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      Evolution of Electronic Cigarette Brands From 2013-2014 to 2016-2017: Analysis of Brand Websites

      research-article
      , PhD 1 , , BA 2 , , PhD 2 , 3 ,
      (Reviewer), (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      electronic cigarettes, vaping, nicotine, longitudinal studies, internet, market research

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          Abstract

          Background

          The electronic cigarette (e-cigarette) industry has grown in size and organizational complexity in recent years, most notably with the entry of major tobacco companies in 2012 and the proliferation of vape shops. Many brands maintain retail websites that present e-cigarette marketing claims and sell directly to consumers. Understanding of the evolving composition of different types of e-cigarette brand websites is currently underdeveloped.

          Objective

          This paper presents how e-cigarette brand websites surveyed in 2013-2014 evolved by 2016-2017, and how the websites run by different types of e-cigarette producers currently differ.

          Methods

          In 2016-2017, we revisited 466 e-cigarette brand websites surveyed in 2013-2014, 288 of which were extant, and identified 145 new English-language websites. We compared product designs, marketing claims, and age-based warnings presented by types of e-cigarette producers: major tobacco companies, independent vape shops, and independent internet-only companies.

          Results

          Among the 433 websites examined in 2016-2017, 12 were owned by major tobacco companies, 162 operated a physical vape shop, and 259 were internet-only operations. Closed-system product designs were sold by 83% (10/12) of tobacco-owned brands. In comparison, 29.0% (47/162, P<.001) of vape shop and 55.2% (143/259, P=.06) of internet-only brands sold closed-system designs. Compared with vape shop and internet-only brands, tobacco-owned brands offered a smaller set of product models ( P values <.001) and a narrower range of flavors ( P values <.01), with greater emphasis on the traditional combustible cigarette flavors of tobacco and menthol ( P values <.001). Tobacco-owned brands also offered a narrower range of nicotine options than the vape shops ( P=.002) and were less likely to offer nicotine-free e-liquid compared with internet-only and vape shop brands ( P values <.001). Finally, 83% (10/12) of tobacco-owned brand websites featured age verification pop-up windows. In comparison, only 50.2% (130/259) of internet-only brands ( P=.01) and 60.5% (98/162) of vape shop brands ( P=.06) featured age verification windows. Websites surveyed in both 2013-2014 and 2016-2017 became more likely to sell open-system mods ( P<.001) and sold an increased number of product models ( P<.001), flavors ( P<.001), and nicotine options ( P<.001). Prevalence of several types of claims decreased significantly, including indirect claims regarding smoking cessation ( P<.001), claims regarding e-cigarettes as healthier ( P<.001), less expensive ( P<.001), and usable in more places ( P<.001) compared with combustible cigarettes.

          Conclusions

          The number of e-cigarette brands has not appeared to increase since 2014, even as website messaging evolved, with brands owned by tobacco companies and vape shops pulling in opposite directions. Brands owned by tobacco companies offered a limited range of e-cigarette products, whereas brands owned by vape shops emphasized a panoply of flavor and nicotine options. Furthermore, the Food and Drug Administration’s regulatory action may influence the types of e-cigarette products offered and the market shares of various companies.

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          Most cited references35

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          A systematic review of health effects of electronic cigarettes.

          To provide a systematic review of the existing literature on health consequences of vaporing of electronic cigarettes (ECs). Search in: PubMed, EMBASE and CINAHL. Original publications describing a health-related topic, published before 14 August 2014. PRISMA recommendations were followed. We identified 1101 studies; 271 relevant after screening; 94 eligible. We included 76 studies investigating content of fluid/vapor of ECs, reports on adverse events and human and animal experimental studies. Serious methodological problems were identified. In 34% of the articles the authors had a conflict of interest. Studies found fine/ultrafine particles, harmful metals, carcinogenic tobacco-specific nitrosamines, volatile organic compounds, carcinogenic carbonyls (some in high but most in low/trace concentrations), cytotoxicity and changed gene expression. Of special concern are compounds not found in conventional cigarettes, e.g. propylene glycol. Experimental studies found increased airway resistance after short-term exposure. Reports on short-term adverse events were often flawed by selection bias. Due to many methodological problems, severe conflicts of interest, the relatively few and often small studies, the inconsistencies and contradictions in results, and the lack of long-term follow-up no firm conclusions can be drawn on the safety of ECs. However, they can hardly be considered harmless. Copyright © 2014. Published by Elsevier Inc.
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            "Smoking revolution": a content analysis of electronic cigarette retail websites.

            Electronic cigarettes (e-cigarettes) have been increasingly available and marketed in the U.S. since 2007. As patterns of product adoption are frequently driven and reinforced by marketing, it is important to understand the marketing claims encountered by consumers. To describe the main advertising claims made on branded e-cigarette retail websites. Websites were retrieved from two major search engines in 2011 using iterative searches with the following terms: electronic cigarette, e-cigarette, e-cig, and personal vaporizer. Fifty-nine websites met inclusion criteria, and 13 marketing claims were coded for main marketing messages in 2012. Ninety-five percent of the websites made explicit or implicit health-related claims, 64% had a smoking cessation-related claim, 22% featured doctors, and 76% claimed that the product does not produce secondhand smoke. Comparisons to cigarettes included claims that e-cigarettes were cleaner (95%) and cheaper (93%). Eighty-eight percent stated that the product could be smoked anywhere and 71% mentioned using the product to circumvent clean air policies. Candy, fruit, and coffee flavors were offered on most sites. Youthful appeals included images or claims of modernity (73%); increased social status (44%); enhanced social activity (32%); romance (31%); and use by celebrities (22%). Health claims and smoking-cessation messages that are unsupported by current scientific evidence are frequently used to sell e-cigarettes. Implied and overt health claims, the presence of doctors on websites, celebrity endorsements, and the use of characterizing flavors should be prohibited. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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              Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices

              A wide range of electronic cigarette (EC) devices, from small cigarette-like (first-generation) to new-generation high-capacity batteries with electronic circuits that provide high energy to a refillable atomizer, are available for smokers to substitute smoking. Nicotine delivery to the bloodstream is important in determining the addictiveness of ECs, but also their efficacy as smoking substitutes. In this study, plasma nicotine levels were measured in experienced users using a first- vs. new-generation EC device for 1 hour with an 18 mg/ml nicotine-containing liquid. Plasma nicotine levels were higher by 35–72% when using the new- compared to the first-generation device. Compared to smoking one tobacco cigarette, the EC devices and liquid used in this study delivered one-third to one-fourth the amount of nicotine after 5 minutes of use. New-generation EC devices were more efficient in nicotine delivery, but still delivered nicotine much slower compared to tobacco cigarettes. The use of 18 mg/ml nicotine-concentration liquid probably compromises ECs' effectiveness as smoking substitutes; this study supports the need for higher levels of nicotine-containing liquids (approximately 50 mg/ml) in order to deliver nicotine more effectively and approach the nicotine-delivery profile of tobacco cigarettes.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                March 2018
                12 March 2018
                : 20
                : 3
                : e80
                Affiliations
                [1] 1 Graduate School of Management University of California Davis Davis, CA United States
                [2] 2 Moores Cancer Center University of California San Diego La Jolla, CA United States
                [3] 3 Department of Family Medicine and Public Health University of California San Diego La Jolla, CA United States
                Author notes
                Corresponding Author: Shu-Hong Zhu szhu@ 123456ucsd.edu
                Author information
                http://orcid.org/0000-0003-4717-1862
                http://orcid.org/0000-0002-4213-7246
                http://orcid.org/0000-0002-4149-3441
                Article
                v20i3e80
                10.2196/jmir.8550
                5869180
                29530840
                c8565d52-2948-430e-b1b1-fb321beaaacb
                ©Greta Hsu, Jessica Y Sun, Shu-Hong Zhu. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.03.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 29 August 2017
                : 14 November 2017
                : 6 December 2017
                Categories
                Original Paper
                Original Paper

                Medicine
                electronic cigarettes,vaping,nicotine,longitudinal studies,internet,market research
                Medicine
                electronic cigarettes, vaping, nicotine, longitudinal studies, internet, market research

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