title: Exploring the e-cigarette e-commerce marketplace: Identifying Internet e-cigarette marketing characteristics and regulatory gaps.
abstract: BACKGROUND
  The electronic cigarette (e-cigarette) market is maturing into a billion-dollar industry. Expansion includes new channels of access not sufficiently assessed, including Internet sales of e-cigarettes. This study identifies unique e-cigarette Internet vendor characteristics, including geographic location, promotional strategies, use of social networking, presence/absence of age verification, and consumer warning representation.
  
  
  METHODS
  We performed structured Internet search engine queries and used inclusion/exclusion criteria to identify e-cigarette vendors. We then conducted content analysis of characteristics of interest.
  
  
  RESULTS
  Our examination yielded 57 e-cigarette Internet vendors including 54.4% (n=31) that sold exclusively online. The vast majority of websites (96.5%, n=55) were located in the U.S. Vendors used a variety of sales promotion strategies to market e-cigarettes including 70.2% (n=40) that used more than one social network service (SNS) and 42.1% (n=24) that used more than one promotional sales strategies. Most vendors (68.4%, n=39) displayed one or more health warnings on their website, but often displayed them in smaller font or in their terms and conditions. Additionally, 35.1% (n=20) of vendors did not have any detectable age verification process.
  
  
  CONCLUSIONS
  E-cigarette Internet vendors are actively engaged in various promotional activities to increase the appeal and presence of their products online. In the absence of FDA regulations specific to the Internet, the e-cigarette e-commerce marketplace is likely to grow. This digital environment poses unique challenges requiring targeted policy-making including robust online age verification, monitoring of SNS marketing, and greater scrutiny of certain forms of marketing promotional practices.
authors.affiliation: Department of Anesthesiology, University of California, San Diego School of Medicine, San Diego, CA, USA; Division of Global Public Health, University of California, San Diego School of Medicine, Department of Medicine, San Diego, CA, USA; Global Health Policy Institute, San Diego, CA, USA. Electronic address: tmackey@ucsd.edu.
authors.forename: Tim K
authors.initials: TK
authors.lastname: Mackey
authors.affiliation: Joint Masters Degree Program in Health Policy and Law, University of California, San Diego - California Western School of Law, USA; Department of Occupational and Environmental Medicine, University of California, San Diego - Health System, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Miner
authors.affiliation: Global Health Policy Institute, San Diego, CA, USA; Joint Doctoral Degree Program in Global Public Health, University of California, San Diego - San Diego State University, USA.
authors.forename: Raphael E
authors.initials: RE
authors.lastname: Cuomo
mesh_terms: D003132:Commerce / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D040541:Marketing / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D014481:United States
keywords: Electronic cigarettes; Internet sales; Nicotine delivery; Regulatory science; Vaping; e-Cigarettes