Effect of Advertising Exposure on Responses of Young Non-e-Cigarette Users to Banning Flavors in China: A Cross-Sectional Study

Abstract

Background

E-cigarettes, particularly those with flavors, have become increasingly popular among young people. Many countries have implemented flavor bans, though limited research has explored how non-users react to flavor bans. This research investigates the influence of advertising exposure on changes in intention to use e-cigarettes among young Chinese non-users in response to a hypothetical flavor ban.

Methods

A probability-based online survey conducted from September to November 2021 included 2989 participants aged 20−34. We assessed the association between advertising exposure and change in intention to use e-cigarettes after a hypothetical flavor ban. We used propensity score weighting (PSW) to reduce potential selection bias.

Results

The intention to use e-cigarettes next year among young non-users was rated highly (3.99 out of 5 points), with the flavor ban, this intention decreased by 5.8%. Females showed a greater decline in intention than males (p = 0.011). After adjusting for covariates, young adults with higher advertising exposure exhibited a more pronounced decline in their intention to try e-cigarettes. The interaction between advertising exposure and sex was statistically significant (B = 0.217, p < 0.05), suggesting that females are more likely than males to initiate e-cigarette use with increased advertising exposure.

Conclusions

A flavor ban may have the potential to significantly reduce young people's intention to use e-cigarettes, particularly among females and those exposed to more advertising. These findings highlight the need for sex-specific approaches in tobacco control policies.