Some anti-smoking advocates fear the rise of a new, battery-powered Joe Camel as researchers find that more young people are being exposed to unregulated electronic cigarette ads mixed in with popular TV shows.
More than four decades after President Richard Nixon banned ads for tobacco cigarettes on radio and television, the airwaves are burning up with e-cigarette ads targeted at adolescents and young adults, according to a study published Monday in the journal Pediatrics.
“This is what we saw back in the 1960s and 1950s, and the study is deeply concerning to me,” says Matthew Myers, president of the Washington, DC-based Campaign for Tobacco-Free Kids. “Congress banned this (TV ads) precisely because of the unique impact it can have on kids. E-cigarettes are doing the exact same thing.”
Researchers from RTI International found that kids aged 12 to 17 experienced a 256 percent increase in exposure to ads touting e-cigs during the study period of 2011 to 2013. The exposure of young adults, those ages 18-24, increased by 321 percent.
Unlike traditional cigarettes, e-smoke advertising is not federally regulated. The cylindrical vaporizers weren’t around when the big tobacco companies regularly made headlines over their advertising tactics. But now, according to the researchers, marketers are using the power of the small screen to promote various brands, in a similar fashion to what was aired when tobacco was king.
“We don’t know the extent to which an e-cigarette is really a gateway to other tobacco products."
Today, though, more than 75 percent of e-cig ads were shown on cable networks, including AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1. Researchers also found that e-cigarette ads appeared on programs like “The Bachelor,” “Big Brother,” and “Survivor,” all of which were among the 100 highest-rated youth programs for the 2012-2013 TV season. More than 80 percent of the ads were for a single brand, blu eCigs.
To figure out just how pervasive e-cigarette TV ads were during the last few years, the researchers used a standard unit of TV exposure measurement called Target Rating Points, or TRPs. These points are measured for a specified audience as a function of an ad’s reach, basically the proportion of people exposed to an advertisement, as well as frequency, or the number of times an advertisement is potentially viewed.
The researchers used a common measurement to gauge how many people saw an e-cigarette, and how often they likely saw it. Based on that data, they estimated that 50.0 percent of all kids between the ages of 12 to 17 in U.S. TV households were exposed to an average of 21 e-cigarette ads from October 2012 through September 2013.
They also say data could represent an exposure to an average of 105 advertisements for 10 percent of all U.S. youth or an exposure to an average of 13 ads for 80% of all U.S. youth over the 1-year period.
Those numbers have researchers and other public health advocates worried.
“We don’t know the extent to which an e-cigarette is really a gateway to other tobacco products,” explains lead researcher Dr. Jennifer Duke, senior public health analyst at RTI. “What we do know is that nicotine spurs changes in the brain that leads to addiction. And no one knows what the ramifications of e-cigarettes and potential addiction will be.”
Indeed, e-cigs are growing in popularity, with about $1 billion in sales as of August 2013. As of 2012, an estimated 1.8 million middle and high school students had ever used e-cigarettes, according to the researchers. With tobacco companies like Lorillard, which bought blu eCigs, entering into the mix, makers of e-cigs have gone Hollywood with celebrity endorsers like Jenny McCarthy and Stephen Dorff touting the benefits of blu, and punk queen Courtney Love plugging another brand called NJOYs.
For doctors on the frontlines of treating and preventing disease among children and young adults, the prevalence of e-cig use among youth is one more battle they must fight to try and keep kids healthy.
“This whole study is tremendously concerning to me,” says pediatrician Dr. Deb Lonzer of Cleveland Clinic Children’s. “Celebrities have enormous power and they are touting the benefits of smoking. I’m just a nerdy little pediatrician, how can I compete with some celebrity or the deep pockets of a tobacco company?”
Neuroscientists now recognize that adolescent brains are still developing, and don’t reach full maturity until the early 20s. The last part of the brain to develop includes areas linked to impulse control and planning.
“Just because a young person has a cell phone like an adult or holds down a job like an adult does not mean they are adults in terms of a mature brain,” Lonzer said. “That means they can’t make decisions like an adult and when they are exposed repeatedly to things that seem to be the social norm, trust me, they will try those things.”
According to a report released by the anti-smoking organization Legacy, e-cig manufacturers spent $39 million in advertising from June through September 2013, much of it targeted to youth. Although some manufacturers would welcome regulation, they do dispute they target America’s young.
“The products are being advertised to adults,” said Cynthia Cabrera, executive director of the Smoke Free Alternatives Trade Association. “If children are watching during that time, it’s possible, but they are being marketed to adult consumers, to adult smokers.”
NBC News' Maggie Fox contributed to this report.