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dc.contributor.authorBlackwell, Anna KM
dc.contributor.authorPilling, Mark A
dc.contributor.authorDe-Loyde, Katie
dc.contributor.authorMorris, Richard W
dc.contributor.authorBrocklebank, Laura A
dc.contributor.authorMarteau, Theresa M
dc.contributor.authorMunafò, Marcus R
dc.date.accessioned2022-04-19T13:17:49Z
dc.date.available2022-04-19T13:17:49Z
dc.date.issued2022-04-13
dc.date.submitted2021-08-12
dc.identifier.issn0964-4563
dc.identifier.othertobaccocontrol-2021-056980
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/336173
dc.description.abstractOBJECTIVES: To estimate the impact of electronic cigarette (e-cigarette) retail display exposure on attitudes to smoking and vaping (susceptibility to tobacco smoking and using e-cigarettes, and perceptions of the harms of smoking and e-cigarette use). DESIGN: Between-subjects randomised experiment using a 2 (e-cigarette retail display visibility: high vs low)×2 (proportion of e-cigarette images: 75% vs 25%) factorial design. SETTING: Online via the Qualtrics survey platform. PARTICIPANTS: UK children aged 13-17 years (n=1034), recruited through a research agency. INTERVENTION: Participants viewed 12 images of retail displays that contained e-cigarette display images or unrelated product images. E-cigarette display images were either high or low visibility, based on a conspicuousness score. Participants were randomised to one of four groups, with e-cigarette display visibility and proportion of e-cigarette images, compared with images of unrelated products, manipulated: (1) 75% e-cigarettes, high visibility; (2) 25% e-cigarettes, high visibility; (3) 75% e-cigarettes, low visibility; (4) 25% e-cigarettes, low visibility. MAIN OUTCOME MEASURES: The primary outcome was susceptibility to smoking (among never smokers only). Secondary outcomes were susceptibility to using e-cigarettes (among never vapers only), and perceptions of smoking and e-cigarette harm (all participants). RESULTS: Neither e-cigarette retail display visibility, nor the proportion of e-cigarette images displayed, appeared to influence susceptibility to smoking (visibility: OR=0.84, 95% CI 0.62 to 1.13, p=0.24; proportion: OR=1.34, 95% CI 1.00 to 1.82, p=0.054 (reference: low visibility, not susceptible)).Planned subgroup analyses indicated that exposure to a higher proportion of e-cigarette images increased susceptibility to smoking among children who visited retail stores more regularly (n=524, OR=1.59, 95% CI 1.04 to 2.43, p=0.034), and those who passed the attention check (n=880, OR=1.43, 95% CI 1.03 to 1.98, p=0.031).In addition, neither e-cigarette retail display visibility nor the proportion of e-cigarette images displayed, appeared to influence susceptibility to using e-cigarettes (visibility: OR=1.07, 95% CI 0.80 to 1.43, p=0.65; proportion: OR=1.22, 95% CI 0.91 to 1.64, p=0.18).Greater visibility of e-cigarette retail displays reduced perceived harm of smoking (mean difference (MD)=-0.19, 95% CI -0.34 to -0.04, p=0.016). There was no evidence that the proportion of e-cigarette images displayed had an effect (MD=-0.07, 95% CI -0.22 to 0.09, p=0.40).Perceived harm of e-cigarette use did not appear to be affected by e-cigarette retail display visibility (MD=-0.12, 95% CI -0.28 to 0.05, p=0.16) or by the proportion of e-cigarette images displayed (MD=-0.10, 95% CI -0.26 to 0.07, p=0.24). CONCLUSIONS: There is no evidence in the full sample to suggest that children's susceptibility to smoking is increased by exposure to higher visibility e-cigarette retail displays, or to a higher proportion of e-cigarette images. However, for regular store visitors or those paying more attention, viewing a higher proportion of e-cigarette images increased susceptibility to smoking. In addition, viewing higher visibility e-cigarette images reduced perceived harm of smoking. A review of the current regulatory discrepancy between tobacco and e-cigarette point-of-sale marketing is warranted. TRIAL REGISTRATION NUMBER: ISRCTN18215632.
dc.languageen
dc.publisherBMJ
dc.subjectOriginal research
dc.subject1506
dc.subjectelectronic nicotine delivery devices
dc.subjectenvironment
dc.subjectpublic policy
dc.titleImpact of e-cigarette retail displays on attitudes to smoking and vaping in children: an online experimental study.
dc.typeArticle
dc.date.updated2022-04-19T13:17:49Z
prism.publicationNameTob Control
dc.identifier.doi10.17863/CAM.83598
dcterms.dateAccepted2022-03-29
rioxxterms.versionofrecord10.1136/tobaccocontrol-2021-056980
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2022-04-12
dc.contributor.orcidBlackwell, Anna KM [0000-0002-4984-1818]
dc.contributor.orcidPilling, Mark A [0000-0002-7446-6597]
dc.contributor.orcidDe-Loyde, Katie [0000-0002-8672-9710]
dc.contributor.orcidMorris, Richard W [0000-0001-7240-4563]
dc.contributor.orcidBrocklebank, Laura A [0000-0002-5928-3143]
dc.contributor.orcidMarteau, Theresa M [0000-0003-3025-1129]
dc.contributor.orcidMunafò, Marcus R [0000-0002-4049-993X]
dc.identifier.eissn1468-3318
pubs.funder-project-idWellcome Trust (206853/Z/17/Z)
cam.issuedOnline2022-04-13
rioxxterms.freetoread.startdate2022-04-12
rioxxterms.freetoread.startdate2022-04-12


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