Aims
To examine bidirectional associations between self‐reported exposure to electronic nicotine delivery system (ENDS) marketing and ENDS use, over four 6‐month follow‐up surveys, among young adults.
Design
The Marketing and Promotions Across Colleges in Texas project (M‐PACT) is a cohort study that examined exposure to tobacco marketing and tobacco use behaviors among college students in Texas, United States.
Setting and participants
Participants were 5478 students from 24 2‐year and 4‐year Texas colleges. Approximately 64% (n = 3506) of the cohort were non‐white, 64% were female and the average age was 20 years.
Measurements
Students completed a baseline survey in Fall 2014/Spring 2015 and three subsequent surveys 6 months apart. Items assessed current ENDS use and self‐reported exposure to ENDS marketing through the point‐of‐sale, on television, on the radio, on the internet and on billboards. A multi‐level cross‐lagged path model was used to examine the bidirectional associations between self‐reported exposure to ENDS marketing and current ENDS use across the four waves, controlling for socio‐demographics.
Findings
Self‐reported exposure to ENDS marketing at each previous wave predicted ENDS use at each subsequent wave (β = 0.07–0.10, P < 0.001). ENDS use at waves 2 and 3 predicted self‐reported exposure to ENDS marketing at wave 3 and 4, respectively (β = 0.07–0.09, P < 0.001). Although ENDS users were more likely than non‐users to report exposure to ENDS marketing, self‐reported exposure to ENDS marketing predicted subsequent ENDS use controlling for prior ENDS use.
Conclusion
Self‐reported exposure to electronic nicotine delivery system (ENDS) marketing was bidirectionally associated with past 30‐day use of ENDS among young adult college students in Texas, USA from 2014/15 to 2016.