Despite advertising restrictions in place, at least 85% of respondents of a survey in India, China, Australia and the UK reported being exposed to e-cigarette advertising, especially on social media and in or around vape shops and other retailers.
The World Health Organization (WHO) recommends banning all forms of e-cigarette advertising, promotion and sponsorship.
India has enacted the Prohibition of Electronic Cigarette Act (PECA) 2019, which prohibits manufacture, sale and advertisements of e-cigarettes and similar devices.
Four thousand people in the age group of 15-30 years participated in the survey conducted by the George Institute of Global Health.
The researchers contend that exposure to e-cigarette advertising can alter people's perceptions of the danger and risk involved and further pique their interest, leading to an increase in their propensity to use.
The survey assessed demographic characteristics, e-cigarette and tobacco use, the number of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising.
These included various modes of media exposure such as television, print, radio, and social media.
"In online contexts, exposure was more common for most social media platforms compared to general Internet usage.
"For example, 50% of those from China and 39% of those from Australia, India and the UK reported seeing e-cigarette advertising on Douyin and Instagram, respectively, compared to 29 % seeing e-cigarette advertising when using other parts of the Internet," the study report said.
The research findings have been published in the journal "Tobacco induced diseases".
"For 'in real life' contexts, exposure was most common for vape shops (48 %) and supermarkets, corner stores and petrol stations (42 %)," it added.
The report pointed out that despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising.
Simone Pettigrew, lead author and Program Director of Health Promotion and Behaviour Change at The George Institute said, "Digital forms of e-cigarette promotion are particularly difficult to monitor and control, and the vaping industry is exploiting this opportunity to target young people".
Social media and advertising on or around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use, it said.
The results of the present study signal the critical importance of restricting e-cigarette advertising on the exterior of vape stores and other retailers, as this appears to be a primary mechanism via which e-cigarette marketers can reach young people, the report said.
"As has been found for alcohol retailing, effective use of signage on and around stores can effectively bypass advertising restrictions to reach vulnerable population groups.”
"Regulations need to be carefully constructed and vigilantly enforced to prevent this exposure," it said.
Exposure to e-cigarette advertising among respondents who had heard of e-cigarettes was assessed across multiple questions, asking them about seeing various ads or promotions, and four options were given as responses.
Descriptive analyses were conducted on those who had heard of e-cigarettes, and a logistic regression analysis was used to identify factors associated with e-cigarette use.