# Impact of e-cigarette characteristics and marketing on tobacco use and health: A longitudinal study among U.S. youth and adults > **NIH NIH R21** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2021 · $244,564 ## Abstract PROJECT SUMMARY/ABSTRACT E-cigarette use has increased rapidly, particularly among youth and young adults. The appealing flavors are a primary reason for young people to initiate and continue to use e-cigarettes. Young adult nonsmokers are more likely to initiate e-cigarette use with non-tobacco and non-menthol (NTM) flavors rather than tobacco and menthol (TM) flavors compared to current smokers, which is worrisome because e-cigarette use leads to cigarette initiation. The types of e-cigarette may also contribute to the surge in e-cigarette use. Advanced generation (open-system) devices deliver nicotine faster than old generation (closed-system) devices and can rapidly reduce withdrawal symptoms. Understanding if and how e-cigarette flavors and device types affect tobacco use behaviors is fundamental to developing regulatory activities that address the epidemic of e- cigarette use. In addition, e-cigarettes have been marketed aggressively using strategies that are appealing to young people. Youth exposure to e-cigarette advertising leads to e-cigarette initiation and greater susceptibility. But the underlying mechanism has not been fully explored. A potential mechanism is that advertising exposure reduces perceived harms and addictiveness of e-cigarettes, which in turn, lead to e- cigarette initiation and susceptibility. Last, e-cigarette use is associated with elevated risks for cardiopulmonary and periodontal diseases. However, evidence has been predominantly from cross-sectional data or on relatively small samples. To fill the knowledge gap, we will use longitudinal data (Waves 1-4) from the Population Assessment of Tobacco and Health (PATH) Study to accomplish three specific aims: (1) identify the impact of e-cigarette flavors and types on e-cigarette use among youth (12-17 years), young adults (18-34 years), and older adults (35 years and older). We will perform multivariate logistic regression with propensity score weights to assess the overall impact of e-cigarette flavors (NTM vs. TM) and types (open vs. closed- system) on e-cigarette use frequency. We will perform causal mediation analysis to test the hypothesis that, compared to TM flavors, NTM flavored e-cigarette use reduces harm and addiction perceptions of e-cigarettes, which lead to more frequent e-cigarette use; (2) determine the impact of exposure to e-cigarette advertising on e-cigarette initiation, use frequency, and susceptibility. Similar to Aim 1, we will perform multivariate logistic regression to assess the effect of e-cigarette advertising exposure on the outcomes, and conduct causal mediation analyses to assess the mediating effect of harm and addiction perceptions of e-cigarettes; and (3) identify the effect of e-cigarette use on cardiovascular, respiratory, and periodontal health, and compare the effects among different types of tobacco users (e.g., exclusive e-cigarette users never cigarette smokers, exclusive e-cigarette users former cigarette smokers, dual users, a... ## Key facts - **NIH application ID:** 10217787 - **Project number:** 1R21CA260423-01 - **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE - **Principal Investigator:** Nan Jiang - **Activity code:** R21 (R01, R21, SBIR, etc.) - **Funding institute:** NIH - **Fiscal year:** 2021 - **Award amount:** $244,564 - **Award type:** 1 - **Project period:** 2021-06-01 → 2023-05-31 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10217787 ## Citation > US National Institutes of Health, RePORTER application 10217787, Impact of e-cigarette characteristics and marketing on tobacco use and health: A longitudinal study among U.S. youth and adults (1R21CA260423-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10217787. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*