Effects of E-cigarette Advertising Message Form and Cues on Cessation Intention: An Exploratory Study

Abstract

A common message in e-cigarette advertising is that e-cigarettes can be used anywhere. E-cigarette advertisements often express this message implicitly (e.g., “Whenever, wherever”) alongside images of e-cigarettes that physically resemble combustible cigarettes. These implicit messages and “cigalike” images may cross-cue combustible cigarette smoking cognitions and behavior. This exploratory study was a 2 (message form: implicit or explicit e-cigarette use anywhere message) by 2 (presence or absence of e-cigarette cue) experiment with U.S. adult smokers (n = 2,201). Participants were randomized to view e-cigarette advertisements that varied by study condition. Three combustible cigarette outcomes were investigated: smoking cessation intention, smoking urges, and immediate smoking behavior. Mediation analysis was also performed to investigate mechanisms of the message form effect through descriptive and normative beliefs about smoking. Compared to its explicit counterpart, the implicit e-cigarette use anywhere message evoked greater smoking urges. Participants exposed to the implicit message also perceived cigarette smoking to be more prevalent and, in turn, reported greater cessation intention. There was no evidence of e-cigarette cue or message form × cue interaction effects. Implicit e-cigarette use anywhere messages may create a predisposition towards smoking compared to their explicitly written counterparts, but whether this effect undermines cessation deserves further attention.

Acknowledgments

The authors would like to thank Shelley Golden and Christine Rini for their input on this study, Dannielle Kelley for facilitating access to the ads used as stimuli, and Tara Queen for her input on statistical analyses.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse [F31DA039609]; National Cancer Institute and the FDA Center for Tobacco Products [P50CA180907]; and Kurt Ribisl and the UNC Lineberger Cancer Prevention and Control Leadership Fund.  The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH) or the Food and Drug Administration.