Background: Manufacturers of e-cigarette-related products are using cartoons as a marketing strategy, despite restrictions on cartoon marketing for combustible cigarettes. Here, we examined associations between exposure to e-liquid packaging with cartoons (operationally defined as recognition of actual marketing images) and e-cigarette use, susceptibility to use, and expectations of benefits and risks of use.
Methods: U.S. adults completed online surveys assessing e-cigarette use. In Study 1, participants (N = 778; Mean age = 23.5 years; 62% women) completed a questionnaire assessing expectations about benefits and risks of use. Then they were presented with 22 e-liquid package images (with and without cartoons) and were asked to endorse whether they recognized the products. In Study 2, participants (N = 522; Mean age = 30.4; 55% women) were presented with 24 e-liquid images (with and without cartoons) and asked to rate product appeal.
Results: For Study 1, among never users, cartoon recognition was associated with greater likelihood of being susceptible to use e-cigarettes, and with expectations of taste enjoyment and social facilitation. For Study 2, there was no significant difference between cartoon and non-cartoon images on appeal ratings.
Conclusions: Cartoon-based marketing exposure - as measured by recognition of e-liquid package images - was associated with susceptibility to use e-cigarettes, which is consistent with previous research on the use of cartoons to promote combustible cigarettes. These data suggest that restrictions on the use of cartoon-based marketing strategies for e-cigarettes should be similar to those for cigarettes, to reduce susceptibility and perceived benefits among non-users.
Keywords: Cartoons; E-cigarette use; Susceptibility to use; Tobacco marketing; Young adults.
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