Advertising Of Tobacco Products Research Articles

Changes in Compliance with Bans on Tobacco Product Display and Advertising at Traditional and Modern Point-of-Sale Retailers in Depok, Indonesia, 2019-2021.

Banning Point-of-Sale (POS) advertising and product display is an important tobacco control strategy. Depok, Indonesia enacted some regional tobacco control policies regulating the POS environment in 2021. This study examined changes in compliance before and after the implementation of these policies as of 2021. Data collectors visited 180 modern retailers (hyper/supermarkets/convenience stores) and 147 traditional retailers (warungs) in 2019. The same retailers were re-visited in 2021. Data collectors assessed compliance with tobacco product display, and advertising regulations at POS, including if products were displayed in spaces to target minors (near candy or at a child's eye-level). Data were analyzed using McNemar and Mann-Whitney U tests. From 2019 to 2021, in modern retailers, tobacco product display (95.6% vs 52.2%) and product advertising (36.1% vs 3.9%) were significantly reduced (p<0.001). In traditional retailers, tobacco product display (94.6% in 2019, 91.2% in 2021, p>0.05) and product advertising (87.1% in 2019, 87.8% in 2021, p>0.05) remained common during both data collection periods. Tobacco products were commonly displayed in spaces to target minors in both modern retailers (43.3% in 2019, 34.4% in 2021, p>0.05) and traditional retailers (90.5% in 2019, 83.0% in 2021, p>0.05). Compliance with bans on tobacco product advertising and display at modern retailers improved significantly from 2019 to 2021; however, most modern retailers continue to display tobacco products in 2021. Traditional retailers remain largely non-compliant. Tobacco products are commonly displayed in areas that target minors. The enforcement of regional regulations should be strengthened, particularly among traditional retailers. In Depok, Indonesia, tobacco advertising and product display bans have been implemented; however, more work is needed to support compliance. Enforcement efforts, such as those carried out by civil police, can focus on tobacco product display bans in traditional and modern retailers, and traditional retailers need additional support to remove tobacco product advertising. Retailers may receive money from the tobacco industry for these advertisements. Creative solutions may include supporting retailers in finding alternative advertising revenue.

Heated tobacco products and cigarette marketing in nightclubs in Gdansk, Poland: A mixed-methods analysis.

Although advertising and promotion of tobacco products in Poland are prohibited, tobacco companies exploit legal loopholes and insufficient enforcement of the laws to conduct their marketing. To reach young adults, advertisements are placed in entertainment and social venues. This aspect of tobacco product marketing in Poland remains under-researched. The main aim of this study was to investigate the occurrence and characteristics of advertising and promotion of tobacco products in nightclubs in Gdansk, a large city in northern Poland. We conducted a single-center observational study of nightclubs in Gdansk, between July and October 2022. Two independent observers visited 30 nightclubs and collected information using pre-prepared research form. The occurrences of tobacco branded bar accessories, logo signs, package displays and other forms of advertising and promotion were recorded. Where possible, photographs of visible marketing displays were taken. Advertising of tobacco products was present in 2/3 of the nightclubs observed. The most commonly advertised product category were heated tobacco products. Tobacco brand representatives promoted and offered consumers free tobacco product samples. Multi-level marketing activities were observed, including tobacco branded bar accessories, prominent sale points and tobacco brand logo signs. The majority of nightclubs observed in Gdansk advertise and promote tobacco products. The ban on tobacco advertising and promotion is being violated in nightclubs, where the most commonly advertised products are heated tobacco products. The authorities should take steps to extend the bans to cover private promotion and enforce the law to protect high-risk individuals from smoking initiation and relapse.

Changes in tobacco imagery and smokers' depiction in Spanish top-grossing films before and after the implementation of a comprehensive tobacco control policy in Spain.

As more restrictions on tobacco marketing communication are implemented, tobacco marketing has persisted through smoking in films. Our aims were to assess changes in tobacco imagery exposure in Spanish top-grossing films before and after the banning of tobacco advertising in Spain, and to determine whether the depiction of smoking characters has changed over the years. A repeated cross-sectional study measured the tobacco content in the 10 Spanish top-grossing films in 2005, 2010 and 2015 (n=30) before and after a complete tobacco advertising ban. We conducted a descriptive and regression analysis of changes in tobacco impressions by year. The 30 films contained 1378 tobacco occurrences (90.2% positive for tobacco) with a median length of eight seconds onscreen. Total tobacco occurrences deemed positive for tobacco interests significantly increased in 2010 and 2015 compared to 2005. However, we observed decreased odds of tobacco brands appearances (OR=0.25; p<0.001) in 2010 and of implied tobacco use (OR=0.44; p=0.002), and tobacco brands appearances (OR=0.36; p<0.001) in 2015 compared to 2005. There was a change of pattern in the type of role smokers played from a leading role to a supporting one (p<0.001). The population reach of positive for tobacco occurrence in Spanish top-grossing films decreased from 15.9 (95% CI: 15.86-15.86) per 1000 spectators in 2005 to 0.8 (95% CI: 0.82-0.82) in 2015. The implementation of a ban on complete tobacco product advertising was followed by a decrease in tobacco incidents across top-grossing Spanish films. Yet, exposure to smoking in films is still unacceptably high.

Miseducation

“Climate science literacy bills in Washington fail.”“Climate change education bills die in Rhode Island.”“Italian students will soon be required to learn about global warming. American kids? Not so much.”These are just a few of the recent headlines taken from science education organizations, such as the National Center for Science Education (NCSE), who have been “working with teachers, parents, scientists, and concerned citizens at the local, state, and national levels to ensure that topics including evolution and climate change are taught accurately, honestly, and confidently.” Defending the teaching of topics such as evolution and climate change in K–12 schools is not new to the NCSE. Alongside these heroic organizations stands Katie Worth, a former investigative journalist for PBS’s FRONTLINE and a stalwart defender of teaching the science of climate change. In her book Miseducation: How Climate Change Is Taught in America, Worth describes various groups at the local, state, and national levels who have fought hard to prevent the teaching of climate change to K–12 students in every state in the country. Although most of these initiatives have failed, unfortunately quite a few have survived the legislative process. Through meticulous research, Worth reviewed hundreds of textbooks, designed and built a 50-state database, and traveled to more than a dozen communities where she interviewed students and teachers about what is being taught about climate change in America’s K–12 public schools. Her findings are both interesting and alarming.The book reads like a suspenseful detective novel as Worth connects the pieces of the climate-change-education-thwarting puzzle by following the money and influence of oil corporations, local and state legislatures, school board officials, libertarian think tanks, conservative lobby groups, and textbook publishers—all of whom have taken their lead and marching orders from previous fights over the teaching of evolution and the advertising of tobacco products. In the first chapter, “The Science and the Doubt,” Worth highlights the disconnect between the nature of science (NOS) and some science teachers’ misconception that science’s openness to change is its weakness, rather than one of its strengths. Her interview with one such science teacher is eye-opening to say the least. Chapter 2, “The Teachers,” recounts a few other teacher interviews and focuses on how little time is spent on the topic of climate change in the science classroom and how pedagogical strategies such as classroom debate, if done poorly when climate change is considered, can lead to student misconceptions about human-induced climate change. Worth states, “No teacher would encourage a class to debate cell theory, when there is no evidence for a competing theory, and neither should students be asked to debate whether significantly raising the amount of carbon dioxide in the atmosphere does or does not heat the planet.”Chapters 3–6 (“The Evolution,” “The Standards,” “The Textbooks,” and “Selling Kids on Fossil Fuels”) highlight the history of science content, focusing on the effect of cancel culture on the teaching of evolution; the nature and development of K–12 science standards in the United States; and the influence of the multimillion-dollar “energy education” campaign by big oil companies, such as the American Petroleum Institute’s decades-long, shrewd, and at times unethical messaging blatantly rejecting the science of climate change. In the closing chapter, “The Victory,” Worth highlights a few of the minor climate change education victories that have been achieved by local, state, and national education boards, while at the same time stating that “the American public’s perspective on global climate change remains wildly out of step with that of scientists.” She goes on to say that “as of 2019, 30 percent of Americans falsely thought global warming was mostly natural.” Worth ends the chapter by warning the reader that “every year, state lawmakers propose legislation that would allow teachers to miseducate their students about human-induced climate change” and that there are still “troves of misleading educational materials [that] are available online.”Miseducation: How Climate Change Is Taught in America is an informative book with richly investigated text and an impressively detailed reference section. It takes the reader on an engaging, data-laden, historical, science education journey, exposing us to the widespread ignorance about the scientific consensus, to ideological pressures, and to the disinformation campaigns promoted by the fossil fuel industry, textbook publishers, school board officials, and other ill-intentioned groups. As a practicing biologist and science educator, I remain hopeful that due to the heroic efforts of investigative reporters such as Katie Worth, books like this will continue to serve as platforms for further conversations about the importance of climate change education, and I think they should be essential reading for teachers of science and other subjects alike, who are concerned for the future of humanity.

Tobacco advertising, promotion, and sponsorship (TAPS) in Ethiopia: a scoping review and narrative synthesis

Background Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Methods Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. Results 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. Conclusions There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.

STRATEGIC PREVENTION OF SOCIAL-PEDAGOGICALLY DEVIANT BEHAVIOR IN GENERAL EDUCATION SCHOOLS

The article deals with the issue of prevention of deviant behavior of adolescents in secondary schools. Unfortunately, now deviant behavior it has become the most important characteristic for minors. Since, the forms and extent of deviant behavior of minors has increased to younger students. Deviant behavior of minors requires special attention to such situations and forms as: violation of the structure and functions of the family, material and domestic problems, advertising of tobacco products and alcoholic beverages, the crisis of basic social institutions, etc.

Electronic nicotine delivery system advertising in business-to-business publications, United States, 2015-2020.

Tobacco retailers are a key target audience for tobacco product advertising, yet little is known about the messages and channels used to market electronic nicotine delivery systems (ENDS) to retailers. We assessed expenditures for business-to-business print advertising for ENDS in the United States, by year and by advertiser, from 2015 to 2020; and the content of advertisements placed in 2020. The total number of ENDS brands placing business-to-business advertisements declined from 45 in 2015 to 6 in 2020; spending declined from $2.6 million in 2015 (for 283 occurrences) to $492,789 in 2020 (69 occurrences). Across years, the top-spending advertisers were Logic ($1.9 million), blu ($1.0 million), JUUL ($625,050), NJOY ($373,126) and Vuse ($322,075). Common messages of advertisements placed in 2020 included that products are not intended for minors; brand market share; health warnings; profitability or revenue potential for retailers; and flavours. This study suggests that ENDS companies anticipate that ENDS retailers are interested in stocking products that maximise profits, appeal to consumers and comply with regulatory requirements. Declines in the number of advertisers mirror the overall consolidation of the ENDS industry that occurred during the study period. Business-to-business print advertising represents an important channel in which ENDS brands communicate a variety of messages about their products directly to potential retailers.

The Framework Convention on Tobacco Control (FCTC) and implementation of tobacco control policies: Lessons learned from Indonesia and Thailand

AbstractThe threat that the tobacco epidemic poses to public health underscores the importance of comprehensive tobacco‐related regulation. Despite aiming to reduce the prevalence of smoking, Indonesia still falls short of this goal. In contrast, within the same region, Thailand's achievement in controlling tobacco serves as a potential role model for Indonesia. To understand the issue, we conducted a literature review of the current regulatory framework as well as the implementation of the World Health Organization's Framework Convention on Tobacco Control (FCTC) and MPOWER framework in both countries. The review was supplemented with a Focus Group Discussion and an in‐depth interview with stakeholders in Thailand and Indonesia. This study finds that: (1) Indonesia currently lacks a strong tobacco control policy champion, whereas Thailand has several authorities that focus on the issue; (2) Thailand's tobacco product advertising and promotion and smoking bans are more restrictive compared to Indonesia's policies; and (3) Thailand's policies on tobacco pictorial health warnings, pharmacotherapy, and excise taxes are more extensive than Indonesia's. We recommend that Indonesia ratify the FCTC as the foundation of tobacco control policies while also strengthening and coordinating organizations working on tobacco control, encouraging subnational governments to introduce regulations, and enforce control, as well as improving excise policies to reduce the affordability of tobacco products.

Co-Plot Method: A Research on Tobacco Control in the European Region

BACKGROUND: The aim of this study is to introduce the uncommonly used Co-Plot method which is called the multivariate graphical analysis and to apply this method to a data set including tobacco control in European region.METHODS: This study uses the data from the World Health Organization database according to Human Development Index of European countries. It takes into account variables such as smoking prevalence in young people and adults, the proportion of smoking-related deaths and domestic legislations casespertaining to tobacco products and analyses the data using the Co-Plot method.RESULTS: Results of the study demonstrated that smoking prevalence and restrictions on advertising of tobacco products were highly negatively correlated. The proportion of deaths associated with smoking-related diseases increased parallel to the increase in the smoking prevalence in young people and adults. Norway, France and Finland have enforced legal limitations on direct and indirect advertising, and thus there has been a decline in smoking prevalence among young people andadults. In some countries, including Ireland, Italy and Serbia, the prevalence of smoking among the young has decreased due to the new or increased legal restrictions on the sale distribution of tobacco products. The governments in the Czech Republic, Kazakhstan, Estonia, Croatia, the Netherlands,Belgium, and Poland have placed restrictions on direct and indirect advertising. The distribution of other causes-related deaths and lung cancer-related deaths are high.CONCLUSION: The restrictions on tobacco products were tightened in time with the increased prevalence of smoking and proportion of smoking-related deaths. It can be said that the significantrelationships identified in this study have even more pertinence in developed countries. Consequently, Co-Plot method has enabled deeper data interpretations of the relationships between the countries and the variables in this study.

Impacto sanitario de la prohibición total de publicidades de tabaco en argentina.

Health impact of the total ban on advertising of tobacco productsThe objective was to estimate the health impact of the total ban on advertising of tobacco products in terms of avoided cardiovascular events in those over 35 years of age in Argentina.The Cardiovascular Disease Policy Model (CVDPM) was used, which is a Markov simulation model used to represent and project mortality and morbidity due to cardiovascular disease (CVD) in the population aged 35 or over. It constitutes a demographic-epidemiological model, which represents the population between 35 and 95 years of age and uses a logistic regression model based on the Framingham equation to estimate the annual incidence of cardiovascular disease. We assumed that implementing a complete ban on the advertising of tobacco products would lead to a 9% reduction in tobacco consumption.The complete ban on advertising could prevent 15,164 deaths over a period of 10 years, of which 2610 would be the result of coronary heart disease and 747 due to stroke. These reductions would mean an annual decrease of 0.46% of total deaths, 0.60% of deaths from coronary heart disease and 0.33% in deaths from stroke. In addition, during the same period, it would avoid 6630 acute myocardial infarctions and 2851 strokes (reductions of 1.35% and 0.40%, respectively).We hope that these findings might contribute to the strengthening of sanitary tobacco control policies in Argentina based on the remarkable benefits of banning the advertising of tobacco products in full and in line with current global recommendations.

Evaluation of Smoking Prevalence, Secondhand Smoke Exposure, Attitudes of Tobacco Control, and Smoking Cessation Knowledge among Pharmacy and Medical Students in a Private University, Malaysia.

Background:Tobacco use is one of the leading causes of premature morbidity and mortality globally, causing over eight million deaths per year. One of the best approaches to reduce smoking-related deaths is to encourage future health-care professionals in tobacco control programs.Objectives:To assess the smoking prevalence, secondhand smoke exposure, attitudes toward tobacco control, and smoking cessation knowledge and associated factors among pharmacy and medical students in a private university in Malaysia.Methodology:A cross-sectional study was conducted at two campuses of a private University in Malaysia, and the data were collected online using the Global Health Professionals Students Survey questionnaire and analyzed using IBM-SPSS Version 20.Results:The overall smoking prevalence was 1.6% (P = 0.009). The exposure to secondhand smoke was 21% and 39% at home and in public places, respectively. About 92% of respondents had a good attitude toward tobacco control, whereas 53.4% had good smoking cessation knowledge. However, only 39.4% of the respondents had received formal smoking cessation training. Logistic regression revealed that significant predictors toward tobacco control are the ban of tobacco sales to adolescents, ban on the advertising of tobacco products, ban of smoking in restaurants, and obtaining a specific training on cessation techniques.Conclusions:The prevalence of smoking among pharmacy and medical students was low, but exposure to secondhand smoke was higher. Most of the respondents had a positive attitude and good knowledge of smoking cessation. However, future training needs to be conducted among upcoming health-care professionals to act as a role model for community transformation.

Knowledge, Attitude and Practice Study on Effects of Smoking, Alcohol and Substance Abuse on Human Health among Students

Introduction: It is well documented that tobacco, alcohol and drug use can be detrimental to health. However, little is known about the impact of smoking, alcohol and substance abuse on human among students. The aim of this study was to study the effect of smoking, alcohol and substance abuse on human among students.&#x0D; Methods: The study was carried out on 51 students comprising of 26 M.B.B.S and 25 non-M.B.B.S students. The students were given a pretested questionnaire and asked to fill up the questions. The responses were collected and analyzed using appropriate statistical tools for parametric and non-parametric data with the help of SPSS for Windows version 22 software.&#x0D; Results: The knowledge of participants on Effects of smoking, alcohol and substance abuse was 73%.&#x0D; The participants had a positive attitude towards the complete ban of advertising of tobacco products and most of them (58%) had a positive attitude towards the complete ban of tobacco usage.&#x0D; 19.6% of participants consumed alcohol and 22.2% had at least once smoked a cigarette and 9.8% practiced substance abuse.&#x0D; Conclusion: The study concludes that there is a definitive and palpable practice of smoking, alcohol and substance abuse among students. To prevent such practices awareness must spread among the students.

Spotting e-cigarette and vapes in social media: A continuing problem to tobacco product advertising and marketing control

Spotting e-cigarette and vapes in social media: A continuing problem to tobacco product advertising and marketing control

Flavors and Implied Reduced-Risk Descriptors in Cigar Ads at Stores Near Schools.

Although the FDA prohibits using inaccurate, reduced-risk descriptors on tobacco product advertising, descriptors that imply reduced risk or an enhanced user experience may be present on cigar product advertising in retail outlets near schools. Therefore, to inform the development of federal labeling and advertising requirements that reduce youth appeal of cigars, we conducted a content analysis of cigar ads in retailers near schools to document the presence of implied health claims and other selling propositions that may convey enhanced smoking experience. Up to four interior and exterior little cigar and cigarillo advertisements were photographed in a random sample of licensed tobacco retailers (n = 530) near California middle and high schools. Unique ads (n = 234) were coded for brand, flavor, and presence of implicit health claims, premium branding descriptors, and sensory descriptors. Logistic regressions assessed the association among flavored ads and presence of implicit health claims, premium branding, or sensory descriptors. Seventeen cigar brands were advertised near schools; Black & Mild (20.1%) and Swisher Sweets (20.1%) were most common. Flavor was featured in 64.5% of ads, with explicit flavor names (eg, grape) being more prevalent than ambiguous names (eg, Jazz) (49.6% vs. 34.2%). Compared to ads without flavors, ads with ambiguous flavors were more likely to feature implicit health claims (OR = 1.83, 95% CI = 1.06% to 3.19%) and sensory descriptors (OR = 2.64, 95% CI = 1.39% to 5.04%); ads with explicit flavors were more likely to feature premium branding (OR = 2.84, 95% CI = 1.53% to 5.41%). Cigar ads that featured implicit health claims and premium branding, and sensory selling propositions are present at retailer stores near schools. We document the presence of implied health claims, premium branding, and sensory descriptors on cigar ads found in retail settings near schools. This study adds to the body of evidence that supports the development of federal labeling and advertising requirements for cigar products to reduce their appeal among vulnerable groups.

Smokeless tobacco industry’s brand stretching in India

Smokeless tobacco (SLT) is a global public health concern because it is used in 140 countries.1 The 200 million SLT users in India represent about two-thirds of the global SLT...

Predictive Validity of Tobacco Product Advertising and Retail Availability.

Measurement properties of key constructs used in tobacco retailer audit studies are infrequently examined. We used diagnostic testing metrics to assess the predictive validity of product advertising and availability. In 2017, we documented tobacco product advertising and availability in a sample of New York City and New Jersey retailers (N = 987). We calculated positive predictive values (PPV, ie, probability of availability given advertising is present) and sensitivity scores (ie, probability of advertising given product is available) for cigarettes, cigars, smokeless tobacco, and electronic nicotine delivery systems (ENDS). Advertising presence was an imprecise indicator of availability for ENDS (PPV: 82.3%) and smokeless tobacco (PPV: 88.2%), particularly in non-chain convenience stores. Cigars were least likely to be advertised, if available (sensitivity: 27.8%), compared to other product types (sensitivity range: 43.8% - 57.9%). The suboptimal predictive validity of advertising for certain products suggests that this measure does not necessarily reflect product accessibility in communities. Moreover, differences in sensitivity scores suggest that some product classes rely on strategies other than physical ads to recruit and retain consumers. A better understanding of these constructs and their influence on behavior can help inform more effective retail-based regulatory approaches.

Advertising and display of tobacco products at points of sale in El Salvador

Objective. To study the impact of advertising and exposure of tobacco products at point of sale and to identify tobacco products marketing on internet. Methodology. Qualitative study using simple random sampling to studying 125 authorized points of sales for merchandising tobacco products; 1,250 adult consumer population visiting the point of sales and 20 websites that refers to sell tobacco products in El Salvador. Analyses were performed using SPSS version 24.0. Results. In 4% of point of sales were advertising of tobacco products inside. There is a high index of impulse purchase of cigarettes because 80% of smokers have decided to buy tobacco cigarettes standing in front of cash register. In 90.4% of point of sales the tobacco sales represent less than 5% of the global sales of the business. Conclusions. It is required to implement a comprehensive ban on tobacco advertising on point of sales, mainly because it undermines the effectiveness of tobacco control law and the implementation of Article 13 of the WHO FCTC.

Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study

Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study

Cigarette stick as valuable communicative real estate: a content analysis of cigarettes from 14 low-income and middle-income countries

BackgroundThe current cigarette market is heavily focused on low-income and middle-income countries. Branding of tobacco products is key to establishing and maintaining a customer base. Greater restrictions on marketing and...

Vital Signs: Exposure to Electronic Cigarette Advertising Among Middle School and High School Students - United States, 2014.

Electronic cigarette (e-cigarette) use has increased considerably among U.S. youths since 2011. Tobacco use among youths in any form, including e-cigarettes, is unsafe. Tobacco product advertising can persuade youths to start using tobacco. CDC analyzed data from the 2014 National Youth Tobacco Survey to estimate the prevalence of e-cigarette advertisement exposure among U.S. middle school and high school students. The 2014 National Youth Tobacco Survey, a school-based survey of middle school and high school students in grades 6-12, included 22,007 participants. Exposure to e-cigarette advertisements (categorized as "sometimes," "most of the time," or "always") was assessed for four sources: retail stores, Internet, TV and movies, and newspapers and magazines. Weighted exposure estimates were assessed overall and by school type, sex, race/ethnicity, and grade. In 2014, 68.9% of middle and high school students (18.3 million) were exposed to e-cigarette advertisements from at least one source. Among middle school students, exposure was highest for retail stores (52.8%), followed by Internet (35.8%), TV and movies (34.1%), and newspapers and magazines (25.0%). Among high school students, exposure was highest for retail stores (56.3%), followed by Internet (42.9%), TV and movies (38.4%), and newspapers and magazines (34.6%). Among middle school students, 23.4% reported exposure to e-cigarette advertising from one source, 17.4% from two sources, 13.7% from three sources, and 11.9% from four sources. Among high school students, 21.1% reported exposure to e-cigarette advertising from one source, 17.0% from two sources, 14.5% from three sources, and 18.2% from four sources. Approximately seven in 10 U.S. middle and high school students were exposed to e-cigarette advertisements in 2014. Exposure to e-cigarette advertisements might contribute to increased use of e-cigarettes among youths. Multiple approaches are warranted to reduce youth e-cigarette use and exposure to e-cigarette advertisements, including efforts to reduce youth access to settings where tobacco products, such as e-cigarettes, are sold, and regulation of youth-oriented e-cigarette marketing.