Introduction E-cigarettes are largely unregulated and internet sales are substantial. This study examines how the online market for e-cigarettes has changed over time: in product design and in marketing messages appearing on websites. Methods Comprehensive internet searches of Englishlanguage websites from May–August 2012 and December 2013–January 2014 identified brands, models, flavours, nicotine strengths, ingredients and product claims. Brands were divided into older and newer groups (by the two searches) for comparison. Results By January 2014 there were 466 brands (each with its own website) and 7764 unique flavours. In the 17 months between the searches, there was a net increase of 10.5 brands and 242 new flavours per month. Older brands were more likely than newer brands to offer cigalikes (86.9% vs 52.1%, p<0.01), and newer brands more likely to offer the more versatile eGos and mods (75.3% vs 57.8%, p<0.01). Older brands were significantly more likely to claim that they were healthier and cheaper than cigarettes, were good substitutes where smoking was banned and were effective smoking cessation aids. Newer brands offered more flavours per brand (49 vs 32, p<0.01) and were less likely to compare themselves with conventional cigarettes. Conclusions The number of e-cigarette brands is large and has been increasing. Older brands tend to highlight their advantages over conventional cigarettes while newer brands emphasise consumer choice in multiple flavours and product versatility. These results can serve as a benchmark for future research on the impact of upcoming regulations on product design and advertising messages of e-cigarettes.

https://tobaccocontrol.bmj.com/content/tobaccocontrol/23/suppl_3/iii3.full.pdf

Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation

Overview of Electronic Nicotine Delivery Systems: A Systematic Review.

For decades, advocacy for tobacco control has been a priority of the American Heart Association (AHA). In partnership with major public health organizations, the association has made major strides in tobacco use prevention and cessation by prioritizing evidence-based strategies such as increasing excise taxes; passing comprehensive smoke-free air laws; facilitating US Food and Drug Administration (FDA) authority to regulate tobacco, including comprehensive tobacco cessation treatment within healthcare plans; and supporting adequate funding of comprehensive tobacco control programs in different states. These tobacco control efforts have cut in half the youth smoking rate from 1997 to 2007 and have saved >8 million lives in the past 50 years.1 However, the work is far from done and has stalled, especially for people living below the poverty line, those with mental illnesses,2 and those with low educational attainment.3 Unless current trends reverse, ≈5.6 million children alive today in the United States will die prematurely of smoking-related diseases.1 Even now, cigarette smoking kills nearly half a million Americans each year, and an additional 16 million individuals suffer from smoking-related illness, which costs the United States $289 billion dollars annually in direct medical care and other economic costs.1

This statement reviews the latest science concerning one of the newest classes of products to enter the tobacco product landscape—electronic cigarettes (e-cigarettes), also called electronic nicotine delivery systems (ENDS)—and provides an overview on design, operations, constituents, toxicology, safety, user profiles, public health, youth access, impact as a cessation aid, and secondhand exposure. On the basis of the current evidence, we provide policy recommendations in key areas of tobacco control such as clean indoor air laws, taxation, regulation, preventing youth access, marketing and advertising to youth, counseling for cessation, surveillance, and defining e-cigarettes in state laws. The statement concludes by outlining a future …

/pdf/electronic-cigarettes-a-policy-statement-from-the-american-2kswyepif6.pdf

Electronic Cigarettes A Policy Statement From the American Heart Association

The use of electronic cigarettes is growing, and some hope that they will replace what is felt to be the more dangerous nicotine-delivery system — cigarettes. However, data on the long-term safety of e-cigarettes are still being gathered.

The Health Effects of Electronic Cigarettes.

https://www.ajpmonline.org/pb/assets/raw/Health%20Advance/journals/amepre/PIIS074937971400107X.pdf

E-Cigarette Awareness and Perceived Harmfulness: Prevalence and Associations with Smoking Cessation Outcomes

E-cigarettes are widely promoted on the Internet, but little is known about what kinds of information about them are available online. This study examines message, source, and health information characteristics of e-cigarette videos on the popular online video-sharing platform YouTube. A content analysis of 365 e-cigarette videos indicates that 85% of the videos were sponsored by marketers. These videos highlight e-cigarettes' economic and social benefits, featuring a low level of fear appeal and negative message valence and a high level of marketing information about e-cigarette products. They also convey certain health claims that have been proscribed by the U.S. Food and Drug Administration, the prevalence of which warrants ongoing monitoring and regulatory guidelines for online e-cigarette marketing.

Jung Yoon Huh

Papers

Reduced Harm or Another Gateway to Smoking? Source, Message, and Information Characteristics of E-Cigarette Videos on YouTube