Marketing a healthier choice: exploring young people’s perception of e-cigarettes

Background: As a consequence of insufficient evidence on the safety and efficacy of e cigarettes, there has been much controversy surrounding its use in the tobacco control field.                                                                            Objectives: We sought to examine smoking prevalence and salience of e-cigarettes marketing stimuli, and whether these affected attitude-relevant responses toward e-cigarettes and intention to vape.                       Methodology: A convenience sampling procedure was used to recruit 436 ever- and never-smokers aged 18 or older in the UK. Correlation analysis and structural equation modelling tested direct and indirect relationships between salience of e-cigarettes marketing messages, attitude relevant variables, and intention to vape.                                                                                      Results: Just over half of never-smokers were females compared to two-thirds of ever-smokers who were males. Majority of respondents comprising 56% of ever-smokers and 63% of never-smokers had seen e-cigarette promotion in stores or gas stations. Only a third or less of ever- and never-smokers had seen e-cigarette promotion on TV, newspaper or online. Among never-smokers, association between e-cigarette promotion awareness and intention to vape was significant (B= .59, p < .001) but this was mediated by conative beliefs (B=.84, p =.05). Among ever-smokers, awareness of e-cigarette significantly affected cognitive (B= .97, p =.01) and conative attitudes (B= .88, p =.001), which in turn affected intention to vape in future (B= .45, p < .001).                      Conclusions: Our results suggest that never-smokers might think of vaping instead of smoking cigarettes in future. Likewise, ever-smokers might have intention to vape if they think favourably about promotional stimuli and develop positive emotions towards vaping. Our study supports the need for more scientific evidence on the efficacy of e-cigarettes to encourage vaping as a substitute to smoking.