More than 90 percent of stores selling e-cigarettes in two major Chinese cities provided WeChat accounts or QR codes for quick delivery services, allowing consumers to bypass a nationwide ban on online sales that took effect in May 2022, a new study has found.

The research, conducted by the Health Communication Institute of Fudan University in Shanghai, compared e-cigarette stores in Shanghai and Chengdu, Sichuan province, before and after the implementation of the regulations. The main findings were published by the institute on Wednesday.

The regulations, in place for three years, explicitly prohibit the sale of flavored e-cigarettes other than tobacco flavor and the sale of e-cigarette products to minors. They also ban the use of vending machines for such products and require warning labels on packaging.

However, the study revealed that one-third of the surveyed stores continued to sell flavored e-cigarette cartridges, and only 83 percent had implemented age restrictions on sales.

The first observation period of the study was from January to May 2021, before the regulations. The second observation took place between December 2023 and March 2024, after the regulations were enforced.

In the first observation, about 25 percent of stores offered a WeChat account and 17 percent provided a QR code for delivery services. These figures jumped to 90 percent and 91 percent, respectively, in the second observation, indicating a significant shift of customers from offline to online purchases.

The research also highlighted the increasing influence of social media platforms in e-cigarette marketing. Analyzing more than 3,100 text data entries from the Xiaohongshu platform using "e-cigarette" as a keyword between January 2022 and March 2025, the team found pervasive covert advertising.

"We found that 85 percent of the e-cigarette-related notes included marketing messages, and most of them employed subtle marketing strategies, such as implanting product marketing content into notes that seem like daily life sharing, and using homophonic words and emoji to circumvent platform supervision," said Zheng Pinpin, a professor from the institute.

"Also, we found in many of such marketing content, elements such as celebrities and screenshots of popular TV series were used to attract followers, and phrases like 'gorgeous ladies only' were used to attract potential users by appealing to people's sense of identity," Zheng added.

Geng Yindi, a project leader at the Center for Social Media Research of Peking University, corroborated these findings. In a separate recent study, her team also found that underage individuals and women are the primary target groups for tobacco products on social platforms.

"On the Xiaohongshu platform, we found that there were eight times as many texts targeting women as there were for men, and much of the content was linked to their sense of identity," Geng said.

Researchers emphasized the need for social media platforms to use artificial intelligence to identify and remove tobacco and e-cigarette marketing content promptly to curb the spread of covert advertising.

Fu Hua, president of the Shanghai School Health Care Association, noted that e-cigarettes have grown in popularity among teenagers in recent years, evolving from a product to a cultural symbol.

He also pointed out that current education about the dangers of smoking focuses on traditional cigarettes and often excludes e-cigarettes, leading to a lack of clear understanding among schools and teachers.

"Many teenagers believe that e-cigarettes are less harmful, don't cause addiction and can help people quit smoking. Social media amplifies such misconceptions, and promotes the association between the fruit tastes of e-cigarettes and their harmlessness," Fu said.

Fu suggested that cross-departmental collaborations are needed to make scientific and engaging content about smoking hazards, including e-cigarettes, on both mainstream and social media.

The Fudan institute's study also showed a significant decrease in the number and size of e-cigarette stores following the implementation of the regulations.

Furthermore, a survey of more than 2,200 e-cigarette users last year by the research team found that 21 percent had quit using e-cigarettes after the regulations took effect, particularly in cities with comprehensive smoke-free legislation.