Examining the impact of e-cigarette advertisement exposure with fruit flavour features among US young adults of varying tobacco-use statuses

Introduction Little is known about the impact of viewing commercial e-cigarette advertisements (ads) with varying fruit flavour features among young adults. Methods US young adult (18–30 years) non-use group (n=1078), cigarette-only group (n=1005) and dual-use group (n=1000) participated in a web-based randomised controlled trial and viewed an ad from six conditions: (1) control condition 1: grey device, ‘tobacco’ flavour name; (2) condition 2: grey device, ‘strawberry’ flavour name; (3) condition 3: coloured (red) device, ‘strawberry’ flavour name; (4) condition 4: condition 3+ strawberry imagery; (5) condition 5: condition 4+ flavour sensation claim; and (6) condition 6: condition 5+ flavour choice claim. Immediately afterwards, participants reported intentions to use (and completely switch to) the advertised e-cigarette and other e-cigarette-related perceptions. Results Among the dual-use group, the trial overall increased e-cigarette use intention, full-switch intention, relative use intentions (vs cigarettes and other e-cigarettes) and positive sensory appeal and use expectancy, compared with the control. Specifically, each non-control condition was associated with higher use intention; conditions 4, 5 and 6 were associated with higher switching intention; and condition 5 produced the highest use and switching intentions. Among non-use and cigarette-only groups, the trial affected sensory appeal and use expectancy. Discussion e-Cigarette ads with fruit flavour features, compared with ads promoting tobacco-flavoured products, increased try-and-switch intentions among the young adult dual-use group but influenced only positive sensory and expectancy perceptions among non-use and cigarette-only groups. Policymakers should consider the impact of fruit flavour features in e-cigarette marketing on complete product switching.