| Summary: | Introduction
Exposure to advertising is a determinant of electronic cigarette
(e-cigarette) use among young adults. Few studies have explored the underlying
mechanisms of advertising exposure on e-cigarette use among young Chinese
adults.
Methods
An online survey was administered to a sample of 2956 young adults (aged
20–34 years) who were never smokers, from April to May 2022, in
China. Mediation analyses were used to test the mediating effects of curiosity and
harm perception, and moderated mediation models were conducted to examine
whether the relationships in mediation modeling vary across different levels of socioeconomic status (household income, education level, and residence).
Results
Greater advertising exposure was associated with a higher likelihood of
e-cigarette use (AOR=1.39; 95% CI: 1.26–1.54) and curiosity about e-cigarettes
(AOR=1.33; 95% CI: 1.25–1.42), and the latter mediated the association between advertising exposure and e-cigarette use (proportion mediated=26.9%; 95% CI: 15.8%–40.7%)
while harm
perception did not. Additionally, the effect of advertising exposure on curiosity
was moderated by household income (p=0.03) and residential area (p=0.001),
and was stronger among participants with lower socioeconomic status.
Conclusions
E-cigarette advertising may promote young adults’ experimentation
by increasing their curiosity towards the products. Socially disadvantaged groups
may be more susceptible to e-cigarette advertising. The study suggests that the
government should explore options for better regulation of e-cigarettes to prevent
initiation by never smokers and protect vulnerable populations.
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