The debate over how tobacco and nicotine products should be advertised — if at all — continues with the more recently developed e-cigarettes that have become a popular alternative to traditional cigarettes. The latest research took a look at flavored e-cigs, and how their advertisement of flavored varieties affect school children.

E-cigs are now the most commonly used nicotine product among children in countries with tight tobacco control policies. The U.S. saw e-cigarette use triple in high schoolers between 2013 and 2014, with 13 percent using them, according to the National Youth Tobacco Survey. Use even increased among middle schoolers, rising from 1 percent to 4 percent. England saw a similar rise in use, with 11- to 18-year-olds’ usage rising from 5 percent in 2013 to 8 percent in 2014.

Researchers from the Behavior and Health Research Unit at the University of Cambridge say that as e-cig use rises, so do concerns that youths will begin using tobacco products. E-cigarettes are currently offered in about 8,000 different flavors, and internal documents from the tobacco industry indicate children prefer tobacco products with candy-like flavors to those without. These kinds of flavors were heavily marketed toward younger people until 2009, when regulations were put in place.

To test the effect of adverts on children, researchers from Cambridge assigned nearly 600 kids to one of three groups: one was shown ads for candy-flavored e-cigs, the second saw advertisements for non-flavored e-cigs, and the third functioned as a control — they were shown no adverts at all. The kids then answered questions aimed at gauging the appeal of using nicotine or tobacco products (like "did using e-cigarettes seem 'cool?'").

Somewhat unsurprisingly, the children shown ads for candy-flavored e-cigs showed a greater interest in buying and trying e--cigarettes than their peers. However, the ads made no significant difference to the overall appeal of tobacco smoking or using e-cigs — or how attractive, fun, or cool they considered the activities.

“We’re cautiously optimistic from our results that e-cigarette ads don’t make tobacco smoking more attractive, but we’re concerned that ads for e-cigarettes, with flavors that might appeal to school children, could encourage them to try the products,” said Dr. Milica Vasiljevic, from the Department of Public Health and Primary Care at the University of Cambridge, in a press release.

Across both Europe and the U.S., advertising and marketing of e-cigs is essentially unregulated. While the UK Committee on Advertising and Practice has stated that e-cigarette adverts must not be likely to appeal to people under 18, the rules didn’t outline any specific prohibitions regarding the marketing of candy-like flavors designed to appeal to youths.

The findings of the study raise questions about possible further legislation about the advertisement of products with a high appeal to children.

Source: Vasiljevic M, Petrescu D, Marteau T. Impact of advertisements promoting candy-like flavored e-cigarettes on appeal of tobacco smoking amongst children: an experimental study. BMJ Tobacco Control. 2016.