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A Picture Is Worth a Lot of Words: E-Cigarette Marketing to Children and Youth

A Picture Is Worth a Lot of Words: E-Cigarette Marketing to Children and Youth

By Marcia Quackenbush, MS, MFT, MCHES | November 27, 2018
Senior Editor, ETR

You probably already know that flavored tobacco and e-cigarettes pose a unique and compelling danger to children and youth. You’ve paid attention to the headlines. You’ve read the articles and reports. You’ve been astonished at the troubling statistics showing how these products are fueling increases in tobacco use among youth.

That was certainly true for me. Then I helped out in a photoshoot of flavored tobacco and e-cigarette products. This was part of ETR’s work with the California Tobacco Control Program. Prevention programs across the state needed photos of the types of products that have been attracting youth, especially the most current brands.

I discovered what the e-cigarette manufacturers already know: it is a powerful experience to actually see these products. They call out to be looked at, touched, explored—even when you’re a health professional and you know they are poison!

Big-Time Cool: Everyone Notices These Products

My colleague Jennifer Silver-Herman and I took over the front lobby of ETR’s Scotts Valley location for the photoshoot. We set up our background and the big photo lights. We spread the flavored products out on a table. We got our shot list and started creating the photos.

Youth E-Cigarette Use Is Rising

  • 1 in 5 high school students and 1 in 20 middle school students currently use e-cigarettes.
  • During 2017-2018, current use among high school students increased from 11.7% to 20.8% (a 78% increase). Among middle school students, rates rose from 3.3% to 4.9% (a 48% increase).
  • 80% of young people who have ever used tobacco started with a flavored tobacco product.
  • Newer products such as JUUL, shaped like USB flash drives, are highly popular among youth.

Sources: CDC MMWR Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students—United States, 2011-2018 and California Tobacco Control Branch infographic The Truth About Flavored Tobacco.

Virtually everyone who walked through the lobby that day stopped to take a look—ETR staff, facility staff, visitors, even the UPS guy! People walked over to the table where the products were displayed and exclaimed over their appearance. “How colorful!” “These look cool.” “This one smells great!” “I love this packaging.” “Wait—what are these again?”

Some of the products are packaged like candy. It’s tough to tell the difference between the real stuff and flavored tobacco products.









Many of the vaping products are packaged as beautifully and carefully as a new iPhone.

We could hear excitement in people’s voices as they looked over and handled the products. Voice volume increased. Speech tempo picked up. People smiled and laughed and made silly jokes—“Okay, this looks awesome. I’m totally ready to try it!”

I was just as enticed as they were. “Take a look at this one!” I’d exclaim. Or, “If you think that’s nice, look at the box this comes in!”

Our Work Is Cut Out for Us

It’s not surprising that young people are drawn to these products. So were a whole bunch of adults—adults who have brains less prone to risk-taking and more suited to impulse control. We know that there are a range of health risks when youth use e-cigarettes. We know that youth can get their hands on these products if they want to—in fact, they’re easier to get than other forms of tobacco. We also know that when young people begin using e-cigarettes, they are at greater risk for use of combustible cigarettes one year later.

The starter kit below came from an online retailer that shipped it with a Charms Watermelon Blow Pop—this from an industry that claims they are not targeting children and youth with their marketing!

This is a serious call to action. I hope you’ll take steps to make a difference. Talk with your kids and grandkids. If you work directly with youth, find ways to address flavored tobacco prevention with them. Join in the effort to promote local flavored tobacco policies that help protect the health of youth in your community. Speak up about the true dangers of these products.

Let’s do our best to turn those numbers around!


Marcia Quackenbush, MS, MFT, MCHES, is Senior Editor at ETR. She can be reached at


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