• Ryan David Kennedy, Meghan Moran, Lauren Czaplicki, Jessica Handy, Kevin Welding, and Dannielle Kelley.
• Dept of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, United States; Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, United States. Electronic address: rdkennedy@jhu.edu.
• Prev Med. 2023 Jun 1; 171: 107513107513.

AbstractThere is no standard way to communicate to consumers how much nicotine is present in electronic nicotine delivery systems (ENDS). This study assessed the inclusion of nicotine-related content, including nicotine strength, in a sample of English language ENDS advertisements that appeared in consumer and business-to-business outlets in the US during 2018-2020. The sample, provided by a media surveillance company, included ads from television, radio, newspapers, magazines (consumer and business-to-business), online platforms, outdoor/billboards, and direct-to-consumer emails. We coded for the presence of nicotine-related content (excluding FDA-required warnings) including nicotine strength presentation, such as mg, mg/ml and percent. The sample included 2966 unique ads, of which 33% (n = 979) featured nicotine-related content. The proportion of ads in the entire sample with nicotine-related content differed by manufacturer/retailer. Ads for Logic e-cigarettes had the highest proportion of nicotine content (62%, n = 258), while ads for JUUL and Vapor4Life had the lowest proportion (13.0% (n = 95) and 19.8% (n = 65), respectively). The proportion of ads with nicotine-related content also differed by media outlet: B2B magazines: 64.8% (n = 68); emails: 41% (n = 529); consumer magazines: 30.4% (n = 41); online: 25.3% (n = 227); television: 20% (n = 6); radio: 19.1% (n = 89); and outdoor (0%, n = 0). Across the sample of ads, 15% reported nicotine strength in mg or mg/ml (n = 444), and 9% reported nicotine strength in percent (n = 260). Most ENDS ads do not include nicotine-related content. There is substantial variation in presentation of nicotine strength, which may present challenges for consumer understanding of absolute and relative nicotine-related content.Copyright © 2023. Published by Elsevier Inc.

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