Changes in Recall to E-Cigarette Advertisement Exposure among Florida Youth, 2016-2019

The Centers for Disease Control and Prevention reported increases in exposure to e-cigarette ads among US middle and high school students from 2014-2016. This study examines changes in exposure to e-cigarette ads by source among youth in Florida. Methods: We analyzed Florida Youth Tobacco Survey (FYTS) data from 2016-2019 (n = 149,407). We calculated the weighted prevalence of exposure to ads by source (on radio, TV, internet, billboards/outdoor signs, or magazines/newspapers) across years and tested differences in prevalence from 2016-2019. We used logistic regression to examine the changes from 2016-2019 and further conducted multivariable logistic regression to examine the likelihood of past-30-day e-cigarette ad recall as a function of sociodemographics, tobacco use among family members, and current use of tobacco products. Results: Exposure to any type of e-cigarette ads decreased significantly from 2016 (weighted, 55.4%, 95% CI = 54.7, 56.1) to 2018 (47.3%, 95% CI = 46.6, 48.1), but rebounded in 2019 (57.0%, 95% CI = 55.7, 58.4). In multivariable logistic models, the following correlates were consistently associated with higher past-30-day exposure to any source of e-cigarette ads: survey year of 2019 (vs. 2016), being a high school (vs. middle school) student, female (vs. male), current use of e-cigarettes, current other tobacco use, and having a family member who uses tobacco. Conclusion: These findings suggest the need for continued surveillance of e-cigarette marketing practices and policies to prevent youth exposure to e-cigarette ads.