ABSTRACT
Purpose: Nearly 4 million U.S. adolescents use e-cigarettes, despite known health harms and laws prohibiting sales to people below 21 years. National surveys show that adolescents self-report buying e-cigarettes from retail stores and online. Although studies show that e-cigarette marketing is associated with adolescent e-cigarette use, these studies have not directly asked adolescents their perception of whether e-cigarette marketing in retail, online and social media influences their browsing, purchasing and use-related behavior. Methods: 90-minute, online focus groups with 14-19 year olds (May-Aug 2021). Photographs were used to help participants recall e-cigarette marketing. Participants were recruited through an Instagram post targeting 30 major U.S. cities (n=27 recruited in 3 focus groups from 10 cities thus far;recruitment ongoing). Thematic analysis was used to identify themes related to appealing marketing characteristics. Results: In addition to bright colors of e-cigarette advertising and names of flavors, participants described appealing e-cigarette marketing characteristics. Appealing characteristics in retails stores: pricing coupons, free smelling samples, individual brands displayed in separate containers, displays at the checkout counter (e.g., “there's a big difference between being at the counter, where you can pick it up yourself, and being behind the counter because I don't want to have to ask the person at the Walgreens –‘can you hand me that?’”). On social media: AYAs were attracted by youth/influencers explaining product safety (e.g., “A lot of influencers market like ‘Oh yeah, they don't have any cancer-causing chemicals”);and inability to trace messages (e.g., Snapchat). Participants also listed ways to purchase e-cigarettes using gift cards, debit cards and using fake or other people’s IDs. Conclusions: Our data show that specific appealing e-cigarette marketing characteristics in retail stores and online can and should inform FDA, state, and local regulation. Notifications on social media, similar to those created to combat misinformation about COVID-19 vaccines, may be developed and tested to prevent AYAs from accessing e-cigarette-related misinformation. Sources of Support: The research reported in this was supported by the Taube Research Faculty Scholar Endowment and the ASPiRE D&I Pilot Award.