Abstract
Purpose
Youth electronic cigarette (e-cigarette) use remains high in the USA, and advertising is a contributor. The purpose of this study was to identify themes and characteristics of popular e-cigarette companies’ advertising after e-cigarette companies became more highly scrutinised in 2018.
Methods
Using a systematic, quantitative content analysis, three trained coders coded e-cigarette advertisements from JUUL, Puff Bar, Vuse and Blu from 2019 and 2020. Based on previous work, they coded for: type of advertisement, flavours, promotions, product cues, descriptors, claims, imagery, youth-oriented themes and sensational appeals.
Results
Of the 401 e-cigarette advertisements, the majority were emails (38.2%) and Instagram posts (30.9%). Over half (53.6%) showed flavours other than tobacco, with Puff Bar leading the brands (70.2%; p<0.001). The most frequently used product cues were showing the product (51.4%) or packaging (42.4%). The most common claim was being an alternative to smoking (14.2%). The most frequently used imagery was fruit (14.0%), employed most by Puff Bar (p<0.001). The only youth-oriented theme present was humour (4.2%). Positive sensations (eg, good taste, good smell or satisfying; 17.1%) was the most common form of appeal, with Puff Bar using it at the highest frequency (p<0.001).
Conclusion
Even with heightened scrutiny of e-cigarette brands, advertisements still included youth-appealing content such as flavours, fruit imagery and positive sensations. Puff Bar led in all these categories, and it rapidly gained market share after market leader JUUL limited the sales of its flavoured products. Research should continue to monitor the characteristics of e-cigarette advertisements and consider their impact on youth.
INTRODUCTION
Prevalence of past month electronic cigarette (e-cigarette) use among high school students in the USA skyrocketed upwards between 2017 and 2018, increasing by 78% in just 1 year (from 11.7% to 20.8%).1 With this surge in youth use came increased scrutiny, with the surgeon general declaring e-cigarette use an ‘epidemic’, the US Food and Drug Administration (FDA) issuing warning letters and fines to e-cigarette manufacturers and retailers, and e-cigarette company JUUL pulling some of its flavoured products out of retail stores in response to public outcry.2-4
Past research has revealed that popular youth-appealing tactics of tobacco and e-cigarette advertising include: marketing of flavours,5 especially fruity flavours,6 7 presenting price reductions and discounts,8 9 showcasing product design,10 displaying harm reduction claims such as e-cigarettes being less harmful than combustible cigarettes,11 integrating of activities and environment,10 featuring of sporting events or bars10 and using emotional appeals and humour.12
All of these approaches were documented in e-cigarette advertising prior to 2018, but there has been little research examining the content of e-cigarette advertisements (ads) since 2018, a period in which e-cigarette companies have been under increased scrutiny and have repeatedly disclaimed any interest in marketing to youth.4 In order to understand what youth are being exposed to with regard to e-cigarette advertising, a content analysis of the most recent ads was necessary. The purpose of this study was to identify themes, characteristics and youth-appealing features of popular e-cigarette companies’ advertising in 2019 and 2020.
METHODS
Overview
Using a systematic, quantitative content analysis methodology, three trained coders coded e-cigarette ads from JUUL, Puff Bar, Vuse and Blu from 2019 and 2020.
A convenience sample of e-cigarette ad images was obtained from the Stanford Research into the Impact of Tobacco Advertising online database13 and Rutgers Centre for Tobacco Studies Trinkets and Trash online archive of tobacco marketing materials.14 Duplicates were removed from the analysis. The analytic sample included all images available on the two databases from 1 January 2019 to 20 October 2020 for both print and online ads for popular e-cigarette brands among youth (Blu, JUUL, Puff Bar and Vuse).15-17 This sample of ads was a convenience sample, as there could be ads missed by those two surveillance sites.
Codebook
Through a review of the literature, a codebook was developed a priori to examine ad characteristics and to identify youth-appealing features and elements of the e-cigarette ads. The codebook was developed by combining and adapting measures from existing tobacco content analyses codebooks.12 18
Coding
The three coders underwent 10 hours of training, then 44 images (11%) of the total sample were coded by all coders to calculate reliability.19 Reliability ranged from Krippendorff’s alpha=0.70–1.00, which is within the acceptable range for reliability.20 The following is a description of the categories coded for. The features within these categories were not mutually exclusive unless otherwise noted.
Ad characteristics
Type of ad
Image type was coded by two main categories: product brand (Blu, JUUL, Puff Bar and Vuse) and ad type. The ad types included social media (Facebook and Instagram), online (email, banner ads and industry website), print (mail and magazine) or other.
Humans/animals
Perceived sex, race, age of humans and presence of animals were coded.12
Warnings and disclaimers
Presence of warning labels and disclaimer messages was coded for in the ads.18 Examples of warnings included text in the ad image stating: ‘Product contains nicotine’ or ‘Must be of certain age to purchase product.’
Descriptors
Promotions
Promotions were defined as tactics used to incentivise use of the product or engagement with brand.18 Promotions were coded as sweepstakes, giveaway, price reduction and cosponsored event.18
Product cues
Product cues were defined as information that could trigger cravings or aid in use18 and included product availability, price shown, product packaging shown, e-liquid bottle shown, product shown, product in use, and smoke or vapour present.18
Ad-level descriptors
Descriptors were defined as exact text or variation of certain terms that appear in the ad itself and not on the product packaging or brand name.18 Twenty-five ad-level descriptors were coded for, with some examples being Cool, Fruity and Bold.
Claims
Claims were coded if the ad conveyed that the product possesses the following qualities: reduced harm, smart choice, alternative to smoking, help one quit smoking, rechargeable, no smell, no ash, no smoke, savings, high quality, made in the USA, made locally, unique, new, similar to a cigarette and good smelling.18
Aesthetics
Activities
Activities were coded if the ad associated the product with specific activities by featuring things associated with the activity or characters engaging in the activity.18 Examples include sports/athletics and relaxing.
Setting
Setting was defined as the primary location as shown in the ad.18 This category was mutually exclusive.
Imagery
Imagery was defined as specific portrayals of non-human objects in the ad.18 Examples include tobacco, alcohol, fruit and flora.
Appeals
Youth-oriented themes
Youth-oriented themes were coded for and included humour, magic or fantasy and violence.12
Rewarding appeals
Rewarding appeals were coded for, including positive sensations promotion, negative sensations avoidance, positive mood promotion, negative mood avoidance, physical performance, adventure/spontaneity, achievement/success, sexual connotation, individuality/freedom, camaraderie/friendship, social positioning, appearance and addiction.12
Data analysis
All data were analysed with R software.21 Descriptive statistics were run to summarise the data, and Pearson’s χ2 test for count data were conducted for specific content areas to examine how they differed by brand.
RESULTS
Ad characteristics
Table 1 depicts a summary of the characteristics of the 401 coded ads.
Table 1.
Characteristics of 2019 and 2020 e-cigarette ad images (n=401)
| n (%) | |
|---|---|
| Brand | |
| Blu | 27 (6.7) |
| JUUL | 101 (25.0) |
| Puff | 161 (40.1) |
| Vuse | 112 (27.9) |
| Image source | |
| Rutgers Center for Tobacco Studies Trinkets and Trash | 114 (28.4) |
| Stanford Research into the Impact of Tobacco Advertising | 287 (71.6) |
| Image year | |
| 2019 | 187 (46.6) |
| 2020 | 214 (53.4) |
| Type of ad | |
| Social media | 128 (31.9) |
| Online | 169 (42.1) |
| 36 (9.0) | |
| Other | 68 (17.0) |
| Flavour(s) present | |
| Yes | 215 (53.6) |
| No | 158 (39.4) |
| Unclear | 28 (7.0) |
| Warning(s) present | |
| Yes | 338 (84.3) |
| No | 63 (15.7) |
| Human(s) present | |
| Yes | 91 (22.7) |
| No | 310 (77.3) |
| Sex present (n=91) *select all that apply | |
| Male | 58 (63.7) |
| Female | 52 (57.1) |
| Unclear | 8 (8.8) |
| Race present (n=91) “select all that apply | |
| White | 54 (59.3) |
| Non-white/other | 37 (40.7) |
| Unclear | 18 (19.8) |
| Youth present (n=91) | |
| Yes (=youth) | 3 (3.3) |
| No (adult) | 90 (96.7) |
| Animal(s) present (n=91) | |
| Yes | 1 (1.1) |
| No | 92 (98.9) |
AD, advertisement.
Descriptors
Thirty per cent of ads contained promotions, and the most widely used was price reduction (25.4%). Most ads employed product cues, with 51.4% showing the product itself, 42.4% showing product packaging, 40.4% describing where the product can be purchased, 21.9% showing the e-liquid bottle, and 15.5% displaying the product in use. A quarter (25.9%) of the ads contained ad-level descriptors, and the most used was ‘satisfying’ (9.7%). Almost half (47.4%) of the ads contained claims, with the most frequently used being that e-cigarettes were exchangeable with smoking (14.2%) and savings (13%). Most ads contained at least one warning label (84.3%), yet 15.7% of ads did not contain any warning labels.
Aesthetics
More than three-quarters (76.8%) of the ads featured activities, with the most popular activity depicted being relaxing or sitting calmly (8.7%). The most frequently used setting was a home-like setting (6%). The most widely used imagery was fruit (15%) and flora (5.5%).
Appeals
The youth-oriented theme that was seen in the ads was humour (4.2%). Almost half (47.4%) of the ads contained rewarding appeals, with the most common appeals used being positive sensations promotion (eg, good taste, good smell and satisfying; 17.2%), positive mood promotion (eg, relaxing, enjoyment and happiness; 13%), camaraderie and friendship (9.2%) and individuality and freedom (9%).
Ad content by brand
The online supplemental table depicts the ad types and some of the most frequently used ad content components that varied widely by e-cigarette brand. Puff Bar ads had the highest frequency of flavours besides tobacco present in their ads, followed by JUUL, Blu and Vuse (χ2=190.5, p=<0.001).
Of the most frequently identified rewarding appeals, positive sensations promotion was most frequent within Blu ads (44.4%; χ2=29.1, p<0.001) compared with the other three brands.
DISCUSSION
Our findings showed that after 2018, ads from popular e-cigarette brands continued to include features that were appealing to youth, despite increased public and governmental scrutiny.2-4 Overall, online and social media posts were the most common ad types used. Research has found that e-cigarette advertising on social media is extensive and easily accessible.22-24 For example, a qualitative study found that e-cigarette brands are able to easily advertise to youth through online platforms, such as through email sign-ups on brand websites and promotions.6 The participants in that study described how ubiquitous both the official e-cigarette brand ad content as well as user-generated social media content was on Instagram and other popular social media platforms.6 Our findings support this existing research and show that e-cigarette brands are likely still using social media as a major avenue to reach youth, though some platforms have taken steps to limit e-cigarette promotions.25
In addition, the ads also employed youth-friendly tactics such as price reductions and showing the product in the ads, both of which may cue youth to use the product.26 Prior research has shown that youth are more price sensitive to e-cigarette product prices, compared with adults.27 Therefore, directly marketing price reductions may potentially lure in youth to purchase and use e-cigarettes.
Even with FDA guidance in January 2020 limiting the use of flavours in some e-cigarette products,28 the ads examined in this study still included content related to flavours including fruit and flora imagery, which are known to be appealing to young people.18 29 Puff Bar led in these categories, likely due to the fact that disposable products such as Puff Bar were not covered by the FDA’s guidance.2 Thus, Puff Bar was still able to sell its flavoured products and likely promoted to youth using appealing ads. Puff Bar possibly filled a void in the e-cigarette landscape for flavoured products and became a replacement product for those youth previously using flavoured JUUL products. Research found that searches online for Puff Bar increased substantially after JUUL, under pressure from the FDA, stopped selling some of its flavoured products in retail stores in November 2018.16
Positive sensations and positive mood promotion were the two most frequently used appeals in the sample of e-cigarette ads. Positive associations such as these in tobacco advertising have been shown to override negative associations youth have with tobacco.30
This study examined the ads of some of the most popular e-cigarette brands, and to our knowledge is the first content analysis on youth appeal of e-cigarette ads from 2019 and 2020. The main limitations were that the ads were taken from two large tobacco surveillance databases, but other ads could exist. Radio, video and television ads were also excluded from the analysis. Thus, findings and proportions may not be generalisable to the entire population of e-cigarette ads. This study did not examine advertising prior to 2018 and thus cannot make direct before and after comparisons. Nevertheless, this study is the first analysis of popular e-cigarette brand ads after the spike in e-cigarette use between 2017 and 2018.
Conclusion
Even after the increased public and governmental focus on stricter regulations around e-cigarettes that followed surging rates of youth use,2 ads still included youth-appealing content such as flavours, fruit imagery and positive sensations. Puff Bar led in all these categories, taking advantage of both voluntary and governmental policies that limited the sale of flavoured products by its competitors.3 Research should continue to monitor the characteristics of e-cigarette advertisements and consider the messages these ads convey.
What this paper adds.
The tobacco industry has had a history of using marketing strategies that directly appeal to youth.
Early e-cigarette advertisements contained youth-appealing features as well.
With the rise of the youth e-cigarette use epidemic in 2018, e-cigarette promotions and sales came under greater public scrutiny.
Since 2018, there has yet to be an extensive content analysis examining the youth appeal of e-cigarette advertising from 2019 and 2020.
Our study found that more recent e-cigarette advertisements still included youth-appealing content.
Funding
This work was funded by the National Institute on Drug Abuse (K99DA046563; E. Stevens, PI). CV-O and JL were funded by the Cancer Prevention Fellowship from the National Cancer Institute and Harvard T.H. Chan School of Public Health – National Institutes of Health grant number 2T32CA057711-27.
Footnotes
Disclaimer Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Competing interests None declared.
Additional supplemental material is published online only. To view, please visit the journal online (http://dx.doi.org/10.1136/tobacco-control-2021-056720).
REFERENCES
- 1.Cullen KA, Ambrose BK, Gentzke AS, et al. Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students - United States, 2011-2018. MMWR Morb Mortal Wkly Rep 2018;67:1276–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.FDA. Statement from FDA commissioner Scott Gottlieb, M.D., on new enforcement actions and a youth tobacco prevention plan to stop youth use of, and access to, JUUL and other e-cigarettes, 2018. Available: https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-enforcement-actions-and-youth-tobacco-prevention [Accessed 6 Feb 2021].
- 3.Office on Smoking and Health NC for CDP and HP. Surgeon General’s Advisory on E-cigarette Use Among Youth The E-cigarette Epidemic Among Youth 2018.
- 4.U.S. Food and Drug Administration. FDA takes new steps to address epidemic of youth e-cigarette use, including a historic action against more than 1,300 retailers and 5 major manufacturers for their roles perpetuating youth access ∣ FDA, 2018. Available: https://www.fda.gov/news-events/press-announcements/fda-takes-new-steps-address-epidemic-youth-e-cigarette-use-including-historic-action-against-more [Accessed 13 Mar 2021]. [Google Scholar]
- 5.McKelvey K, Halpern-Felsher B. Youth say flavored e-cigarette ads are for them. J Adolesc Heal 2018;62:S136–7. [Google Scholar]
- 6.Liu J, McLaughlin S, Lazaro A, et al. What does it Meme? A qualitative analysis of adolescents’ perceptions of tobacco and marijuana messaging. Public Health Rep 2020;135:578–86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Nguyen N, McKelvey K, Halpern-Felsher B. Popular flavors used in alternative tobacco products among young adults. J Adolesc Heal 2019;65:306–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Huang J, Kornfield R, Szczypka G, et al. A cross-sectional examination of marketing of electronic cigarettes on Twitter. Tob Control 2014;23:iii26–30. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Clark EM, Jones CA, Williams JR, et al. Vaporous marketing: uncovering pervasive electronic cigarette advertisements on Twitter. PLoS One 2016;11:e0157304. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Ling PM, Glantz SA. Why and how the tobacco industry Sells cigarettes to young adults: evidence from industry documents. Am J Public Health 2002;92:908–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Hammal F, Finegan BA. Exploring Attitudes of Children 12–17 Years of Age Toward Electronic Cigarettes. J Community Health 2016;41:962–8. [DOI] [PubMed] [Google Scholar]
- 12.Padon AA, Maloney EK, Cappella JN. Youth-Targeted e-cigarette marketing in the US. Tob Regul Sci 2017;3:95–101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Stanford University. Stanford research into the impact of tobacco advertising. Available: http://tobacco.stanford.edu/tobacco_main/main_pods.php [Accessed 29 Jan 2021].
- 14.Rutgers Center for Tobacco Studies. Trinkets & Trash. Available: https://www.trinketsandtrash.org/ [Accessed 29 Jan 2021].
- 15.Tan ASL, Soneji SS, Choi K, et al. Prevalence of using pod-based vaping devices by brand among youth and young adults. Tob Control 2020;29:461–3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Dai H, Hao J. Online popularity of JUUL and puff bars in the USA: 2019-2020. Tob Control 2020. doi: 10.1136/tobaccocontrol-2020-055727. [Epub ahead of print: 13 Oct 2020]. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Giovenco DP, Hammond D, Corey CG, et al. E-Cigarette market trends in traditional U.S. retail channels, 2012–2013. NICTOB 2015;17:1279–83. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Moran MB, Heley K, Baldwin K, et al. Selling tobacco: a comprehensive analysis of the U.S. tobacco advertising landscape. Addict Behav 2019;96:100–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Brett EI, Stevens EM, Wagener TL, et al. A content analysis of JUUL discussions on social media: using Reddit to understand patterns and perceptions of JUUL use. Drug Alcohol Depend 2019;194:358–62. [DOI] [PubMed] [Google Scholar]
- 20.Krippendorff K Reliability in content analysis: some common misconceptions and recommendations, 2004. Available: http://repository.upenn.edu/ascpapers/242 [Accessed 29 Jan 2021]. [Google Scholar]
- 21.R Team Core. R: a language and environment for statistical computing, 2020.
- 22.Vandewater EA, Clendennen SL, Hébert ET, et al. Whose post is it? predicting e-cigarette brand from social media posts. Tob Regul Sci 2018;4:30–43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.McCausland K, Maycock B, Leaver T, et al. The messages presented in electronic Cigarette–Related social media promotions and discussion: Scoping review. J Med Internet Res 2019;21:e11953. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Richardson A, Ganz O, Vallone D. Tobacco on the web: surveillance and characterisation of online tobacco and e-cigarette advertising. Tob Control 2015;24:341–7. [DOI] [PubMed] [Google Scholar]
- 25.Rowell A. Despite being banned, big tobacco is still on social media. independent, 2020. [Google Scholar]
- 26.Perks SN, Armour B, Agaku IT. Cigarette brand preference and Pro-Tobacco advertising among middle and high school students — United States, 2012–2016. MMWR Morb Mortal Wkly Rep 2018;67:119–24. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Pesko MF, Huang J, Johnston LD, et al. E-Cigarette price sensitivity among middle- and high-school students: evidence from monitoring the future. Addiction 2018;113:896–906. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.U.S. Food & Drug Administration (FDA). Enforcement priorities for electronic nicotine delivery system (ends) and other deemed products on the market without Premarket authorization, 2020.
- 29.Moran MB, Heley K, Czaplicki L, et al. Tobacco advertising features that may contribute to product appeal among US adolescents and young adults. Nicotine Tob Res 2021;23:1373–1381. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Garrison KA, O’Malley SS, Gueorguieva R, et al. A fMRI study on the impact of advertising for flavored e-cigarettes on susceptible young adults. Drug Alcohol Depend 2018;186:233–41. [DOI] [PMC free article] [PubMed] [Google Scholar]