Cumulative Exposure to E-Cigarette Coupons and Changes in E-Cigarette Use Among U.S. Adults

Authors

Zongshuan Duan, Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia.
Kristen R. Hamilton-Moseley, Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
Timothy S. McNeel, Information Management Services, Inc., Calverton, Maryland.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia; George Washington Cancer Center, George Washington University, Washington, District of Columbia.
Kelvin Choi, Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland. Electronic address: kelvin.choi@nih.gov.

Document Type

Journal Article

Publication Date

9-4-2023

Journal

American journal of preventive medicine

DOI

10.1016/j.amepre.2023.09.001

Abstract

INTRODUCTION: Coupons are an effective, frequently used tobacco marketing strategy. This study examined prospective associations between cumulative exposure to e-cigarette coupons and changes in e-cigarette use among U.S. adults. METHODS: Data were from a representative U.S. adult cohort (n=19,824) in the Population Assessment of Tobacco and Health Study (waves [W] 2, 3, 4, and 5), collected from October 2014 to November 2019. Analysis was conducted in 2022. Four logistic regression models examined associations of a number of waves for which participants received e-cigarette coupons during W2-W4 with changes in e-cigarette use: W2 never use to W5 current use (initiation); W2 current nondaily use to W5 daily use (progression); W2 current use to W5 former use (cessation), and W2 former use to W5 current use (return-to-use). RESULTS: Overall, 66.1% of U.S. adults never used e-cigarettes, 10.6% currently used e-cigarettes, and 23.4% formerly used e-cigarettes at W2. The average number of waves for which participants received e-cigarette coupons during W2-W4 was 0.13: 0.10 among W2 individuals who never used e-cigarettes, 0.30 among individuals who currently used e-cigarettes on a nondaily basis, 0.50 among individuals who currently used e-cigarettes, and 0.17 among individuals who formerly used e-cigarettes. Receiving coupons at increased waves was associated with (1) greater odds of initiation (AOR=1.58, 95% CI=1.26-1.97); (2) lower odds of cessation (AOR=0.78, 95% CI=0.67-0.91); and (3) increased odds of return-to-use (AOR=1.39, 95% CI=1.14-1.69). Findings did not differ by W2 cigarette smoking status. CONCLUSIONS: E-cigarette coupons may encourage and sustain e-cigarette use. Policies restricting e-cigarette coupons may curb e-cigarette use.

APA Citation

Duan, Zongshuan; Hamilton-Moseley, Kristen R.; McNeel, Timothy S.; Berg, Carla J.; and Choi, Kelvin, "Cumulative Exposure to E-Cigarette Coupons and Changes in E-Cigarette Use Among U.S. Adults" (2023). GW Authored Works. Paper 3455.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3455

Department

Prevention and Community Health