Study Finds E-Cigarette Promotional Products Can Double Chances of Youth Tobacco Use

Since cannabis has become legal in places like Colorado, California and all across Canada, the ongoing debate has been over marketing and advertising. Some cannabis companies have argued that they should be able to advertise their products freely, whether those ads make their way to minors or not, just like alcohol advertisements are ubiquitous across the countries. Others, like Canadian Prime Minister Justin Trudeau, were more concerned about allowing these brands to use marketing strategies that could reach, or even subtly target, minors.

If you go somewhere like the U.K., you'll notice that cigarette packaging is completely devoid of all branding. At best, they come in a plain white packaging with the company's name in unassuming black type. At worst, the brand name is tucked between gruesome pictures of health affects of smoking.

But, is branding really what draws kids to smoking? Is seeing Joe Camel on a T-shirt really going to be the tipping point that pushes a 16-year-old to smoke?

That's long been a question. And, now, in the age of e-cigarettes and other non-tobacco nicotine devices, researchers want to know if exposure to and ownership of promotional products and materials from tobacco companies makes kids more likely to start using products like a Juul e-cigarette.

That's the question at the heart of a study conducted by Dr. Bonnie Halpern-Felsher, from Stanford University's Department of Pediatrics, and Dr. Hoda S. Abdel Magid, a postdoctoral scholar at Stanford.

The Food and Drug Administration (FDA) has ordered e-cigarette product makers to devise a plan to keep their devices away from minors, declaring use by teens has reached an "epidemic proportion". | Credit: Getty Images by Scott Olson

"Dr. Hoda Magid, my former graduate student, and I wanted to examine whether owning promotional items for e-cigarettes and other non-cigarette products predicted youth use of those products," Dr. Halpern-Felsher told MedicalResearch.com. "Other studies have examined whether ownership of coupons, samples and other promotional materials influenced cigarette use, but no longitudinal study examined other tobacco products."

Their research found that kids who own promotional items advertising e-cigarettes and other "alternative tobacco products" are two times more likely to use them a year later.

This result could be a factor in how states and countries regulate the advertisement of tobacco and, as it becomes legal more commonly, cannabis. It also underscores the inconsistency of marketing laws related to tobacco products.

"Currently, marketing to minors and providing free samples of a product is illegal," Dr. Halpern-Felsher said. "However, providing coupons and branded promotional items such as T-shirts and hats is only prohibited for smokeless tobacco. Our findings clearly show that such promotional products need to be illegal for all tobacco products in order to help prevent youth use. Specifically, our study suggests that the current marketing restrictions for cigarettes such as restrictions on the distribution of all promotional materials for cigarettes should extend to e-cigarettes and other non-cigarette products. Further, our findings show that FDA and other enforcement agencies need to enforce existing laws prohibiting promotion of tobacco to youth."

Currently, tobacco companies need to apply to market their products with the FDA, but Dr. Halpern-Felsher said that compliance dates have been pushed to 2021 or 2022, depending on the product, which means that companies currently are free to market their product without FDA intervention.

The fact that a T-shirt or similarly harmless item bearing a logo or phrase can double the likelihood of a minor developing a tobacco habit is eyebrow-raising to say the least. It certainly proves just how effective promotional products can be, though likely not in the way the industry would prefer.