First introduced in the United States in 2007, electronic cigarettes have risen dramatically in part because they are popularly considered safer and more socially acceptable than combustible cigarettes and because there are fewer restrictions on their purchase and use. A study by University of California, San Diego School of Medicine researchers, published in the journal Drug and Alcohol Dependence, points to aggressive online marketing tactics that make purchasing e-cigarettes easy for all ages.
"We found e-cigarette vendors were highly engaged in promoting the culture of 'vaping' online, including posting images to Instagram, a social media site used by 52 percent of teens," said Tim K. Mackey, PhD, UC San Diego School of Medicine assistant professor of anesthesiology and global public health and first author of the study. "Despite the fact that 47 states prohibit the sale of e-cigarettes to minors, the results highlight the potential of the Internet to encourage e-cigarette initiation and underage purchasing. This is particularly concerning given that the FDA does not have specific proposed regulations for online e-cigarette sales."
Data from the 2014 National Youth Tobacco Survey shows that e-cigarette use tripled among middle and high school students from 2013 to 2014.
E-cigarettes are tobacco-less, battery-operated devices that spritz vapor into the mouth with flavors like bubble gum and peach fuzz. Users of these devices, known colloquially as "vapers," exhale a mixture of volatile organic compounds, heavy metals and ultrafine particles that usually contain aerosolized nicotine in a cloud of vapor.
Researchers found that 68 percent of the 57 online e-cigarette vendors they studied displayed one or more health warnings about the devices on their website. However, the notices were often depicted in smaller fonts or placed discretely in the terms and conditions section of a website.
One third of the vendors had no detectable age verification process for buyers and of those that did, most required only a simple click to say the buyer was within the legal age limit. Industry analysts estimate that online sales comprise 25 to 30 percent of the $2 billion annual e-cigarette market, which may account for a high presence of vendors on social media, said Mackey, who is also associate director of the joint master's degree in Health Policy and Law.
"The study found that online e-cigarette vendors use a variety of sophisticated and aggressive marketing practices, including promotional offers and high social media engagement to promote the sale of their products," said Mackey.
Mackey and team reported that 70 percent of the online vendors used more than one of the three most commonly used social media platforms: 63 percent used Twitter, 52 percent posted to Facebook and 42 percent were on Instagram.
The researchers said the findings could impact the U.S. Food and Drug Administration's 2014 proposed regulations of e-cigarette use, sale, marketing and manufacturing to include online monitoring of the laws.
Co-authors include Angela Miner and Raphael Cuomo of UC San Diego.