title: Differences in Electronic Cigarette Awareness, Use History, and Advertisement Exposure Between Black and White Hospitalized Cigarette Smokers.
abstract: E-cigarette use has increased rapidly over the past decade. There is growing concern about e-cigarette use and advertising given limited regulation of these products. This cross-sectional study reports on data collected at baseline from hospitalized cigarette smokers (N=944) recruited in monthly cohorts between December 2012 and September 2013. Participants were queried regarding e-cigarette awareness and use, and number and sources of e-cigarette advertisement exposures in the previous 6 months. Most Whites (99%) reported ever hearing of an e-cigarette compared to 96% of Blacks (p<0.001). Over two thirds (64%) of Whites reported ever using an e-cigarette compared to 30% of Blacks (p<0.001). There were significant trends in increasing e-cigarette use for both racial groups with an average increase of 13% each month (p<0.005) and in increasing e-cigarette advertisement exposure reported for the previous 6 months, with a 14% increase each month (p<0.0001). Whites reported 56% greater advertisement exposure than Blacks (mean=25 vs. 8 in month 1 to 79 vs. 45 in month 9, respectively; p<0.0001). For Blacks, advertisement exposure was significantly associated with e-cigarette use (p<0.001). Whites reported more advertisement exposure from stores and the Internet, and Blacks reported more advertisement exposure from radio or television. Results suggest that e-cigarette marketing is beginning to breach the Black population who are, as a consequence, "catching up" with Whites with regard to e-cigarette use. Given the significant disparities for smoking-related morbidity and mortality between Blacks and Whites, these findings identify new areas for future research and policy.
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave South, THT 541-F, Birmingham, AL, 35294, USA. angelabaumann@uab.edu.
authors.forename: Angela Warren
authors.initials: AW
authors.lastname: Baumann
authors.affiliation: Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Connie
authors.initials: C
authors.lastname: Kohler
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Young-il
authors.initials: YI
authors.lastname: Kim
authors.affiliation: Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: JeeWon
authors.initials: J
authors.lastname: Cheong
authors.affiliation: Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Hendricks
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave South, THT 541-F, Birmingham, AL, 35294, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Bailey
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave South, THT 541-F, Birmingham, AL, 35294, USA.
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Harrington
mesh_terms: D000329:Advertising; D001741:Black or African American / Q000523:psychology*; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D044465:White People / Q000523:psychology*
keywords: Advertising; E-cigarettes; Electronic cigarettes; Racial differences