Exposure to e-cigarette and heated tobacco product advertisements via digital, traditional media, and points-of-sale: An examination of associations with use intentions and perceived risk among adults in Armenia and Georgia

Zhanna Sargsyan, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
Ana Dekanosidze, Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia.
Varduhi Hayrumyan, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
Arevik Torosyan, National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia.
Yuxian Cui, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, United States.
Lilit Grigoryan, National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia.
Nour Alayan, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
Varduhi Petrosyan, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
Alexander Bazarchyan, National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia.
Lela Sturua, Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia.
Regine Haardörfer, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States.
Michelle C. Kegler, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, United States.

Document Type

Journal Article

Publication Date

1-1-2024

Journal

Tobacco prevention & cessation

Volume

10

DOI

10.18332/tpc/191992

Keywords

e-cigarettes; heated tobacco products; risk perceptions; tobacco industry; tobacco marketing

Abstract

INTRODUCTION: E-cigarette and heated tobacco product (HTP) marketing often leverages digital media and points-of-sale (POS) and advertises risk reduction, including in Armenia and Georgia where male cigarette use rates are high. METHODS: Using 2022 survey data from Armenian and Georgian adults (n=1468, mean age=42.92 years, 51.4% female; and past-month use of e-cigarettes 3.2%, HTPs 2.7%, and cigarettes 31.6%), multivariable linear regression examined 4 outcomes - e-cigarette and HTP use intentions and perceived risk (1=not at all, to 7=extremely) - in relation to past-month e-cigarette or HTP advertisement exposure via digital media, traditional media, and POS, controlling for covariates (country, age, gender, education level, relationship status, children, past-month cigarette and e-cigarette/HTP use). RESULTS: E-cigarette and HTP use intentions were low (mean score=1.47, SD=1.39 each), while perceived risk was high (mean score=5.83, SD=1.6, and mean score=5.87, SD=1.56, respectively). Past-month exposure to e-cigarette and HTP advertisements, respectively, were 12.9% and 11.2% via digital media, 6.1% and 4.8% traditional media, and 22.5% and 21.1% POS. For e-cigarettes, ad exposure via digital media was associated with greater use intentions (β=0.24; 95% CI: 0.03-0.44), ad exposure via traditional media (β= -0.32; 95% CI: -0.55 - -0.09) and POS (β= -0.30; 95% CI: -0.60 - -0.004) was associated with lower risk perceptions. For HTPs, ad exposure via digital media (β=0.35; 95% CI: 0.14-0.56) and POS (β=0.21; 95% CI: 0.04-3.63) was associated with greater use intentions, and ad exposure at POS was associated with lower risk perceptions (β= -0.23; 95% CI: -0.42 - -0.03). CONCLUSIONS: Tobacco control efforts should monitor and regulate e-cigarette and HTP marketing, particularly via digital media which may effectively promote use, and via POS which may target and influence risk perceptions.

Department

Prevention and Community Health

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