Outdoor and Point-of-Sale Ends Marketing and Ends Use Among College Students

Introduction: Previous work has documented the positive relationship between exposure to traditional cigarette marketing at the point-of-sale (POS) and tobacco use. Further, studies have consistently documented the targeting of minority communities by tobacco marketing. As the prevalence of electronic nicotine delivery system (ENDS) use continues to rise among college students, it is likely that exposure to POS and outdoor marketing of ENDS products is related to use. Therefore, the purpose of this study was to determine the association between POS and outdoor ENDS marketing and ENDS use among college students and if this association was differed by race/ethnicity of the students.

Methods: Participants were 5,458 students (M age= 20.49, SD age= 2.36; 63.7% Non-white) from 24 2-year and 4-year universities/colleges in the southwestern United States. Students completed self-report surveys which assessed exposure to tobacco marketing and tobacco use. Two questions assessed exposure to ENDS advertising (signs marketing ENDS products) and ENDS products (ENDS products on display) at convenience and drug stores, gas stations, and liquor stores visited in the past month. Response options for the questions ranged from never (0) to every time (3). One question assessed exposure to ENDS advertising on billboards (e.g. How often do you see any advertisements or promotions for ENDS products (i.e. e-cigarettes, vape pens, e-hookah) on billboards?). Response options for the questions ranged from never (0) to every time (4). Associations between exposure to ENDS marketing, demographics, and current ENDS use (use on at least 1 day in past 30 days) were examined using logistic regression models, controlling for age, gender, race/ethnicity, school, and school type (2 year/4 year college).

Results: Exposure to signs marketing ENDS products was significantly associated with current ENDS use (OR=1.49, CI= 1.38, 1.61). Similarly, exposure to ENDS products on display was significantly associated with current ENDS use (OR=1.61, CI=1.49, 1.73). However, exposure to ENDS marketing on billboards was not found to have an association with current ENDS use (OR=1.05, CI=.98, 1.13). Race/ethnicity did not moderate any of the associations.

Conclusion: Much of the research on point-of-sale and outdoor advertising has focused on cigarette marketing. However, the findings from this study suggest that exposure to ENDS marketing may influence ENDS use among college students. Longitudinal research is needed to examine these associations prospectively. While there were no differences in the relationships by race/ethnicity, work is needed which documents if minority groups are disproportionately targeted by ENDS marketing as they have been with traditional cigarette marketing.