Electronic Cigarettes: Diffusion of a Controversial Innovation Public Deposited

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  • March 20, 2019
  • Pepper, Jessica Kadis
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Introduction: Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that have become increasingly popular in the U.S. and have the potential to serve as a harm reduction tool for adult smokers. We sought to understand the diffusion of e-cigarettes into the U.S. marketplace. Methods: A U.S. national sample of 17,522 adults (>18 years old) completed an online survey in March 2013 assessing their awareness of and sources of information about e-cigarettes. As part of the same study, smokers (n=6,607) responded to questions about perceived health risks related to tobacco products, and smokers who had never tried e-cigarettes (n=3,253) participated in a between-subjects experiment investigating their responses to e-cigarette advertisements. Results: Most respondents (86%) had heard of e-cigarettes. The most commonly reported sources of information were another person, ads on television, and seeing e-cigarettes being sold. Smokers believed that e-cigarettes were less likely to cause lung cancer, oral cancer, and heart disease than cigarettes, traditional smokeless tobacco, snus, and dissolvable tobacco. Ads that emphasized the differences between e-cigarettes and regular cigarettes or showed an image of a person using an e-cigarette created the greatest interest among smokers in trying the product. Conclusions: The positive reaction to e-cigarettes over other non-cigarette tobacco products may be, in part, because e-cigarettes embody more of the desirable features of an innovation (relative advantage, compatibility, trialability, and observability). Future research should concentrate on understanding the impact of risk beliefs on trajectories of use, determining efficient ways to deliver appropriate information about e-cigarettes to the public, and examining the effects of changes in the e-cigarette industry (e.g., the entry of multinational tobacco corporations into the marketplace and the development of new styles of e-cigarettes).
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  • In Copyright
  • Brewer, Noel T.
  • Doctor of Philosophy
Graduation year
  • 2014

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