title: Exposure to Advertisements and Susceptibility to Electronic Cigarette Use Among Youth.
abstract: Despite the rapid increase in e-cigarette use among youth, little is known about the social and behavioral factors that have contributed to this rise. We investigated whether young e-cigarette users are susceptible to e-cigarette advertisements.
  
  
  
  Estimates of e-cigarette use and exposure to e-cigarette advertisements from the 2014 National Young Tobacco Survey were investigated. Factors associated with the prevalence and levels of e-cigarette use were analyzed using multinomial logistic regression.
  
  
  
  Of all respondents (n = 21,491), 19.8% had tried e-cigarettes and 9.4% were current e-cigarette users. Exposure to e-cigarette ads was prevalent among youth, with 38.6%/29.6%/53.2%/35.4% having medium to high exposure to e-cigarette ads from the Internet/newspapers/stores/TV, respectively. Current use of e-cigarettes among youth was associated with frequent exposure (high vs. low) to e-cigarette advertising from the Internet (odd ratio [OR] = 3.1, p < .0001), newspapers/magazines (OR = 2.5, p < .0001), stores (OR = 2.8, p < .0001), and TV/movies (OR = 2.1, p < .0001). In the multivariate analysis that joint analyzed four advertisement channels and covariates, greater exposure to e-cigarette ads on the Internet (adjusted OR = 1.9, p < .0001) and in retail stores (adjusted OR = 1.9, p < .0001) remained to be significantly associated with increased odds of using e-cigarettes. Vaping by other household members significantly increased the risk of adolescent e-cigarette use (OR = 8.7, p < .0001).
  
  
  
  Exposure to e-cigarette ads significantly increased susceptibility to e-cigarette use among adolescents. E-cigarette advertising regulations and educational campaigns are critically needed.
authors.affiliation: Department of Pediatrics, Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, Missouri; College of Business, Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri. Electronic address: hdai@cmh.edu.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: Bellevue University, Omaha, Nebraska.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000329:Advertising / Q000191:economics / Q000706:statistics & numerical data*; D002648:Child; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D019460:Tobacco Industry / Q000379:methods
keywords: Advertisements; E-cigarette use; National Young Tobacco Survey; youth