@article {Hansen00155-2018, author = {Julia Hansen and Reiner Hanewinkel and Matthis Morgenstern}, title = {Electronic cigarette marketing and smoking behaviour in adolescence: a cross-sectional study}, volume = {4}, number = {4}, elocation-id = {00155-2018}, year = {2018}, doi = {10.1183/23120541.00155-2018}, publisher = {European Respiratory Society}, abstract = {The aim of this study was to investigate the association between exposure to electronic cigarette (e-cigarette) advertisements and use of e-cigarettes, combustible cigarettes and hookahs.A cross-sectional survey of 6902 German students (mean age 13.1 years, 51.3\% male) recruited in six German states was performed. Exposure to e-cigarette advertisements was measured with self-rated contact frequency to three advertising images. Multilevel mixed-effect logistic regression models were used to assess associations between exposure to e-cigarette advertisement and use of e-cigarettes, combustible cigarettes and hookahs (ever and past 30 days).Overall, 38.8\% of the students were exposed to e-cigarette advertisements; ever-use of e-cigarettes was 21.7\%, of combustible cigarettes was 21.8\% and of hookahs was 23.2\%, and poly-use of all three products was 12.4\%. Exposure to e-cigarette advertisements was positively related to ever and past 30-day use of e-cigarettes, combustible cigarettes, hookahs and combined use.We concluded that a considerable number of German teenagers are exposed to e-cigarette advertisement. There was a clear exposure{\textendash}behaviour link, indicating that advertising contact was associated with different kinds of {\textquotedblleft}vaping{\textquotedblright} and also smoking behaviour. Although causal interpretation is not possible due to the cross-sectional design, findings raise concerns about the current tobacco control policies.E-cigarette advertising reaches a considerable number of German teenagers. Exposure is positively related to use of e-cigarettes, combustible cigarettes and hookahs, and combined use. Findings raise concerns about the current tobacco control policies. http://ow.ly/mbWm30mspIT}, URL = {https://openres.ersjournals.com/content/4/4/00155-2018}, eprint = {https://openres.ersjournals.com/content/4/4/00155-2018.full.pdf}, journal = {ERJ Open Research} }