Trial on the Effect of E-cigarette Advertising on Cigarette Perceptions in Adolescents
Does Exposure to Electronic Nicotine Delivery Systems Advertising Affect Positive Smoking Expectancies and Social Normative Beliefs About Smoking?
2 other identifiers
interventional
139
1 country
1
Brief Summary
This research aims to investigate how exposure to advertising for Electronic Nicotine Delivery Systems (commonly called e-cigarettes) may lead to combustible smoking initiation in adolescents.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Feb 2019
Typical duration for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 20, 2018
CompletedFirst Posted
Study publicly available on registry
December 24, 2018
CompletedStudy Start
First participant enrolled
February 4, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 9, 2021
CompletedStudy Completion
Last participant's last visit for all outcomes
December 9, 2021
CompletedResults Posted
Study results publicly available
September 26, 2025
CompletedSeptember 26, 2025
September 1, 2025
2.8 years
December 20, 2018
November 18, 2024
September 5, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (3)
Implicit Positive Smoking Expectancies, Measured by the Implicit Association Test
Scores are measured by recording the amount of time (milliseconds) it takes to categorize smoking-related words with positive (e.g., cool) and negative (e.g., cancer) words. Faster reaction times when categorizing smoking-related words with positive words is evidence of higher positive smoking expectancies.
within 5 minutes post intervention
Amount of Time Spent Looking at Static Smoking Cues in E-cigarette Advertisements
Eye-tracking will be used to measure the amount of time (milliseconds) spent looking at static smoking cues in screen shots taken from e-cigarette advertisements. The amount time spent looking at a smoking cue is a measure how much attention was given to the smoking cue. The longer the looking time, the greater amount of attention.
approximately 30 minutes post intervention
Implicit Positive Vaping Expectancies, Measured by the Implicit Association Test
Scores are measured by recording the amount of time (milliseconds) it takes to categorize vaping-related words with positive (e.g., cool) and negative (e.g., cancer) words. Faster reaction times when categorizing smoking-related words with positive words is evidence of higher positive smoking expectancies.
within 5 minutes post intervention
Study Arms (2)
E-cigarette ad exposure
ACTIVE COMPARATORParticipants in the e-cigarette ad exposure condition will view e-cigarette ads on the computer screen while having their eye movements tracked
non e-cigarette ad exposure
SHAM COMPARATORParticipants in the non e-cigarette ad exposure condition will view non e-cigarette ads on the computer screen while having their eye movements tracked
Interventions
Participants view a series of e-cigarette TV commercials
Participants view a series of non e-cigarette TV commercials
Eligibility Criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Trustees of Dartmouth Collegelead
- National Cancer Institute (NCI)collaborator
- Dartmouth Collegecollaborator
Study Sites (1)
Dartmouth-Hithchock Medical Center
Lebanon, New Hampshire, 03756, United States
Related Publications (54)
Singh T, Agaku IT, Arrazola RA, Marynak KL, Neff LJ, Rolle IT, King BA. Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students. Pediatrics. 2016 May;137(5):e20154155. doi: 10.1542/peds.2015-4155.
PMID: 27244815BACKGROUNDNational Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012. Available from http://www.ncbi.nlm.nih.gov/books/NBK99237/
PMID: 22876391BACKGROUNDPierce JP, Sargent JD, White MM, Borek N, Portnoy DB, Green VR, Kaufman AR, Stanton CA, Bansal-Travers M, Strong DR, Pearson JL, Coleman BN, Leas E, Noble ML, Trinidad DR, Moran MB, Carusi C, Hyland A, Messer K. Receptivity to Tobacco Advertising and Susceptibility to Tobacco Products. Pediatrics. 2017 Jun;139(6):e20163353. doi: 10.1542/peds.2016-3353.
PMID: 28562266BACKGROUNDVillanti AC, Rath JM, Williams VF, Pearson JL, Richardson A, Abrams DB, Niaura RS, Vallone DM. Impact of Exposure to Electronic Cigarette Advertising on Susceptibility and Trial of Electronic Cigarettes and Cigarettes in US Young Adults: A Randomized Controlled Trial. Nicotine Tob Res. 2016 May;18(5):1331-9. doi: 10.1093/ntr/ntv235. Epub 2015 Nov 16.
PMID: 26574551BACKGROUNDHeatherton TF, Sargent JD. Does Watching Smoking in Movies Promote Teenage Smoking? Curr Dir Psychol Sci. 2009 Apr 15;18(2):63-67. doi: 10.1111/j.1467-8721.2009.01610.x.
PMID: 20160916BACKGROUNDSargent JD, Beach ML, Adachi-Mejia AM, Gibson JJ, Titus-Ernstoff LT, Carusi CP, Swain SD, Heatherton TF, Dalton MA. Exposure to movie smoking: its relation to smoking initiation among US adolescents. Pediatrics. 2005 Nov;116(5):1183-91. doi: 10.1542/peds.2005-0714.
PMID: 16264007BACKGROUNDDal Cin S, Gibson B, Zanna MP, Shumate R, Fong GT. Smoking in movies, implicit associations of smoking with the self, and intentions to smoke. Psychol Sci. 2007 Jul;18(7):559-63. doi: 10.1111/j.1467-9280.2007.01939.x.
PMID: 17614861BACKGROUNDNational Cancer Institute. The role of the media in promoting and reducing tobacco use. Tobacco control monograph No. 19. (2008).
BACKGROUNDCenters for Disease Control and Prevention. Smoking in Movies. Available at: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/movies/index.htm. (Accessed: 5 November 2016)
BACKGROUNDDuke JC, Lee YO, Kim AE, Watson KA, Arnold KY, Nonnemaker JM, Porter L. Exposure to electronic cigarette television advertisements among youth and young adults. Pediatrics. 2014 Jul;134(1):e29-36. doi: 10.1542/peds.2014-0269. Epub 2014 Jun 2.
PMID: 24918224BACKGROUNDUS Department of Health and Human Services. The health consequences of smoking - 50 years of progress. (2014).
BACKGROUNDKing AC, Smith LJ, Fridberg DJ, Matthews AK, McNamara PJ, Cao D. Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire. Psychol Addict Behav. 2016 Feb;30(1):106-12. doi: 10.1037/adb0000123. Epub 2015 Nov 30.
PMID: 26618797BACKGROUNDR, W. & A, S. Handbook of implicit cognition and addiction. (Sage, 2006).
BACKGROUNDBooth P, Albery IP, Frings D. Effect of e-cigarette advertisements and antismoking messages on explicit and implicit attitudes towards tobacco and e-cigarette smoking in 18-65-year-olds: a randomised controlled study protocol. BMJ Open. 2017 Jun 23;7(6):e014361. doi: 10.1136/bmjopen-2016-014361.
PMID: 28645957BACKGROUNDBaschnagel JS. Using mobile eye-tracking to assess attention to smoking cues in a naturalized environment. Addict Behav. 2013 Dec;38(12):2837-40. doi: 10.1016/j.addbeh.2013.08.005. Epub 2013 Aug 14.
PMID: 24018227BACKGROUNDPrimack BA, Switzer GE, Dalton MA. Improving measurement of normative beliefs involving smoking among adolescents. Arch Pediatr Adolesc Med. 2007 May;161(5):434-9. doi: 10.1001/archpedi.161.5.434.
PMID: 17485617BACKGROUNDHanewinkel R, Isensee B, Sargent JD, Morgenstern M. Cigarette advertising and teen smoking initiation. Pediatrics. 2011 Feb;127(2):e271-8. doi: 10.1542/peds.2010-2934. Epub 2011 Jan 17.
PMID: 21242217BACKGROUNDStautz K, Brown KG, King SE, Shemilt I, Marteau TM. Immediate effects of alcohol marketing communications and media portrayals on consumption and cognition: a systematic review and meta-analysis of experimental studies. BMC Public Health. 2016 Jun 9;16:465. doi: 10.1186/s12889-016-3116-8.
PMID: 27278656BACKGROUNDFarrelly MC, Duke JC, Crankshaw EC, Eggers ME, Lee YO, Nonnemaker JM, Kim AE, Porter L. A Randomized Trial of the Effect of E-cigarette TV Advertisements on Intentions to Use E-cigarettes. Am J Prev Med. 2015 Nov;49(5):686-693. doi: 10.1016/j.amepre.2015.05.010. Epub 2015 Jul 7.
PMID: 26163170BACKGROUNDSoneji S, Pierce JP, Choi K, Portnoy DB, Margolis KA, Stanton CA, Moore RJ, Bansal-Travers M, Carusi C, Hyland A, Sargent J. Engagement With Online Tobacco Marketing and Associations With Tobacco Product Use Among U.S. Youth. J Adolesc Health. 2017 Jul;61(1):61-69. doi: 10.1016/j.jadohealth.2017.01.023. Epub 2017 Mar 28.
PMID: 28363720BACKGROUNDLewis-Esquerre JM, Rodrigue JR, Kahler CW. Development and validation of an adolescent smoking consequences questionnaire. Nicotine Tob Res. 2005 Feb;7(1):81-90. doi: 10.1080/14622200412331328475.
PMID: 15804680BACKGROUNDGrana RA, Ling PM. "Smoking revolution": a content analysis of electronic cigarette retail websites. Am J Prev Med. 2014 Apr;46(4):395-403. doi: 10.1016/j.amepre.2013.12.010.
PMID: 24650842BACKGROUNDVoigt K. Smoking Norms and the Regulation of E-Cigarettes. Am J Public Health. 2015 Oct;105(10):1967-72. doi: 10.2105/AJPH.2015.302764. Epub 2015 Aug 13.
PMID: 26270285BACKGROUNDHunt K, Sweeting H. You have been QUALIFIED for a smokeless e-cig starter kit. J Epidemiol Community Health. 2014 Aug;68(8):786. doi: 10.1136/jech-2014-203879. Epub 2014 Apr 29. No abstract available.
PMID: 24782418BACKGROUNDGrana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014 May 13;129(19):1972-86. doi: 10.1161/CIRCULATIONAHA.114.007667. No abstract available.
PMID: 24821826BACKGROUNDFairchild AL, Bayer R, Colgrove J. The renormalization of smoking? E-cigarettes and the tobacco "endgame". N Engl J Med. 2014 Jan 23;370(4):293-5. doi: 10.1056/NEJMp1313940. Epub 2013 Dec 18. No abstract available.
PMID: 24350902BACKGROUNDTyas SL, Pederson LL. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998 Winter;7(4):409-20. doi: 10.1136/tc.7.4.409.
PMID: 10093176BACKGROUNDGerrard, M., Gibbons, F. X., Houlihan, A. E., Stock, M. L. & Pomery, E. A. A dual-process approach to health risk decision making: The prototype willingness model. Dev Rev 28, 29-61 (2008).
BACKGROUNDFrith CD, Frith U. Implicit and explicit processes in social cognition. Neuron. 2008 Nov 6;60(3):503-10. doi: 10.1016/j.neuron.2008.10.032.
PMID: 18995826BACKGROUNDWellman RJ, Sugarman DB, DiFranza JR, Winickoff JP. The extent to which tobacco marketing and tobacco use in films contribute to children's use of tobacco: a meta-analysis. Arch Pediatr Adolesc Med. 2006 Dec;160(12):1285-96. doi: 10.1001/archpedi.160.12.1285.
PMID: 17146027BACKGROUNDPokhrel P, Fagan P, Herzog TA, Chen Q, Muranaka N, Kehl L, Unger JB. E-cigarette advertising exposure and implicit attitudes among young adult non-smokers. Drug Alcohol Depend. 2016 Jun 1;163:134-40. doi: 10.1016/j.drugalcdep.2016.04.008. Epub 2016 Apr 25.
PMID: 27125661BACKGROUNDNosek BA. Moderators of the relationship between implicit and explicit evaluation. J Exp Psychol Gen. 2005 Nov;134(4):565-84. doi: 10.1037/0096-3445.134.4.565.
PMID: 16316292BACKGROUNDField, M. & Wiers, R. in Drug Abuse and Addiction in Medical Illness: Causes, Consequences and Treatment (eds. Verster, J. C., Brady, K., Galanter, M. & Conrod, P.) 35-45 (Springer New York, 2012).
BACKGROUNDHanewinkel R, Sargent JD. Exposure to smoking in internationally distributed American movies and youth smoking in Germany: a cross-cultural cohort study. Pediatrics. 2008 Jan;121(1):e108-17. doi: 10.1542/peds.2007-1201.
PMID: 18166530BACKGROUNDSargent JD, Beach ML, Dalton MA, Mott LA, Tickle JJ, Ahrens MB, Heatherton TF. Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study. BMJ. 2001 Dec 15;323(7326):1394-7. doi: 10.1136/bmj.323.7326.1394.
PMID: 11744562BACKGROUNDDalton MA, Sargent JD, Beach ML, Titus-Ernstoff L, Gibson JJ, Ahrens MB, Tickle JJ, Heatherton TF. Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study. Lancet. 2003 Jul 26;362(9380):281-5. doi: 10.1016/S0140-6736(03)13970-0.
PMID: 12892958BACKGROUNDDistefan JM, Pierce JP, Gilpin EA. Do favorite movie stars influence adolescent smoking initiation? Am J Public Health. 2004 Jul;94(7):1239-44. doi: 10.2105/ajph.94.7.1239.
PMID: 15226149BACKGROUNDJackson C, Brown JD, L'Engle KL. R-rated movies, bedroom televisions, and initiation of smoking by white and black adolescents. Arch Pediatr Adolesc Med. 2007 Mar;161(3):260-8. doi: 10.1001/archpedi.161.3.260.
PMID: 17339507BACKGROUNDBarnett TE, Soule EK, Forrest JR, Porter L, Tomar SL. Adolescent Electronic Cigarette Use: Associations With Conventional Cigarette and Hookah Smoking. Am J Prev Med. 2015 Aug;49(2):199-206. doi: 10.1016/j.amepre.2015.02.013. Epub 2015 Mar 31.
PMID: 25840880BACKGROUNDWills TA, Knight R, Williams RJ, Pagano I, Sargent JD. Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents. Pediatrics. 2015 Jan;135(1):e43-51. doi: 10.1542/peds.2014-0760. Epub 2014 Dec 15.
PMID: 25511118BACKGROUNDLochbuehler K, Otten R, Voogd H, Engels RC. Parental smoking and children's attention to smoking cues. J Psychopharmacol. 2012 Jul;26(7):1010-6. doi: 10.1177/0269881112439254. Epub 2012 Feb 27.
PMID: 22371194BACKGROUNDKersbergen I, Field M. Visual attention to alcohol cues and responsible drinking statements within alcohol advertisements and public health campaigns: Relationships with drinking intentions and alcohol consumption in the laboratory. Psychol Addict Behav. 2017 Jun;31(4):435-446. doi: 10.1037/adb0000284. Epub 2017 May 11.
PMID: 28493753BACKGROUNDYoshida, E., Peach, J. M., Zanna, M. P. & Spencer, S. J. Not all automatic associations are created equal: How implicit normative evaluations are distinct from implicit attitudes and uniquely predict meaningful behavior. J Exp Soc Psychol 48, 694-706 (2012).
BACKGROUNDAndrews JA, Hampson SE, Greenwald AG, Gordon J, Widdop C. Using the Implicit Association Test to Assess Children's Implicit Attitudes toward Smoking. J Appl Soc Psychol. 2010 Sep;40(9):2387-2406. doi: 10.1111/j.1559-1816.2010.00663.x.
PMID: 21566676BACKGROUNDHine DW, Honan CA, Marks AD, Brettschneider K. Development and validation of the Smoking Expectancy Scale for Adolescents. Psychol Assess. 2007 Sep;19(3):347-55. doi: 10.1037/1040-3590.19.3.347.
PMID: 17845126BACKGROUNDGilbert-Diamond D, Emond JA, Lansigan RK, Rapuano KM, Kelley WM, Heatherton TF, Sargent JD. Television food advertisement exposure and FTO rs9939609 genotype in relation to excess consumption in children. Int J Obes (Lond). 2017 Jan;41(1):23-29. doi: 10.1038/ijo.2016.163. Epub 2016 Sep 22.
PMID: 27654143BACKGROUNDBernhardt AM, Wilking C, Gottlieb M, Emond J, Sargent JD. Children's reaction to depictions of healthy foods in fast-food television advertisements. JAMA Pediatr. 2014 May;168(5):422-6. doi: 10.1001/jamapediatrics.2014.140.
PMID: 24686476BACKGROUNDGilbert, D. G. & Rabinovich, N. E. International smoking series (with neural counterparts) verion 1.2. (1999).
BACKGROUNDMacy JT, Chassin L, Presson CC, Yeung E. Exposure to graphic warning labels on cigarette packages: Effects on implicit and explicit attitudes towards smoking among young adults. Psychol Health. 2016;31(3):349-63. doi: 10.1080/08870446.2015.1104309. Epub 2015 Nov 3.
PMID: 26442992BACKGROUNDWahl SK, Turner LR, Mermelstein RJ, Flay BR. Adolescents' smoking expectancies: psychometric properties and prediction of behavior change. Nicotine Tob Res. 2005 Aug;7(4):613-23. doi: 10.1080/14622200500185579.
PMID: 16085531BACKGROUNDSargent JD, Worth KA, Beach M, Gerrard M, Heatherton TF. Population-Based Assessment of Exposure to Risk Behaviors in Motion Pictures. Commun Methods Meas. 2008 Jan;2(1-2):134-151. doi: 10.1080/19312450802063404.
PMID: 19122801BACKGROUNDLochbuehler K, Voogd H, Scholte RH, Engels RC. Attentional bias in smokers: exposure to dynamic smoking cues in contemporary movies. J Psychopharmacol. 2011 Apr;25(4):514-9. doi: 10.1177/0269881110388325. Epub 2010 Nov 23.
PMID: 21098549BACKGROUNDConnor CE, Egeth HE, Yantis S. Visual attention: bottom-up versus top-down. Curr Biol. 2004 Oct 5;14(19):R850-2. doi: 10.1016/j.cub.2004.09.041.
PMID: 15458666BACKGROUNDDalton MA, Sargent JD, Beach ML, Bernhardt AM, Stevens M. Positive and negative outcome expectations of smoking: implications for prevention. Prev Med. 1999 Dec;29(6 Pt 1):460-5. doi: 10.1006/pmed.1999.0582.
PMID: 10600426BACKGROUND
Results Point of Contact
- Title
- Research Scientist
- Organization
- Dartmouth college
Study Officials
- PRINCIPAL INVESTIGATOR
James Sargent, MD
Geisel School of Medicine at Dartmouth College
- PRINCIPAL INVESTIGATOR
Diane Gilbert-Diamond, ScD
Geisel School of Medicine at Dartmouth College
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- PREVENTION
- Intervention Model
- FACTORIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Professor
Study Record Dates
First Submitted
December 20, 2018
First Posted
December 24, 2018
Study Start
February 4, 2019
Primary Completion
December 9, 2021
Study Completion
December 9, 2021
Last Updated
September 26, 2025
Results First Posted
September 26, 2025
Record last verified: 2025-09
Data Sharing
- IPD Sharing
- Will not share