The effect of vaping cues in e-cigarette advertisements on normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes in Boston

Introduction: E-cigarette advertising frequently involves vaping cues-hand to mouth motions and vapor-that physically resemble traditional cigarette smoking cues. There has been concern that these vaping cues could make cigarettes seem more frequently used and acceptable by society. This analysis examined whether exposure to vaping cues in e-cigarette ads influence descriptive and injunctive normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes (dual use).Method: Secondary analysis was conducted on an experiment that randomly exposed young adults living in Boston who dual used in the past-week to either 1) E-cigarette ads with vaping cues; 2) E-cigarette ads that edited out vaping cues; or 3) Beverage ads. Descriptive and injunctive normative perceptions about cigarettes were compared across participants who viewed e-cigarette ads with vaping cues versus those who viewed ads without vaping cues.Results: Those who viewed e-cigarette ads with vaping cues had decreased perceptions that cigarette smoking was common compared to those who viewed e-cigarette ads without vaping cues. Exposure to e-cigarette ads with vaping cues also led to increased perceptions of other peoples' unfavorable views toward cigarette smoking in general and their own cigarette smoking.Conclusion: Contrary to renormalization concerns, vaping cues in e-cigarette ads increased anti-smoking normative perceptions among people who dual used in the past week. Further research is needed to examine the impact of vaping cues in e-cigarette ads on normative perceptions among those who don't smoke or quit smoking cigarettes.