The Effect of E-cigarette Advertising on Tobacco Use: Evidence from Monitoring the Future

E-cigarettes and other forms of electronic nicotine delivery systems (ENDS) have radically transformed the tobacco marketplace and are creating new challenges for tobacco regulatory efforts. According to surveys, 2014 was the first year that teenagers in the United States reported being more likely to currently use ENDS than cigarettes.

In this research project, we evaluate the effects of ENDS advertising on youth use of ENDS and cigarettes. Other studies have used variation in ENDS minimum legal purchase age laws and prices, and these studies have generally found that higher regulations and prices reduced youth use of ENDS and increased use of cigarettes. We similarly hypothesize that ENDS advertising may increase youth ENDS use and decrease youth cigarette use.

We specifically assess the impact of ENDS advertising on television and magazines, which account for over 90% of total media spending, as well as youth exposure to ENDS marketing through social media on Twitter. Advertising data in magazines and TV are obtained from Kantar Media, and END-related messages on Twitter are obtained from Brandwatch. These advertising data are aggregated to the county-year-month level by demographic groups, accounting for media consumption patterns (TV viewing patterns, internet and social media use, and magazine reading habits) from another proprietary dataset on consumers, the Simmons National Consumer Survey. We then match these measure of advertising to the Monitoring the Future, which surveyed 220,000 youth between the years of 2012 to 2016. We evaluate the effect of within-county and/or within-county-demographic changes in advertisement exposure on the youth’s probability of using ENDS and on their smoking behaviors (initiation, participation, and smoking intensity), controlling for time fixed effects, county fixed effects, demographics, and other tobacco control policies.

The Food and Drug Administration has the authority to regulate ENDS advertisement but has refrained from doing so for the time being, noting that the evidence is limited on the public health impact of ENDS and the role played by advertising. We provide the first evidence on how ENDS advertising messages impact youth, informing the public health debate centered on ENDS and youth. Our study will provide the first evidence of likely impacts on youth ENDS use and smoking behaviors if the FDA exercises its authority and restricts advertising. If ENDS advertisement leads to less consumption of cigarettes among youth, and if ENDS are only 5% as harmful as traditional cigarettes as advocated in a recent British government report, then such restrictions could have the counter-intuitive effect of worsening public health.