Teens Use of E-Cigarettes Increases with Advertising

E-cigarette use among youth is rising as e-cigarette advertising grows. About seven in ten middle and high school students – more than 18 million young people – see e-cigarette advertising in stores, online, in newspapers and magazines, or on television and in movies, according to a new CDC report. About 2.4 million middle and high school students were current (past 30-day) users of electronic cigarettes, or e-cigarettes, in 2014.


E-cigarettes typically deliver nicotine, which at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use. In 2014, e-cigarettes became the most commonly used tobacco product among youth, surpassing conventional cigarettes. During 2011 to 2014, current e-cigarette use among high school students soared from 1.5 percent to 13.4 percent, and among middle school students from 1.6 percent to 3.9 percent. Spending on e-cigarette advertising rose from $6.4 million in 2011 to an estimated $115 million in 2014.


E-cigarette ads use many of the same themes – independence, rebellion, and sex – used to sell cigarettes and other conventional tobacco products. Advertising of tobacco products has been shown to cause youth to start using those products. The unrestricted marketing of unregulated e-cigarettes and dramatic increases in their use by youth could reverse decades of progress in preventing tobacco use among youth.


“The same advertising tactics the tobacco industry used years ago to get kids addicted to nicotine are now being used to entice a new generation of young people to use e-cigarettes,” said the CDC Director Tom Frieden, M.D., M.P.H. “I hope all can agree that kids should not use e-cigarettes.”


Data from the 2014 National Youth Tobacco Survey (NYTS) show 68.9 percent of middle and high school students see e-cigarettes ads from one or more media sources. More youth see e-cigarette ads in retail stores (54.8 percent) than online (39.8 percent), in TV/movies (36.5 percent), or in newspapers and magazines (30.4 percent).


In commenting on the CDC report, CDC Director Dr. Tom Frieden said, “We asked kids, students, if they see ads for e-cigarettes on the internet, in retail stores such as supermarkets and gas stations, on TV or in movies and in newspapers or magazines and we found that more than two-thirds, about seven out of every ten middle and high school kids had seen these ads in at least one of these sources. This is important because tobacco advertising entices youths to use tobacco. Really the e-cigarette advertising we're seeing is like old time wild west, no rules, no regulations and heavy spending advertising the products. In fact, advertising spending by e-cigarette companies increased dramatically between 2011 and 2014.”


Strategies to reduce youth access to e-cigarettes could include:


  • Limiting tobacco product sales to facilities that never admit youth,
  • Restricting the number of stores that sell tobacco and how close they can be to schools,
  • Requiring that e-cigarettes be sold only through face-to-face transactions, not on the Internet, and
  • Requiring age verification to enter e-cigarette vendor’s websites, make purchases, and accept deliveries of e-cigarettes.


“States and communities can also help reduce youth tobacco use by funding tobacco prevention and control programs that address the diversity of tobacco products available on the market, including e-cigarettes,” said Corinne Graffunder, director of the CDC’s Office on Smoking and Health. “We know what works to effectively reduce youth tobacco use. If we were to fully invest in these proven strategies, we could significantly reduce the staggering toll that tobacco takes on our families and communities.”


The 2009 Family Smoking Prevention and Tobacco Control Act gave the FDA authority to regulate the manufacture, marketing, and sale of certain tobacco products. The FDA has announced its intention to regulate e-cigarettes and other currently unregulated tobacco products as part of this Act. The rulemaking is currently under review at the Office of Management and Budget.


Until there is regulation at the federal level, states and communities can:


  • Fund tobacco prevention and control programs at the CDC-recommended levels to prevent youth use of all tobacco products, including e-cigarettes.
  • Work to limit where and how all tobacco products, including e-cigarettes, are sold to reduce youth e-cigarette use, as well as ad exposure.
  • Support efforts to implement and sustain proven youth tobacco prevention actions such as tobacco price increases, comprehensive smoke-free laws, and high-impact mass media campaigns.


See the CDC Announcement


See the CDC Report


See the CDC Telebriefing Transcript


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