The Mediating Effect of E-Cigarette Harm Perception in the Relationship between E-Cigarette Advertising Exposure and E-Cigarette Use

Nan Jiang, Shu Xu, Le Li, Omar El-Shahawy, Nicholas Freudenberg, Jenni A. Shearston and Scott E. Sherman
Additional contact information
Nan Jiang: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Shu Xu: School of Global Public Health, New York University, New York, NY 10003, USA
Le Li: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Omar El-Shahawy: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Nicholas Freudenberg: School of Public Health, City University of New York, New York, NY 10027, USA
Jenni A. Shearston: Mailman School of Public Health, Columbia University, New York, NY 10032, USA
Scott E. Sherman: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA

IJERPH, 2022, vol. 19, issue 10, 1-10

Abstract: Exposure to e-cigarette advertising is associated with e-cigarette use among young people. This study examined the mediating effect of e-cigarette harm perception on the above relationship. Cross-sectional survey data were collected from 2112 college students in New York City in 2017–2018. The analytic sample comprised 2078 participants (58.6% females) who provided completed data. Structural equal modeling was performed to examine if e-cigarette harm perception mediated the relationship between e-cigarette advertising exposure (via TV, radio, large signs, print media, and online) and ever e-cigarette use and susceptibility to e-cigarette use. About 17.1% of participants reported ever e-cigarette use. Of never users, 17.5% were susceptible to e-cigarette use. E-cigarette advertising exposure was mainly through online sources (31.5%). Most participants (59.4%) perceived e-cigarettes as equally or more harmful than cigarettes. Advertising exposure showed different effects on e-cigarette harm perception depending on the source of the advertising exposure, but perceiving e-cigarettes as less harmful than cigarettes was consistently associated with e-cigarette use and susceptibility. Low harm perception mediated the association between advertising exposure (via online, TV, and radio) and ever e-cigarette use and between online advertising exposure and e-cigarette use susceptibility. Regulatory actions are needed to address e-cigarette marketing, particularly on the Internet.

Keywords: e-cigarette; smoking; advertising; perception; mediator; college student (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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