title: Exploring Differences in Youth Perceptions of the Effectiveness of Electronic Cigarette Television Advertisements.
abstract: BACKGROUND
  Studies suggest that exposure to televised electronic cigarette (e-cigarette) advertising contributes to the recent increase in e-cigarette use among youth. This study examines the relationship between perceptions of e-cigarette advertisements and attitudes toward and intentions to use e-cigarettes among youth who had never used e-cigarettes.
  
  
  METHODS
  In May 2014, we conducted an online survey of 5020 youth aged 13 to 17. Participants were randomly assigned to answer questions about their attitudes toward and intentions to use e-cigarettes before or after viewing e-cigarette advertisements. Perceived effectiveness (PE) of advertisements was measured after ad exposure. Ordinary least squares models were used to assess the relationship between PE and study outcomes.
  
  
  RESULTS
  Among never e-cigarette users, greater PE was associated with more positive attitudes toward e-cigarettes (b = 0.74, P < .001) and intentions to use e-cigarettes (b = 0.16, P < .001). Findings suggest that PE is predictive of outcomes controlling for study condition, youth demographics, and media use variables.
  
  
  CONCLUSIONS
  After ad exposure, youth who have never used e-cigarettes previously perceive e-cigarettes as cooler, more fun, healthier, and more enjoyable. Youth who thought the ads were more effective were more likely to have a positive attitude toward e-cigarettes and greater intention to try e-cigarettes in the future. Restricting televised e-cigarette advertising may reduce e-cigarette initiation among youth.
  
  
  CONCLUSIONS
  Previous studies demonstrate that, among adults, PE is antecedent to actual ad effectiveness across a range of behaviors. To our knowledge, this is the first study to document the relationship between PE and advertising effectiveness among youth. It provides evidence that PE may be a useful tool to quantify the potential influence of advertising on youth-advertising that, in this case, is designed to market a consumer good that may be harmful to youth but that may also be used to develop public health campaigns.
authors.affiliation: Center for Health Policy Science and Tobacco Research, RTI International , Research Triangle Park, NC.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Duke
authors.affiliation: Center for Health Policy Science and Tobacco Research, RTI International , Research Triangle Park, NC.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Allen
authors.affiliation: Center for Health Policy Science and Tobacco Research, RTI International , Research Triangle Park, NC.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Eggers
authors.affiliation: Center for Health Policy Science and Tobacco Research, RTI International , Research Triangle Park, NC.
authors.forename: James
authors.initials: J
authors.lastname: Nonnemaker
authors.affiliation: Center for Health Policy Science and Tobacco Research, RTI International , Research Triangle Park, NC.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Farrelly
mesh_terms: D000293:Adolescent; D000329:Advertising; D001290:Attitude; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D010465:Perception; D012907:Smoking; D011795:Surveys and Questionnaires; D013690:Television; D062789:Tobacco Products