Exposure to Ends Advertising and Use of Marijuana in Ends Among College Students

Introduction: In addition to their commercially intended use, electronic nicotine delivery systems (ENDS) may be used to consume marijuana. Widespread advertising for ENDS has increased awareness of these products among young adults. Therefore, greater exposure to ENDS advertising may increase the likelihood that marijuana users will view ENDS devices as a way to consume marijuana. The purpose of this study was to examine the relationship between self-reported exposure to ENDS advertising and marijuana use in ENDS devices among current marijuana-using college students.

Methods: Participants included 1347 students who had used marijuana in the past month (60% female; 42% white, m age=21) from 24 2-year and 4-year universities/colleges in the southwestern United States. Students reported their exposure to ENDS advertising in various locations (i.e. bars, liquor stores) and media channels (i.e. TV, internet) and received a score of 1 for each location or channel exposed. Total exposure ranged from 0-8. Due to their known associations with substance use, models controlled for sensation seeking and impulsivity. Sensation seeking was measured using the Brief Sensation Seeking Scale-4 (e.g. “I like to do frightening things,”) rated from 1-strongly disagree to 4-strongly agree. Impulsivity measures were adapted from the Substance Use Risk Profile Scale (SURPS). Participants were asked how strongly they agree or disagree with three statements (e.g., “I act without stopping to think.”), rated on a 4-point scale. Marijuana use was measured by asking participants how many times in the past 30 days they used marijuana, dichotomized into nonuser (0 times) or current user (1 or more times). Finally, use of marijuana in ENDS was measured by asking, “Have you ever smoked marijuana in an ENDS product?” (yes/no). The relationship between exposure to ENDS advertising and marijuana use in ENDS was tested using logistic regression, controlling for impulsivity, sensation-seeking, age, gender, race, school, and school type (2 yr/4 yr).

Results: Approximately 42% of respondents reported ever using marijuana in an ENDS device. There was a positive significant relationship between exposure to ENDS advertising and using marijuana in ENDS (OR=1.09, CI 1.03-1.16). Specifically, for every additional exposure to ENDS advertisements, students were 1.09 times more likely to have used marijuana in an ENDS product.

Conclusion: Exposure to widespread advertising of ENDS at various locations frequented by college students and on a number of channels, including television, is associated with current marijuana users who use these products as a tool to consume marijuana. Further research investigating mechanisms related to exposure to ENDS advertising and marijuana use in ENDS is warranted.