title: Vital Signs: Exposure to Electronic Cigarette Advertising Among Middle School and High School Students - United States, 2014.
abstract: BACKGROUND
  Electronic cigarette (e-cigarette) use has increased considerably among U.S. youths since 2011. Tobacco use among youths in any form, including e-cigarettes, is unsafe. Tobacco product advertising can persuade youths to start using tobacco. CDC analyzed data from the 2014 National Youth Tobacco Survey to estimate the prevalence of e-cigarette advertisement exposure among U.S. middle school and high school students.
  
  
  METHODS
  The 2014 National Youth Tobacco Survey, a school-based survey of middle school and high school students in grades 6-12, included 22,007 participants. Exposure to e-cigarette advertisements (categorized as "sometimes," "most of the time," or "always") was assessed for four sources: retail stores, Internet, TV and movies, and newspapers and magazines. Weighted exposure estimates were assessed overall and by school type, sex, race/ethnicity, and grade.
  
  
  RESULTS
  In 2014, 68.9% of middle and high school students (18.3 million) were exposed to e-cigarette advertisements from at least one source. Among middle school students, exposure was highest for retail stores (52.8%), followed by Internet (35.8%), TV and movies (34.1%), and newspapers and magazines (25.0%). Among high school students, exposure was highest for retail stores (56.3%), followed by Internet (42.9%), TV and movies (38.4%), and newspapers and magazines (34.6%). Among middle school students, 23.4% reported exposure to e-cigarette advertising from one source, 17.4% from two sources, 13.7% from three sources, and 11.9% from four sources. Among high school students, 21.1% reported exposure to e-cigarette advertising from one source, 17.0% from two sources, 14.5% from three sources, and 18.2% from four sources.
  Approximately seven in 10 U.S. middle and high school students were exposed to e-cigarette advertisements in 2014. Exposure to e-cigarette advertisements might contribute to increased use of e-cigarettes among youths. Multiple approaches are warranted to reduce youth e-cigarette use and exposure to e-cigarette advertisements, including efforts to reduce youth access to settings where tobacco products, such as e-cigarettes, are sold, and regulation of youth-oriented e-cigarette marketing.
authors.forename: Tushar
authors.initials: T
authors.lastname: Singh
authors.forename: Kristy
authors.initials: K
authors.lastname: Marynak
authors.forename: René A
authors.initials: RA
authors.lastname: Arrazola
authors.forename: Shanna
authors.initials: S
authors.lastname: Cox
authors.forename: Italia V
authors.initials: IV
authors.lastname: Rolle
authors.forename: Brian A
authors.initials: BA
authors.lastname: King
mesh_terms: D000293:Adolescent; D000329:Advertising / Q000706:statistics & numerical data*; D002648:Child; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D012574:Schools / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States