A randomized controlled trial examining the effects of human models in e-cigarette advertisements and e-cigarette use
Donghee Nicole Lee1, Ian Pagano1, Darren Mays2
1Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, United States.
Background:
The tobacco industry's aggressive marketing has driven e-cigarette use prevalence in young adults. Restricting appealing features - human models - from industry advertisements may reduce product appeal and discourage e-cigarette use in younger populations.
Design:
We conducted a 2-arm parallel design randomized trial to examine the effects of regulating e-cigarette advertisements by removing human models and collected self-reported measures at 0, 4, 12, and 24 weeks.
Intervention:
Susceptible young adults (N = 185; Mage = 22.5) were randomly assigned to the regulated or unregulated advertisement conditions and viewed an online magazine containing an e-cigarette advertisement every week for 24 weeks during the study.
Measures:
The primary outcome was self-reported e-cigarette harm perceptions and use intentions, and salivary cotinine results assessed at 4, 12, and 24 weeks.
Results:
Path analyses showed a sequential pathway, with harm perceptions partially mediating the relationship between viewing the unregulated (humans present) advertisement condition and increased intentions to use e-cigarettes (SRMR = 0.074, AGFI = 0.902, NNFI = 0.944).
Conclusions:
The inclusion of human models in e-cigarette advertisements may reduce perceived e-cigarette harms over time, potentially increasing use intentions among susceptible young adults. Findings can inform the FDA and public advocacy initiatives to strengthen marketing regulations of tobacco products and reduce the impact of industry marketing on young people.


