In the past 2 years, e-cigarette television advertising in the US directed at youth has increased two-fold, while ads directed at young adults have increased three-fold, according to a study by researchers at RTI International and the Florida Department of Health.

The study, published in Pediatrics, found that youth (age 12-17) exposure to electronic cigarette advertisements increased by 256% from 2011 to 2013 and young adult (age 18-24) exposure to e-cigarette ads jumped 321% in the same time period.

Traditional cigarette TV ads were banned in the US in 1971; however, e-cigarettes currently are not included in the restrictions.

More than 80% of the advertisements in 2013 were for a single brand, blu eCigs, which is owned by the tobacco company Lorillard. The study is the first to extensively analyze trends in youth and young adult exposure to e-cigarette TV ads.

“If the current trends continue, awareness and use of e-cigarettes will increase among youth and young adults,” said Jennifer Duke, PhD, senior research public health analyst and co-author of the study. “And unfortunately, in the absence of evidence-based public health messages regarding the health risks of e-cigarettes, television advertising is promoting beliefs and behaviors that pose harm to youth and young adults and raise public health concerns.”

Researchers analyzed TV advertising data and viewership ratings for e-cigarette commercial occurrences by quarter, year and sponsor across US cable networks and programs. Researchers calculated ad exposure for youth ages 12 to 17 years of age and young adults 18 to 24 years old.

The research showed that more than 75% of e-cigarette ad exposure to youth occurred on cable networks, including AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1. Researchers found that e-cigarette ads appeared on programs like The Bachelor, Big Brother, and Survivor that were among the 100 highest-rated youth programs for the 2012-2013 TV season.

“E-cigarette companies advertise to a broad TV audience that includes 24 million youth,” Duke said. “Given the potential harm of e-cigarettes to youth and their potential as a gateway to using cigarettes and other tobacco products, the FDA needs to regulate the positive images of e cigarettes on television and other venues where youth view advertising and marketing like they do for traditional cigarettes.”

According to a Centers for Disease Control and Prevention study, as of 2012, an estimated 1.8 million middle and high school students had used e-cigarettes. Almost 10 percent of students who have used e-cigarettes have never used traditional cigarettes.

Previous research by RTI indicated that particles found in e-cigarette vapors may cause or worsen acute respiratory diseases, including asthma and bronchitis, among youth. The study found up to 40 percent of particles emitted by an e-cigarette can deposit in the deepest area of a teen’s lungs. Another RTI study found that e-cigarette ad expenditures tripled in the United States from $6.4 million in 2011 to $18.3 million in 2012.