Proximal Exposure to THC Vape Ads Is Associated with Event-Level Vaping Among Young Adults

The current study used Ecological Momentary Assessment (EMA) and four years of survey data to examine whether history of cannabis advertising exposure in early young adulthood, and more proximal ad exposure, are associated with event-level THC vaping. Young adults in California (N = 119) completed annual surveys in a longitudinal cohort study from 2018 to 2022 (ages 22-25) and participated in an EMA study on vaping in 2023 (ages 25-26). Annual surveys assessed cannabis advertising exposure, and EMA surveys assessed exposure to advertisements for THC vaping products, other cannabis product advertisements, and THC vaping. Multilevel logistic regression models examined associations between cannabis advertising exposure (from annual surveys and EMA surveys) and the likelihood of THC vaping at the event-level, controlling for demographics and prior cannabis and nicotine use. Exposure to THC vape product advertisements during the EMA period was associated with 1.96 higher odds of THC vaping (95% CI: 1.02-3.75) relative to non-exposure events. Greater exposure to cannabis product advertisements in previous survey waves (aOR = 1.13, 95% CI: 0.82-1.56) and exposure to other types of cannabis advertising during EMA surveys (aOR = 1.36, 95% CI: 0.82-2.25) were not associated with THC vaping at the event-level. Proximal exposure to THC vaping ads may have a stronger association with THC vaping than proximal exposure to other cannabis advertisements, or young adults' prior history of cannabis advertising exposure. Results demonstrate the importance of assessing proximal advertising exposure when investigating THC vaping among young adults.