Exposure to the Tobacco Power Wall Increases Adolescents' Willingness to Use E-cigarettes in the Future

Published in: Nicotine & Tobacco Research [Epub June 2018], nty112. doi: 10.1093/ntr/nty112

Posted on RAND.org on June 28, 2018

by Michael Stephen Dunbar, Steven Martino, Claude Messan Setodji, William G. Shadel

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Access further information on this document at Nicotine & Tobacco Research [Epub June 2018]

This article was published outside of RAND. The full text of the article can be found at the link above.

Research Question

  1. Does exposure to the tobacco power wall in a replica convenience store increase adolescents' willingness to try e-cigarettes?

Introduction

Adolescents' e-cigarette use is now more prevalent than their combustible cigarette use. Youth are exposed to e-cigarette advertising at retail point-of-sale (POS) locations via the tobacco power wall (TPW), but no studies have assessed whether exposure to the TPW influences susceptibility to future e-cigarette use.

Methods

The study was conducted in the RAND Store Lab (RSL), a life-sized replica of a convenience store developed to experimentally evaluate how POS advertising influences tobacco use risk under simulated shopping conditions. In a between-subjects experiment, 160 adolescents (M age = 13.82; 53% female, 56% white) were randomized to shop in the RSL under one of two conditions: (1) TPW located behind the cashier (n = 80); or (2) TPW hidden behind an opaque wall (n = 80). Youths rated willingness to use e-cigarettes ("If one of your best friends were to offer you an e-cigarette, would you try it?"; 1 = definitely not, 10 = definitely yes) before and after exposure. Linear regression assessed differences in pre-post changes in willingness to use across conditions.

Results

Ever-use of e-cigarettes was 5%; use of cigarettes was 8%; use of both e-cigarettes and cigarettes was 4%. There were no differences between TPW conditions on these or other baseline variables (eg, age, gender). Compared to the hidden condition, TPW exposure was associated with greater increases in willingness to use e-cigarettes in the future (B = 1.15, standard error [SE] = 0.50, p = .02).

Conclusions

Efforts to regulate visibility of the TPW at POS may help to reduce youths' susceptibility to initiating e-cigarettes as well as conventional tobacco products like cigarettes.

Implications

Past work suggests that exposure to the TPW in common retail settings, like convenience stores, may increase adolescents' susceptibility to smoking cigarettes. This experimental study builds upon prior research to show that exposure to the TPW at retail POS similarly increases adolescents' willingness to use e-cigarettes in the future. Efforts to regulate the visibility of the TPW in retail settings may help to reduce youths' susceptibility to initiating nicotine and tobacco products, including e-cigarettes.

Key Findings

  • Adolescents exposed to a convenience store setting in which there was a tobacco power wall reported being more willing to use e-cigarettes in the future than adolescents exposed to a setting in which the power wall was hidden.
  • This association persisted after controlling for demographics, past tobacco and e-cigarette use, and self-reported prior exposure to e-cigarette advertising.
  • Exposure to the tobacco wall may increase adolescents' susceptibility to using e-cigarettes, much like combustible cigarettes.
  • These findings suggest that policies to regulate both tobacco and e-cigarette advertising may help reduce future use among adolescents.

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