Cartoon marketing exposure decreases perceived risks of e-cigarette use in adolescents.

e-Cigarette companies use cartoon images to market their products, and exposure to this marketing strategy may lead to increased risk for adolescent e-cigarette use. This study examined the effects of cartoon marketing image exposure on perceived expectations of benefits and risks of e-cigarette use, and willingness to buy e-cigarette-related products in the future, among adolescents with and without a history of e-cigarette use. To accomplish this, participants completed an online survey experiment, during which they were randomly assigned to view pictures of e-cigarette products with cartoon or noncartoon packaging, followed by questionnaires about wanting to buy e-cigarettes, and perceived benefits and risks of e-cigarette use. Participants, a sample of Southern California high school students (ninth to 11th grade; = 1,376), completed the study from September 2021 to November 2021. Overall, 27% of participants had used an e-cigarette or other tobacco product at least once in their lifetime (ever user). Thirty-six percent of participants never used e-cigarettes or other tobacco products but were considered to be susceptible to using e-cigarettes in the future (susceptible-never user). Thirty-seven percent of participants never used e-cigarettes or other tobacco products and were considered insusceptible to using e-cigarettes in the future (insusceptible-never user). There were no significant differences between image exposure groups (cartoon, no cartoon) on demographic variables (age, gender, race/ethnicity), lifetime e-cigarette use, or susceptibility to use in the future. Exposure to e-cigarette-related cartoon-based marketing produced lower perceived e-cigarette-related risks in insusceptible-never users. Exposure to e-cigarette marketing with cartoon images decreases the perceived harmfulness of e-cigarettes, which can increase adolescents' intentions to try e-cigarettes. Curbing adolescent e-cigarette use is a national public health priority. (PsycInfo Database Record (c) 2023 APA, all rights reserved).