Differences in Electronic Cigarette Awareness, Use History, and Advertisement Exposure Between Black and White Hospitalized Cigarette Smokers

E-cigarette use has increased rapidly over the past decade. There is growing concern about e-cigarette use and advertising given limited regulation of these products. This cross-sectional study reports on data collected at baseline from hospitalized cigarette smokers (N = 944) recruited in monthly cohorts between December 2012 and September 2013. Participants were queried regarding e-cigarette awareness and use, and number and sources of e-cigarette advertisement exposures in the previous 6 months. Most Whites (99 %) reported ever hearing of an e-cigarette compared to 96 % of Blacks (p < 0.001). Over two thirds (64 %) of Whites reported ever using an e-cigarette compared to 30 % of Blacks (p < 0.001). There were significant trends in increasing e-cigarette use for both racial groups with an average increase of 13 % each month (p < 0.005) and in increasing e-cigarette advertisement exposure reported for the previous 6 months, with a 14 % increase each month (p < 0.0001). Whites reported 56 % greater advertisement exposure than Blacks (mean = 25 vs. 8 in month 1 to 79 vs. 45 in month 9, respectively; p < 0.0001). For Blacks, advertisement exposure was significantly associated with e-cigarette use (p < 0.001). Whites reported more advertisement exposure from stores and the Internet, and Blacks reported more advertisement exposure from radio or television. Results suggest that e-cigarette marketing is beginning to breach the Black population who are, as a consequence, "catching up" with Whites with regard to e-cigarette use. Given the significant disparities for smoking-related morbidity and mortality between Blacks and Whites, these findings identify new areas for future research and policy.