The TV commercial starts out sounding like an anti-smoking ad as actress Jenny McCarthy says smelling like an ashtray isn’t ideal for dating. Then she takes a sultry puff from an e-cigarette.

“I can have a smoke without the smell, ash or the stink-eye look from others,” she says.

What she doesn’t mention is that she’s promoting a brand, Blu, owned by a tobacco company. Cigarette advertising was banned from the airwaves 45 years ago, but there’s no such restriction on e-cigarettes, which deliver nicotine through a vaporized liquid.

As vaping among teens increases, public health officials are working to develop effective counter-campaigns against a product often viewed as a safe, socially acceptable alternative to smoking.

The effort has taken on new urgency with research published last week showing that teens who vape are much more likely to begin using tobacco products than teens who don’t. The study, led by USC researchers, followed students at the start of high school, who had never smoked tobacco. Six months later, 30.7 percent of the e-cigarette users went on to smoke cigarettes, hookah or cigars, vs. 8.1 percent of students who hadn’t tried e-cigarettes.

“Clearly recreational use of e-cigarettes is now a somewhat common phenomenon among today’s teens in America,” said lead researcher Adam Leventhal, director of USC’s Health, Emotion & Addiction Laboratory. “To my knowledge, there aren’t scientifically tested prevention programs that we can use and disseminate to teens, to their parents and their teachers about the potential causes and consequences of e-cigarette use.”

California banned the sale of e-cigarettes to minors in 2011 but has not moved on legislation that would ban use of them in public or require licensing of stores that sell them. The Food and Drug Administration is in the process of determining rules but has not proposed an advertising ban.

The state Department of Public Health spent $7 million in tobacco tax dollars developing an anti-vaping ad campaign that includes two television commercials that debuted in the spring and will run again this fall.

One ad says, “From the people who brought you lung cancer, e-cigarettes a new way to inhale toxic chemicals.”

“California has been a world leader in tobacco use prevention and cessation since 1990, with one of the lowest youth and adult smoking rates in the nation,” Dr. Karen Smith, director of the Department of Public Health , said in a statement in March when the ads were released. “The aggressive marketing and escalating use of e-cigarettes threatens to erode that progress.”

The state said last year the e-cigarette industry spent more than $110 million on advertising, mostly on television. Additionally, market research before the launch of the campaign found that many Californians did not know that e-cigarettes contain nicotine or that nicotine is highly addictive, and most were not aware of the potential dangers of e-cigarette emissions.

A study published last year in the journal Pediatrics found that 80 percent of kids ages 12-17 had seen 13 such ads in a year.

Most commercials ran on cable channels, including AMC, Comedy Central and VH1. The commercials also ran during network shows that are popular with teens, including “The Bachelor,” “Big Brother” and “Survivor,” according to the study.

Public health advocates say there are lessons that can be drawn from the multifaceted campaign against smoking, which has driven down the nation’s smoking rate to about 18 percent, according to the Centers for Disease Control and Prevention.

“There were multiple things that occurred that contributed to the drop in tobacco use,” said Amy Buch, division manager of health promotion for the Orange County’s Health Care Agency. “We know that knowledge alone doesn’t change behavior. It was changing the social norms around smoking. It went from being something cool to something kind of rebellious to something that’s just not really accepted at all in our society.”

Buch said warnings about long-term health consequences aren’t very effective with youths, who are most interested in living in the moment.

What has worked is the award-winning Truth campaign that attacked the practices of tobacco companies.

“It took that rebelliousness that sometimes comes with adolescence and instead of associating rebelliousness with smoking, the rebellion was against the tobacco industry and what the industry isn’t telling you,” Buch said.

The challenge with e-cigarettes is that much still isn’t known, and it’s important not to overstate the facts, she said.

The Orange County Department of Education created a campaign that emphasizes the risk of those unknowns, comparing vaping to smoking, which was seen as safe in the early days. Pediatrician Marc Lerner, medical officer for the department, said focus groups were held with teens to come up with ideas that would resonate.

“What we heard is that adolescents were really not interested in being guinea pigs,” Lerner said.

The campaign, which was designed for sharing on social media, gives a series of facts that begin with: “E-cigarettes don’t have tobacco. Guess what they do have?”

One reads: “Arsenic. Also found in bug spray. Tasty, tasty bug spray.”

Another: “Lithium. It’s not rocket science. It’s rocket fuel. Literally.”

And: “Nickel. Just our two cents: keep it out of your lungs.”

Lerner said physical and social barriers to vaping also need to be created.

“We can have a media campaign but we’re not going to overwhelm the impact of Hollywood stars on Letterman talking up and vaping up the value of e-cigarettes,” he said.

Contact the writer: cperkes@ocregister.com 714-796-3686