New studies examine e-cigarette availability, advertising effectiveness

June 27, 2014

Two new studies on e-cigarettes by researchers at UNC’s Gillings School of Global Public Health are among the first to examine the availability of these products nationwide and how advertisements are affecting consumer perceptions. Both were published in a special July issue of the journal Tobacco Control.

Dr. Shyanika Rose

Dr. Shyanika Rose

The first study, “The availability of electronic cigarettes in US retail outlets, 2012: results of two national studies,” was led by Shyanika Rose, PhD, doctoral candidate in the Gillings School’s Department of Health Behavior at the time of the study.

Study researchers examined two independent samples of national tobacco retailers in 2012; the first sample comprised 2,165 outlets, and the second comprised 2,426. The survey found that availability of e-cigarettes exceeded 31 percent of the outlets examined. Tobacco shops, pharmacies, gas stations and convenience stores surveyed were more likely to sell e-cigarettes, as compared with beer wine and liquor outlets, which were least likely to carry such products.

The study also found economic and geographic factors contributed to market availability of e-cigarettes. The products were more available for sale in neighborhoods with higher median income and less likely to be available in neighborhoods that were predominantly African-American or Hispanic. Availability also was higher in states with an American Lung Association “Smoke-Free Air” grade of F or D than in states with a grade of A.

“E-cigarette retail availability is likely to continue to grow in the future, and patterns of availability will change with increased industry marketing and government regulation,” Rose said. “States and localities should continue to monitor e-cigarette availability over time.”

Rose’s co-authors include Dianne Barker, MHS, of Barker Bi-Coastal Health Consultants Inc., in Calabasas, Calif.; Heather D’Angelo, doctoral student, and Kurt Ribisl, PhD, professor, of UNC Gillings School’s Department of Health Behavior; and from the University of Illinois at Chicago, Tamkeen Khan, doctoral student, Jidong Huang, PhD, senior research scientist, and Frank L. Chaloupka, PhD, distinguished professor of economics. Ribisl also is leader of the cancer prevention and control program at UNC Lineberger Comprehensive Cancer Center.

The full study is available online here.

Dr. Jess Pepper

Dr. Jess Pepper

The second study, “Effects of advertisements on smokers’ interest in trying e-cigarettes: the roles of product comparison and visual cues,” was led by Jessica Pepper, PhD, doctoral candidate in the Gillings School’s Department of Health Behavior at the time of the study and now a postdoctoral fellow at the UNC Lineberger Comprehensive Cancer Center.

Pepper and her fellow researchers surveyed 3,253 self-identified smokers across the U.S. who had never tried e-cigarettes. The smokers viewed an online advertisement promoting e-cigarettes using one of three messages  – one that emphasized similarities to regular cigarettes, one that emphasized differences, and a third that offered no comparison. Three different images were combined with each advertisement strategy to create nine different advertisements. After seeing the ads, smokers were asked to indicate their interest in trying e-cigarettes.

Ads that emphasized differences between e-cigarettes and regular cigarettes elicited the most interest. The subjects responded most strongly to claims that e-cigarettes’ cost less, are healthier and would help with smoking cessation. Smokers also preferred ads that showed a person using e-cigarettes, a behavior that is similar in appearance to smoking.

According to Pepper, knowing which advertising strategies make e-cigarettes attractive will be important as more information about the effects of e-cigarettes becomes known.

“We don’t know whether e-cigarettes will be good or bad for public health,” Pepper said. “That will depend upon their health effects and whether they help smokers quit smoking. Once we know more, we can take what we’ve learned about advertisement appeal to develop public health messages that either encourage or discourage use of e-cigarettes.”

Pepper added that more advertisement research should be done to help discover which messages appeal to youth.

Co-authors with Pepper are Sherry Emery, MBA, PhD, of UIC’s Institute for Health Research and Policy; Kurt Ribisl, PhD, Gillings School professor of health behavior and program leader at UNC Lineberger; Brian Southwell, PhD, of the Gillings School’s health behavior department, the UNC School of Journalism and Mass Communication and RTI International; and Noel Brewer, PhD, associate professor of health behavior at the Gillings School and member of UNC Lineberger.

The full study can be found here.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or

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