=1449). Outcomes: Perceived harm of occasional smoking of one or two tobacco cigarettes was the primary outcome. Secondary outcomes included: perceived harm of regular tobacco smoking, susceptibility to tobacco smoking and perceived prevalence of tobacco smoking in young people. Perceptions of using e-cigarettes were gauged by adapting all the outcome measures used to assess perceptions of tobacco smoking. Results: Tobacco smokers and e-cigarette users were excluded from analyses (final sample n=1057). Children exposed to glamorous e-cigarette adverts perceived the harms of occasional smoking of one or two tobacco cigarettes to be lower than those in the control group (Z=−2.13, p=0.033). An updated meta-analysis comprising three studies with 1935 children confirmed that exposure to different types of e-cigarette adverts (glamorous, healthful, flavoured, non-flavoured) lowers the perceived harm of occasional smoking of one or two tobacco cigarettes (Z=3.21, p=0.001). Conclusions: This study adds to existing evidence that exposure to e-cigarette adverts reduces children’s perceptions of the harm of occasional tobacco smoking.

Citation

Vasiljevic, M., St John Wallis, A., Codling, S., Couturier, D.-L., Sutton, S., & Marteau, T. (2018). E-cigarette adverts and children's perceptions of tobacco smoking harms: an experimental study and meta-analysis. BMJ Open, 8, Article e020247. https://doi.org/10.1136/bmjopen-2017-020247

• Journal Article Type: Article
• Acceptance Date: Jun 4, 2018
• Online Publication Date: Jul 16, 2018
• Publication Date: Jul 16, 2018
• Deposit Date: Oct 24, 2018
• Publicly Available Date: Oct 26, 2018
• Journal: BMJ Open
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Article Number: e020247
• DOI: https://doi.org/10.1136/bmjopen-2017-020247
• Public URL: https://durham-repository.worktribe.com/output/1315435
• Related Public URLs: https://www.repository.cam.ac.uk/handle/1810/280013