1
|
The effect of exposure to tobacco smoking-related media messages on youths' smoking behavior in Jordan: A longitudinal, school-based study. Prev Med 2023; 166:107386. [PMID: 36503015 DOI: 10.1016/j.ypmed.2022.107386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Only a few studies investigated the link between tobacco smoking-related media and youth smoking in the Eastern Mediterranean Region (EMR). This study aimed to assess the influence of both promotional and control messages on cigarette smoking behavior among young Jordanian students. Generalized Linear Mixed Models were analyzed using data from the Irbid Longitudinal Smoking Study that followed a random sample of 2174 students (2008-2011). We examined the associations of media messaging with smoking behavior, as well as intention-to-quit smoking, and intention-to-start smoking, among young adolescents. At baseline, 12.2% and 43.7% of students were exposed to only pro-smoking or only anti-smoking messages, while 41.8% were equally exposed to both. Exposure to anti-smoking messages was associated with lower odds of ever smoking at baseline among girls (AOR = 0.4; 95% CI: 0.2, 0.8). Boys who were exposed to anti-smoking messages were more likely to report an intention to quit, with borderline significance (AOR = 2.0; 95% CI: 0.9, 4.1). The cumulative exposure to anti-smoking messages over time was associated with lower odds of intention to smoke among girls (AOR = 0.5; 95% CI: 0.3, 0.9) but with higher odds among boys (AOR = 1.8; 95% CI: 1.0, 3.1). In both sexes, media messaging was not associated with progression of the smoking habit. In conclusion, this comprehensive analysis of both pro- and anti-smoking messages advances our understanding of their role in influencing youths' smoking behaviors, and could guide the development of evidence-based interventions to address adolescent tobacco smoking in Jordan and the EMR.
Collapse
|
2
|
Nian Q, Grilo G, Cohen JE, Smith KC, Reynales-Shigematsu LM, Flores Escartin MG, Moran MB. Disparities in self-reported exposure to tobacco marketing among youth and young adults from low-socioeconomic status neighbourhoods in Mexico City. Glob Public Health 2023; 18:2049346. [PMID: 35301935 DOI: 10.1080/17441692.2022.2049346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 02/11/2022] [Indexed: 11/04/2022]
Abstract
Exposure to tobacco marketing is positively associated with smoking initiation and behaviours. There is limited literature examining disparities among reported exposure in low- and middle-income countries. This study sought to fill this gap with a survey among 1427 adolescents and 889 adult smokers in Mexico City in 2020. Data were analysed using chi-square and hierarchical regression models. Two-thirds of adolescents noticed cigarette pack displays in stores. Participants from low- and mid-socioeconomic status (SES) neighbourhoods were more exposed to tobacco marketing than their counterparts through several channels. After addressing the shared variance among participants from the same household nested in neighbourhood SES level and controlling for gender, adolescent non-smokers and adult smokers who noticed pack displays were more likely to be susceptible to smoking (OR = 1.8, 95% CI 1.4-2.4) and to smoke more (OR = 1.7, 95% CI 1.21-2.47); adult smokers who noticed tobacco marketing at more places were less likely to be certain about smoking risks (OR = 0.9, 95% CI 0.8-0.9). The results suggest that the tobacco industry targets youth and individuals from low-SES neighbourhoods through several channels. Greater exposure to tobacco marketing was associated with increased susceptibility to smoking and decreased risk perception. These findings support a comprehensive ban on tobacco marketing in Mexico.
Collapse
Affiliation(s)
- Qinghua Nian
- Department of Health, Behaviour & Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Graziele Grilo
- Department of Health, Behaviour & Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Joanna E Cohen
- Department of Health, Behaviour & Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Katherine C Smith
- Department of Health, Behaviour & Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Luz Myriam Reynales-Shigematsu
- Departamento de Prevención y Control de Tabaquismo, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Maria Guadalupe Flores Escartin
- Departamento de Prevención y Control de Tabaquismo, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Meghan B Moran
- Department of Health, Behaviour & Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
3
|
Fauzi R, Arumsari I, Maruf MA, Ahsan A. Association of Tobacco Advertising, Promotion, and Sponsorship (TAPS) exposure on smoking intention and current smoking behavior among youth in Indonesia. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2120432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ridhwan Fauzi
- Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
| | - Imas Arumsari
- Faculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. Hamka, Jakarta, Indonesia
| | | | - Abdilah Ahsan
- Faculty of Economics and Business, Universitas Indonesia, Depok, Indonesia
| |
Collapse
|
4
|
Stubbs T. Commercial determinants of youth smoking in ASEAN countries: A narrative review of research investigating the influence of tobacco advertising, promotion, and sponsorship. Tob Induc Dis 2021; 19:61. [PMID: 34305507 PMCID: PMC8288466 DOI: 10.18332/tid/139124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/26/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Tobacco smoking is one of the leading causes of death and disability in the Association of Southeast Asian Nations (ASEAN). Despite implementation of some tobacco control measures, youth continue to initiate smoking. This narrative review outlines how tobacco advertising, promotion, and sponsorship (TAPS) may influence smoking attitudes and uptake among youth in the region. METHODS Nine electronic databases were searched on EBSCOhost to identify studies published up until December 2019. All studies published in English that investigated youth smoking and TAPS in ASEAN countries were included. Thematic analysis was used to investigate the influence of TAPS on youth smoking. RESULTS Thirty-seven studies were identified. This research showed that youth were exposed and receptive to tobacco advertising, which may contribute to positive attitudes towards tobacco brands and smoking. Studies also demonstrated that youth were exposed to point-of-sale (POS) advertisements or promotions and individual sales promotions. However, little research has explored how these strategies influence attitudes and consumption behaviors among youth, or, how online advertising and cigarette packet branding may influence youth smoking. CONCLUSIONS Youth in ASEAN countries continue to be exposed to TAPS, particularly through POS advertisements or promotions and individual sales promotions. There is also cause for concern about ‘below-the-line’ advertising and the increasing role of cigarette packaging as a promotional tool. These findings support calls for all ASEAN countries to ratify the Framework Convention on Tobacco Control (FCTC), introduce comprehensive bans on all forms of tobacco advertising, including POS advertising and cigarette pack displays, and implement plain packaging legislation for tobacco products.
Collapse
Affiliation(s)
- Thomas Stubbs
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| |
Collapse
|
5
|
Mishu MP, Siddiqui F, Shukla R, Kanaan M, Dogar O, Siddiqi K. Predictors of Cigarette Smoking, Smokeless Tobacco Consumption, and Use of both forms in Adolescents in South Asia: A Secondary Analysis of the Global Youth Tobacco Surveys. Nicotine Tob Res 2021; 23:956-965. [PMID: 33022045 DOI: 10.1093/ntr/ntaa202] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/29/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Tobacco uptake in adolescents is associated with a range of predictors. We examined the predictors of cigarette smoking, smokeless tobacco (ST) consumption, and use of both ST and cigarettes among adolescents in four South Asian countries. METHODS We analyzed the Global Youth Tobacco Surveys (GYTS) data for Bangladesh (2013), India (2009), Pakistan (2013), and Sri Lanka (2015), using multinomial regression to examine associations between several predictors and tobacco use. RESULTS Data from 23 681 adolescents were analyzed. Overall, 82.8% of the study population were between 13 and 15 years and 52.7% were girls, 2% were cigarette smokers, 6.5% were ST users, and 1.1% used both ST and cigarettes, in the past 30 days. Exposure to smoking in public places was associated with past 30-day smoking (relative risk ratio [RRR] 5.59, 95% confidence intervals [CI] 4.28-7.28), ST use (RRR 2.07, 95% CI 1.84-2.32), and use of both ST and cigarettes (RRR 11.42, 95% CI 7.44-17.54). Exposure to tobacco use in electronic media and being offered free tobacco products were associated with all forms of tobacco use. Shopkeepers' refusal to sell cigarettes protected adolescents from smoking (RRR 0.47, 95% CI 0.36-0.63) and ST use (RRR 0.65, 95% CI 0.45-0.95). However, exposure to antitobacco mass media messages was not protective for any form of tobacco use. Adolescents taught at school about harmful effects of tobacco were less likely to use ST; no evidence of this association was observed for smoking. CONCLUSION The associations between tobacco use and protobacco factors were strong, but the associations with antitobacco factors lacked strength and consistency in this study population. IMPLICATIONS The predictors of adolescents using different tobacco products, crucial to inform and evaluate tobacco control efforts, are poorly understood. We investigated the associations between several environmental-level factors and cigarette smoking, ST consumption, and use of both forms among adolescents, whereas most of the previous studies focused on individual-level factors. Our study found strong associations between tobacco use and protobacco factors and lack of strength and consistency in associations between antitobacco factors and tobacco use in the study population. Our results indicate that the current tobacco control policies need strengthening to curb the tobacco epidemic in these countries.
Collapse
Affiliation(s)
| | - Faraz Siddiqui
- Department of Health Science, University of York, York, UK
| | - Radha Shukla
- Department of Health Science, University of York, York, UK
| | - Mona Kanaan
- Department of Health Science, University of York, York, UK
| | - Omara Dogar
- Department of Health Science, University of York, York, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Kamran Siddiqi
- Department of Health Science, University of York, York, UK
- Centre for Health and Population Sciences, Hull York Medical School, University of York, York, UK
| |
Collapse
|
6
|
Czaplicki L, Rahman B, Simpson R, Rose SW, Liu M, Perks SN, Moran MB, Schillo BA. Going Smokeless: Promotional Features and Reach of US Smokeless Tobacco Direct-Mail Advertising (July 2017–August 2018). Nicotine Tob Res 2020; 23:1349-1357. [DOI: 10.1093/ntr/ntaa255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Although cigarette use in the United States has declined over time, smokeless tobacco (SLT) use has remained steady. Direct-mail advertising and coupon redemption have been linked to increased tobacco use, and efforts to promote SLT through direct-mail advertising may contribute to sustained SLT use. We examined reach of SLT direct-mail advertisements by recipient demographics and promotional features, including coupons.
Methods
Direct-mail data (n = 418) were acquired from Comperemedia (Mintel) and coded for product type (traditional [eg, chewing tobacco], pouched [eg, moist snuff, snus], or both [traditional SLT and any pouched SLT products]); promotions (eg, coupons); flavors; and themes (eg, masculinity). Using Mintel’s volume estimates for number of pieces sent, we calculated the proportion of mail volume sent by recipient demographics (age, income, region) and advertising features across product type.
Results
Between July 2017 and August 2018, tobacco companies sent an estimated 249 million pieces of SLT direct-mail to US households; approximately half (49.6%) featured pouched SLT products. Across product types, over 75% of mail volume was sent to 31- to 60-year-old adults and 30–40% was sent to low-income households. The majority (>70%) of pouched SLT product mail contained coupons and flavor promotions. Outdoor and blue-collar-lifestyle themes were prominent in advertisements for all product types, along with less common adventure- and fun-related appeals.
Conclusions
Coupons, flavors, and a combination of blue-collar and fun/adventure message themes were used to promote traditional and pouched SLT products through direct-mail, particularly to low-income households. Results support limits on direct-mail coupon distribution and continued surveillance of marketing appeals.
Implications
There is a long history of research into tobacco advertising practices, largely focusing on cigarettes. This study highlights specific direct-mail marketing tactics used by the tobacco industry, including coupons to promote SLT products across the United States. Given the limited success in reducing SLT use and the association between direct-mail promotions and tobacco use, these study results provide support for policies to restrict use of coupons in direct-to-consumer tobacco marketing and indicate the need for continued surveillance of direct-mail advertisements as the SLT market continues to evolve.
Collapse
Affiliation(s)
- Lauren Czaplicki
- Truth Initiative Schroeder Institute, Washington, DC
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Basmah Rahman
- Truth Initiative Schroeder Institute, Washington, DC
| | | | - Shyanika W Rose
- Center for Health Equity Transformation and Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY
| | - Michael Liu
- Truth Initiative Schroeder Institute, Washington, DC
| | | | - Meghan B Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | |
Collapse
|
7
|
Pechmann C, Phillips C, Calder D, Prochaska JJ. Facebook Recruitment Using Zip Codes to Improve Diversity in Health Research: Longitudinal Observational Study. J Med Internet Res 2020; 22:e17554. [PMID: 32501274 PMCID: PMC7305557 DOI: 10.2196/17554] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/13/2020] [Accepted: 03/29/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Facebook's advertising platform reaches most US households and has been used for health-related research recruitment. The platform allows for advertising segmentation by age, gender, and location; however, it does not explicitly allow for targeting by race or ethnicity to facilitate a diverse participant pool. OBJECTIVE This study looked at the efficacy of zip code targeting in Facebook advertising to reach blacks/African Americans and Hispanics/Latinos who smoke daily for a quit-smoking web-based social media study. METHODS We ran a general market campaign for 61 weeks using all continental US zip codes as a baseline. Concurrently, we ran 2 campaigns to reach black/African American and Hispanic-/Latino-identified adults, targeting zip codes ranked first by the percentage of households of the racial or ethnic group of interest and then by cigarette expenditure per household. We also ran a Spanish language campaign for 13 weeks, targeting all continental US zip codes but utilizing Facebook's Spanish language targeting. The advertising images and language were common across campaigns. Costs were compared for advertisement clicks, queries, applications, and participants, and yields were compared for the final three outcomes. We examined outcomes before and after the Cambridge Analytica scandal that broke in March 2018. Finally, we examined 2 promoted Facebook features: lookalike audiences and audience network placement. RESULTS Zip code targeting campaigns were effective for yielding the racial or ethnic groups of interest. The black-/African American-focused versus general market campaign increased black/African American weekly queries (mean 9.48, SD 5.69 vs general market mean 2.83, SD 2.05; P<.001) and applicants (mean 1.11, SD 1.21 vs general market mean 0.54, SD 0.58; P<.001). The Hispanic-/Latino-focused versus general market campaign increased Hispanic/Latino weekly queries (mean 3.10, SD 2.16 vs general market mean 0.71, SD 0.48; P<.001) and applicants (mean 0.36, SD 0.55 vs general market mean 0.10, SD 0.14; P=.001). Cost metrics did not differ between campaigns at generating participants (overall P=.54). Costs increased post- versus prescandal for the black-/African American-focused campaign for queries (mean US $8.51, SD 3.08 vs US $5.87, SD 1.89; P=.001) and applicants (mean US $59.64, SD 35.63 vs US $38.96, SD 28.31; P=.004) and for the Hispanic-/Latino-focused campaign for queries (mean US $9.24, SD 4.74 vs US $7.04, SD 3.39; P=.005) and applicants (mean US $61.19, SD 40.08 vs US $38.19, SD 21.20; P=.001). CONCLUSIONS Zip code targeting in Facebook advertising is an effective way to recruit diverse populations for health-based interventions. Audience network placement should be avoided. The Facebook lookalike audience may not be necessary for recruitment, with drawbacks including an unknown algorithm and unclear use of Facebook user data, and so public concerns around data privacy should be considered. TRIAL REGISTRATION ClinicalTrial.gov NCT02823028; https://clinicaltrials.gov/ct2/show/NCT02823028.
Collapse
Affiliation(s)
- Cornelia Pechmann
- Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Connor Phillips
- Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Douglas Calder
- Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| |
Collapse
|
8
|
Davis DR, Parker MA, Villanti AC, Streck JM, Priest JS, Tidey JW, Gaalema DE, Sigmon SC, Heil SH, Higgins ST. Examining Age as a Potential Moderator of Response to Reduced Nicotine Content Cigarettes in Vulnerable Populations. Nicotine Tob Res 2020; 21:S49-S55. [PMID: 31867655 PMCID: PMC6939764 DOI: 10.1093/ntr/ntz134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/30/2019] [Indexed: 01/13/2023]
Abstract
Introduction Young adults (aged 18–24 years) have a higher smoking prevalence than younger and older age groups and young adulthood is an important developmental period during which long-term behavior patterns like cigarette smoking are established. The aim of the current study was to examine how young adult smokers with additional vulnerabilities to smoking respond to reduced nicotine content cigarettes. Methods This is a secondary analysis of a double-blind, within-subject experiment conducted with 169 cigarette smokers recruited from populations with comorbid psychiatric conditions or socioeconomic disadvantage assessing acute effects of research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g). Participants were dichotomized by chronological age (18–24 vs. ≥25 years). Across 14 laboratory sessions effects of nicotine content were examined on measures of relative reinforcing efficacy (Cigarette Purchase Task [CPT] and Concurrent Choice testing), subjective effects, craving/withdrawal, and smoking topography. Repeated measures analysis of variances were used to examine potential moderating effects of age. Results Young adults exhibited lower demand for reduced nicotine content cigarettes than older adults across three of five CPT indices (ps < .05). No differences by age were observed on other measures of reinforcing efficacy, subjective effects, craving/withdrawal, or smoking topography where effects generally decreased as an orderly function of decreasing nicotine content (ps <.05). Conclusion Overall, these findings suggest that reducing the nicotine content of cigarettes would decrease the addiction potential of cigarette smoking in young adult smokers as much or perhaps more than older adult smokers from populations at increased vulnerability to smoking, addiction, and smoking-related health consequences. Implications Reducing the nicotine content in cigarettes to lower addiction potential of smoking has been proposed as a means to improve overall population health. It is imperative to examine how young adults may respond to a nicotine reduction policy. We saw minimal evidence that age moderates acute response and where there was evidence it was in the direction of reduced nicotine content cigarettes having less addictive potential among young versus older adults (eg, steeper decreases in demand for very low nicotine content cigarettes among young versus older adults). Overall, a nicotine reduction policy has the potential to reduce smoking across age groups.
Collapse
Affiliation(s)
- Danielle R Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.,Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
| | - Maria A Parker
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
| | - Andrea C Villanti
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| | - Joanna M Streck
- Harvard Medical School/Massachusetts General Hospital, Department of Psychiatry, Boston, MA
| | - Jeff S Priest
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| | - Stacey C Sigmon
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| | - Sarah H Heil
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| | - Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
| |
Collapse
|
9
|
Escobedo P, Tsai KY, Majmundar A, Allem JP, Soto DW, Pattarroyo M, Unger JB, Cruz TB. Do tobacco industry websites target content to specific demographic groups? Drug Alcohol Depend 2020; 208:107852. [PMID: 31991328 PMCID: PMC7039770 DOI: 10.1016/j.drugalcdep.2020.107852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prior research has not examined whether tobacco brand websites vary content based on audience demographics. This study explored whether marketing content on tobacco brand websites varied by user ethnicity, gender or age group. METHODS Participants (n = 32) were adult smokers, representing equal numbers of eight demographic groups: user ethnicity (Non-Hispanic White, Hispanic, African American, Asian), gender (women, men) and age (age 21-35, age 36+). This study examined 12 tobacco brand websites representing four tobacco product categories (cigarettes, cigar/cigarillos, smokeless tobacco, and e-cigarettes). From January 2016 to January 2017, participants coded websites for themes, interactive activities, and links to social media sites (n = 874 website visits). Logistic regression was used to analyze observed content by participant ethnicity, age and gender. RESULTS All themes, all interactive activities and all links to social media were observed at least once for each demographic category. Male participants were more likely to observe Harm reduction themes, while female participants were more likely to observe Promotion themes. Older participants were more likely to observe website features allowing them to select music, and request coupons. Compared to Non-Hispanic White participants, African American participants were more likely to observe links to social media sites. CONCLUSION Tobacco brand website content varied across ethnic, age and gender groups. These findings suggest that other factors, such as tobacco use behaviors, may influence marketing strategies participants recall or find appealing. The findings from this study can inform future regulatory activities and communication strategies aimed at countering pro-tobacco content online.
Collapse
Affiliation(s)
- Patricia Escobedo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Kai-Ya Tsai
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anuja Majmundar
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jon-Patrick Allem
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel W. Soto
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Monica Pattarroyo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
10
|
Cho SM, Saw YM, Latt NN, Saw TN, Htet H, Khaing M, Than TM, Win EM, Aung ZZ, Kariya T, Yamamoto E, Hamajima N. Cross-sectional study on tobacco advertising, promotion and sponsorship (TAPS) and violations of tobacco sale regulations in Myanmar: do these factors affect current tobacco use among Myanmar high school students? BMJ Open 2020; 10:e031933. [PMID: 32054624 PMCID: PMC7045140 DOI: 10.1136/bmjopen-2019-031933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the associations of current tobacco use with tobacco advertising, promotion and sponsorship (TAPS), and illicit tobacco sales exposures among Myanmar high school students. DESIGN A quantitative, cross-sectional study. SETTING Seven high schools from both urban and rural areas of four states and regions in Myanmar. PARTICIPANTS In total, 1174 high school students (482 males and 692 females) were interviewed using a self-administered questionnaire. MAIN OUTCOME MEASURE Current tobacco use of participants, defined as using any kind of smoked or smokeless tobacco product at least one occasion within the past 30 days. RESULTS The prevalence of TAPS exposure was 90.9% among high school students in Myanmar. Current tobacco use was positively associated with being over 14 years old (adjusted OR (AOR) 9.81; 95% CI 4.54 to 21.19), being male (AOR 28.06; 95% CI 13.29 to 59.25), exposure to any kind of TAPS (AOR 6.59; 95% CI 2.33 to 18.64), having seen any smoked tobacco product for sale inside or within 100 feet of the school premises (AOR 4.17; 95% CI 1.65 to 10.58), having seen the sale or gifting of any smoked tobacco product to minors (AOR 6.46; 95% CI 2.18 to 19.12) and having seen the sale or distribution of any smoked tobacco product by minors (AOR 2.42; 95% CI 1.42 to 4.10). Having ever received health education about tobacco use (AOR 0.45; 95% CI 0.27 to 0.78), or having a higher perception score of tobacco use (AOR 0.17; 95% CI 0.10 to 0.30) were negatively associated with current tobacco use. CONCLUSIONS There was an alarming prevalence of TAPS exposure among Myanmar high school students. TAPS exposure and violations of tobacco sale regulations were strong risk factors for current tobacco use among Myanmar high school students, while health education about tobacco products was reported as an effective protective factor. Specific smokeless tobacco sale regulations for minors are needed immediately in Myanmar.
Collapse
Affiliation(s)
- Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Nyi Nyi Latt
- Aung Myin Myint Mo Hospital, Gyobingauk, Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hein Htet
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Moe Khaing
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thet Mon Than
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Medical Services, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Ei Mon Win
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Zaw Zaw Aung
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
11
|
Donaldson EA, Robinson JN, Nguyen Zarndt A. Association between free tobacco product sample receipt and tobacco use in youth and adults in the PATH Study, 2014-2016. Prev Med 2020; 131:105951. [PMID: 31816358 PMCID: PMC10542903 DOI: 10.1016/j.ypmed.2019.105951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/15/2019] [Accepted: 11/30/2019] [Indexed: 11/25/2022]
Abstract
Tobacco companies have distributed free samples of tobacco products in the past. While prior studies have found a relationship between various marketing strategies and tobacco use, no study has assessed the prevalence of free sample receipt or the relationship between receipt and subsequent tobacco use. We analyze three waves of Population Assessment of Tobacco and Health (PATH) Study data to provide the first nationally representative prevalence estimates of free tobacco product receipt among US youth and adults in 2014 to 2016. This analysis also examines the relationship between free tobacco product receipt and ever, past 30-day, and new tobacco use one year later. The prevalence of free sample receipt in the US population in 2014-2016 was 0.8% for any tobacco product but 1.6% for ENDS/e-liquid in adults, and 0.5% for any tobacco product but 1.05% for ENDS/e-liquid in youth. Free sample receipt was higher among vulnerable subgroups. Receipt of free tobacco product samples was associated with tobacco use status using cross-sectional data in youth and adults, as well as one year later in youth. Receipt of a free ENDS or e-liquid sample was associated with any tobacco and ENDS use status using cross-sectional data in youth and adults. After these data were collected, the US Food and Drug Administration broadened the ban on distributing free samples to include all tobacco products except smokeless tobacco in adult-only facilities. Our findings support limiting free samples to further prevent youth access to tobacco products.
Collapse
Affiliation(s)
- Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA.
| | - Joelle N Robinson
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Anh Nguyen Zarndt
- Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| |
Collapse
|
12
|
Escobedo P, Cruz TB, Tsai KY, Allem JP, Soto DW, Kirkpatrick MG, Pattarroyo M, Unger JB. Monitoring Tobacco Brand Websites to Understand Marketing Strategies Aimed at Tobacco Product Users and Potential Users. Nicotine Tob Res 2019; 20:1393-1400. [PMID: 29059386 DOI: 10.1093/ntr/ntx200] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 09/05/2017] [Indexed: 11/13/2022]
Abstract
Introduction Limited information exists about strategies and methods used on brand marketing websites to transmit pro-tobacco messages to tobacco users and potential users. This study compared age verification methods, themes, interactive activities and links to social media across tobacco brand websites. Methods This study examined 12 tobacco brand websites representing four tobacco product categories: cigarettes, cigar/cigarillos, smokeless tobacco, and e-cigarettes. Website content was analyzed by tobacco product category and data from all website visits (n = 699) were analyzed. Adult smokers (n = 32) coded websites during a one-year period, indicating whether or not they observed any of 53 marketing themes, seven interactive activities, or five external links to social media sites. Results Most (58%) websites required online registration before entering, however e-cigarette websites used click-through age verification. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature themes related to "party" lifestyle, and e-cigarette websites were much more likely to feature themes related to harm reduction. Cigarette sites featured greater levels of interactive content compared to other tobacco products. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature activities related to events and music. Compared to cigarette sites, both cigar and e-cigarette sites were more likely to direct visitors to external social media sites. Conclusion Marketing methods and strategies normalize tobacco use by providing website visitors with positive themes combined with interactive content, and is an area of future research. Moreover, all tobacco products under federal regulatory authority should be required to use more stringent age verification gates. Implications Findings indicate that the Food and Drug Administration (FDA) should require brand websites of all tobacco products under its regulatory authority use more stringent age verification gates by requiring all visitors be at least 18 years of age and register online prior to entry. This is important given that marketing strategies may encourage experimentation with tobacco or deter quit attempts among website visitors. Future research should examine the use of interactive activities and social media on a wide variety of tobacco brand websites as interactive content is associated with more active information processing.
Collapse
Affiliation(s)
- Patricia Escobedo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kai-Ya Tsai
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jon-Patrick Allem
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Daniel W Soto
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Matthew G Kirkpatrick
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Monica Pattarroyo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jennifer B Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| |
Collapse
|
13
|
Cruz TB, Rose SW, Lienemann BA, Byron MJ, Meissner HI, Baezconde-Garbanati L, Huang LL, Carroll DM, Soto C, Unger JB. Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature. Tob Induc Dis 2019; 17:68. [PMID: 31582956 PMCID: PMC6770621 DOI: 10.18332/tid/111397] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION We reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups. METHODS Five journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004-2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group. RESULTS There were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results. CONCLUSIONS We found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies.
Collapse
Affiliation(s)
- Tess Boley Cruz
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Shyanika W Rose
- Truth Initiative Schroeder Institute, Washington, United States.,Center for Health Equity Transformation and Behavioral Science, University of Kentucky College of Medicine, Lexington, United States
| | - Brianna A Lienemann
- Keck School of Medicine, University of Southern California, Los Angeles, United States.,Moores Cancer Center, University of California San Diego, San Diego, United States
| | - M Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Helen I Meissner
- Office of Disease Prevention, National Institutes of Health, Bethesda, United States
| | | | - Li-Ling Huang
- Global Health and Health Security, Taipei Medical University, Taipei, Taiwan
| | - Dana M Carroll
- Masonic Cancer Center, University of Minnesota, Minneapolis, United States
| | - Claradina Soto
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Jennifer B Unger
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| |
Collapse
|
14
|
Osman A, Queen T, Choi K, Goldstein AO. Receipt of direct tobacco mail/email coupons and coupon redemption: Demographic and socioeconomic disparities among adult smokers in the United States. Prev Med 2019; 126:105778. [PMID: 31323282 PMCID: PMC6717625 DOI: 10.1016/j.ypmed.2019.105778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
Abstract
A key marketing strategy used by tobacco companies to lower tobacco product prices is the distribution of tobacco coupons via direct marketing channels such as mail or email. We analyzed data on adult smokers from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (n = 10,994) to examine the prevalence and correlates of coupon receipt via both channels, and associations with cigarette coupon redemption. Overall, 22% and 32% of smokers received tobacco coupons via email and mail, respectively, and 22% redeemed cigarette coupons. White, 25-44 year old, female, sexual minority, and more nicotine dependent smokers were more likely to receive coupons via both channels and to redeem coupons, as were smokers with mid-levels education (GED to associate degree) and those unable to pay important bills (OR email receipt = 1.37, 95% CI 1.22-1.54; OR mail receipt = 1.38, 95% CI 1.24-1.55; and OR coupon redemption = 1.44, 95% CI 1.26-1.64). Smokers who received coupons via mail only or via both channels, had three times (OR = 2.97, 95% CI 2.31-3.83) and five times (OR = 4.56, 95% CI 3.61-5.76) higher odds to redeem cigarette coupons compared to those who received them via email only. Major demographic and socioeconomic disparities exist in receipt and redemption of direct email\mail tobacco coupons among US smokers. Cigarette coupons received via direct mail are more likely to be redeemed than coupons received via email. Restrictions on tobacco coupon redemption, implemented jointly with increasing access to affordable cessation resources, may incentivize smokers vulnerable to tobacco marketing tactics to quit.
Collapse
Affiliation(s)
- Amira Osman
- School of Nursing, Zefat Academic College, Zefat, Israel; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Tara Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - Adam O Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
15
|
Kreitzberg DS, Hinds JT, Pasch KE, Loukas A, Perry CL. Exposure to ENDS advertising and use of marijuana in ENDS among college students. Addict Behav 2019; 93:9-13. [PMID: 30677567 DOI: 10.1016/j.addbeh.2019.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/04/2018] [Accepted: 01/14/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Factors associated with marijuana use in electronic nicotine delivery systems (ENDS) are largely unknown. ENDS advertising, through subtle normative cues as well as explicit and implicit messages suggesting ENDS products are socially condoned and healthier alternatives, may influence the use of marijuana in ENDS. The aim of our study was to examine the association between exposure to ENDS advertising and subsequent use of ENDS with marijuana among college students. METHODS Data for this study were from waves 2 and 4 of the Marketing and Promotions across Colleges in Texas (M-PACT) study. Participants included 3720 college students (mean age = 21.4, SD = 2.3; 35.78% white; 35.7% male) across 24 colleges in Texas who completed online tobacco behavior surveys one year apart. Multilevel logistic regression was conducted to examine the association between ENDS advertising exposure at wave 2 (spring 2015) and use of marijuana in ENDS one year later at wave 4 (spring 2016), controlling for age, sex, race/ethnicity, and wave 2 sensation-seeking, impulsivity, current tobacco use, current marijuana use, and ever use of ENDS with marijuana. Use of ENDS to consume marijuana in the past six months was the outcome variable and ENDS advertising exposure was the independent variable. RESULTS Nearly half of participants reported ever ENDS use at waves 2 and 4, and 10% used marijuana in ENDS in the past 6-months at wave 4. Multilevel logistic regression analyses indicated that for every unit increase in ENDS advertising exposure, the odds of subsequently using ENDS with marijuana one year later were 1.08 times (95% CI = 1.01-1.14) greater. CONCLUSIONS ENDS advertising uniquely contributed to the subsequent use of marijuana in an ENDS, over and above the effects of other risk factors.
Collapse
|
16
|
Abdel Magid HS, Bradshaw PT, Ling PM, Halpern-Felsher B. Association of Alternative Tobacco Product Initiation With Ownership of Tobacco Promotional Materials Among Adolescents and Young Adults. JAMA Netw Open 2019; 2:e194006. [PMID: 31099874 PMCID: PMC6537923 DOI: 10.1001/jamanetworkopen.2019.4006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
IMPORTANCE Use of alternative tobacco products (ATPs) such as electronic cigarettes, chewing tobacco, pipes, cigars, cigarillos, little cigars, and hookah is rapidly increasing. Although marketing restrictions exist for cigarettes, marketing of ATPs is not yet fully regulated, and studies have not assessed the association between ownership of ATP promotional materials and subsequent ATP or cigarette initiation among adolescents and young adults. OBJECTIVE To estimate the association between marketing receptivity measured at baseline and ATP and any tobacco initiation 1 year later, including cigarettes, among adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS Longitudinal cohort study of adolescents and young adults aged 13 to 19 years recruited at high schools in California from July 2014 to October 2015, with follow-up 1 year later. Data were analyzed from January to March 2018. EXPOSURES Ownership of ATP-specific promotional material and ownership of any tobacco promotional materials (eg, samples, coupons, branded caps, t-shirts, or posters) assessed in wave 1. MAIN OUTCOMES AND MEASURES Outcomes were (1) ATP initiation and (2) either ATP or cigarette initiation in wave 2. RESULTS Of 757 participants (mean [SD] age at wave 1, 16.1 [1.1] years; 481 [63.5%] female; 166 [21.9%] Asian or Pacific Islander, 202 [26.7%] white, and 276 [36.4%] Latino), 129 (17.0%) initiated ATP use and 141 (18.6%) initiated ATP or cigarette use 1 year later. In unadjusted models, wave 2 ATP initiation was found to be significantly associated with wave 1 ownership of ATP promotional materials (odds ratio, 2.23; 95% CI, 1.26-3.97). After adjustment for wave 1 demographic covariates, the association between ownership of ATP promotional material and ATP initiation 1 year later yielded similar results (odds ratio, 2.13; 95% CI, 1.16-3.91). Results of models assessing a combined outcome variable of either ATP or cigarette ever use were not statistically significant. CONCLUSIONS AND RELEVANCE Ownership of ATP promotional materials was associated with subsequent initiation of ATPs. The results of this study are consistent with the suggestion that current marketing restrictions for cigarettes, including restrictions of the distribution of samples, coupons, and other promotional material, should extend to ATPs.
Collapse
Affiliation(s)
- Hoda S. Abdel Magid
- Division of Epidemiology, Department of Health Research and Policy, Stanford University, Palo Alto, California
| | - Patrick T. Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California
| |
Collapse
|
17
|
Corrective Statements from the Tobacco Industry: More Evidence for Why We Need Effective Tobacco Control. Ann Am Thorac Soc 2019; 15:127-130. [PMID: 29140104 DOI: 10.1513/annalsats.201711-845gh] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
18
|
Choi K, Soneji S, Tan ASL. Receipt of Tobacco Direct Mail Coupons and Changes in Smoking Status in a Nationally Representative Sample of US Adults. Nicotine Tob Res 2018; 20:1095-1100. [PMID: 30124987 PMCID: PMC6093365 DOI: 10.1093/ntr/ntx141] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 06/20/2017] [Indexed: 11/15/2022]
Abstract
Introduction Direct-to-consumer tobacco marketing, including direct mail and email coupons, is a potentially influential marketing strategy. We examined the associations between receipt of tobacco direct mail/email coupons and trajectories of smoking behavior among US adults. Methods Data were from the US Population Assessment on Tobacco and Health (PATH) Study adult sample (n = 32160) collected during 2013-2014. Participants self-reported their smoking status (every day, some days, not at all) 12 months prior to the survey (T0) and at the time of the survey (T1). Three smoking trajectories were identified: nonsmokers progressing to current smokers, current smokers continuing to smoke, and among current smokers at T0, progressing to or continuing with daily smoking. Participants also reported receipt of direct mail/email tobacco coupons in the 6 months preceding T1 (yes/no). Weighted multiple logistic regression models were used to test the associations between receiving direct mail/email tobacco coupons and different smoking trajectories adjusted for demographic characteristics. Results One in eight (12.4%) US adult nonsmokers and 36.2% adult smokers at T0 reported receiving tobacco coupons. Receipt of tobacco coupons was negatively associated with poverty status. Receipt of tobacco coupons was associated with increased odds of progression to current smoking (AOR = 1.76, 95% CI = 1.45 to 2.12), continuation of smoking (AOR = 1.34, 95% CI = 1.09 to 1.65), and current smokers' progression to or continuation with daily smoking (AOR = 1.70, 95% CI = 1.50 to 1.91). Conclusions Direct-to-consumer tobacco coupons may promote progression of smoking among nonsmokers, and continuation of smoking and progression to daily smoking among smokers in US adults. Implications Distributing direct mail coupons is a strategy employed by tobacco companies to promote their products. We found, in a US national study, that many adults received tobacco coupons, and receiving these coupons was associated with subsequent progression of smoking among nonsmokers, and continuation of smoking and daily smoking among smokers. Scrutiny over the use of direct mail coupons and its effects on population health is warranted. Future research is needed to evaluate the effect of different interventions to reduce the impact of these coupons on smoking behaviors.
Collapse
Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Samir Soneji
- The Dartmouth Institute for Health Policy & Clinical Evaluation, Dartmouth College, Lebanon, New Hampshire, USA
| | - Andy S L Tan
- Dana Farber Cancer Institute, McGraw-Patterson Division of Population Sciences, Center for Community-Based Research
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts, USA
| |
Collapse
|
19
|
Cantrell J, Bennett M, Mowery P, Xiao H, Rath J, Hair E, Vallone D. Patterns in first and daily cigarette initiation among youth and young adults from 2002 to 2015. PLoS One 2018; 13:e0200827. [PMID: 30096141 PMCID: PMC6086419 DOI: 10.1371/journal.pone.0200827] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 07/03/2018] [Indexed: 11/19/2022] Open
Abstract
This study’s objective was to describe long-term trends and patterns in first cigarette use (cigarette initiation) and daily cigarette use (daily initiation) among youth and young adults in the U.S. We used cross-sectional survey data from the National Survey on Drug Use and Health, 2002–2015, to estimate annual incidence of first cigarette use (N = 270,556) and first daily cigarette use (N = 373,464) for each year by age groups, race/ethnicity and gender, examining trends over time and the average annual change in initiation for each group. Several clear patterns emerged: 1) cigarette initiation and daily initiation significantly decreased over time among those aged 12–14 and 15–17 and these trends were consistent among nearly all racial/ethnic and gender subgroups; 2) among 18–21 year olds, cigarette initiation sharply increased through 2009, surpassing rates among 15–17 year olds, and sharply declined through 2015 while remaining higher than rates among the younger group, and this trend was consistent for almost all racial/ethnic subgroups; 3) daily initiation for those aged 18–21 significantly declined, and this was significant among most subgroups 4) there was no change in cigarette initiation and daily initiation for 22–25 year olds overall and most subgroups; 5) there was a significant increase in cigarette initiation for 22–25 year old Hispanics males and daily initiation for 22–25 year old males. This study provides a comprehensive look at trends in cigarette and daily initiation among U.S. youth and young adults. Despite notable declines in smoking initiation among youth and young adult populations over the last two decades, targeted prevention and policy efforts are needed for subgroups at higher risk, including young adults and Hispanic males.
Collapse
Affiliation(s)
- Jennifer Cantrell
- College of Global Public Health, New York University, New York, NY, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- * E-mail:
| | - Morgane Bennett
- Schroeder Institute at Truth Initiative, Washington, DC, United States of America
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America
| | - Paul Mowery
- Biostatistics, Inc., Atlanta, GA, United States of America
| | - Haijun Xiao
- Schroeder Institute at Truth Initiative, Washington, DC, United States of America
| | - Jessica Rath
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Schroeder Institute at Truth Initiative, Washington, DC, United States of America
| | - Elizabeth Hair
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Schroeder Institute at Truth Initiative, Washington, DC, United States of America
| | - Donna Vallone
- College of Global Public Health, New York University, New York, NY, United States of America
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Schroeder Institute at Truth Initiative, Washington, DC, United States of America
| |
Collapse
|
20
|
Becker SJ, Helseth SA, Frank HE, Escobar K, Weeks B. Parent Preferences and Experiences with Psychological Treatment: Results from a Direct-to- Consumer Survey using the Marketing Mix Framework. PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE 2018; 49:167-176. [PMID: 30237655 PMCID: PMC6141043 DOI: 10.1037/pro0000186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Direct-to-consumer (DTC) marketing strategies represent an increasingly popular approach to promote patient awareness of psychological treatments (PTs). The Marketing Mix is a well-established framework used to inform marketing decisions consisting of four "P's": Product (or Service), Promotion, Place, and Price. We conducted the first DTC marketing survey using the Marketing Mix framework to explore how parents concerned about their adolescents' behavioral health receive information about PTs. A sample of 411 parents (51% girls, 82% Non-Hispanic White) of 12- to 19-year-old adolescents completed an online survey asking how they would prefer to receive information about PTs, including five questions spanning the Promotion, Price, and Place dimensions of The Marketing Mix. A subsample of 158 parents also reported on how they had received PT information during their adolescent's most recent therapy experience, allowing us to compare ideal versus actual therapy experiences. We explored the extent to which experiences varied as a function of parent race/ethnicity, income per capita, parent education level, and adolescent treatment history. Bivariate analyses and multivariate logistic regressions were used to examine which of these variables were associated with parents' responses to specific survey items. Analyses revealed that parent preferences varied as a function of income per capita, education level, and history of treatment. In addition, there were significant gaps between parents' ideal and most recent therapy experiences. Implications for the marketing of PTs are discussed.
Collapse
|
21
|
Lewis MJ, Zimmermann MH, Delnevo CD, Steinberg MB. Evaluating receipt of and inability to discontinue tobacco industry direct mail. Tob Control 2018; 27:e65. [PMID: 29588391 DOI: 10.1136/tobaccocontrol-2017-054182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/21/2018] [Accepted: 03/02/2018] [Indexed: 11/04/2022]
Affiliation(s)
- M Jane Lewis
- Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Mia Hanos Zimmermann
- Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, New Brunswick, New Jersey, USA
| | - Michael B Steinberg
- Division of General Internal Medicine, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| |
Collapse
|
22
|
Becker SJ, Weeks BJ, Escobar KI, Moreno O, DeMarco CR, Gresko SA. Impressions of "Evidence-Based Practice": A Direct-to-Consumer Survey of Caregivers Concerned about Adolescent Substance Use. ACTA ACUST UNITED AC 2018; 3:70-80. [PMID: 30984870 DOI: 10.1080/23794925.2018.1429228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
National behavioral health organizations have recently started using direct-to-consumer (DTC) marketing strategies as a means of promoting increased utilization of evidence-based practice (EBP). Such strategies often encourage patients and caregivers to proactively seek out EBP, based on the assumptions that patients and caregivers understand the concept and view it favorably. We conducted a DTC marketing survey of caregivers concerned about their adolescents' substance use in order to explore how these caregivers define, value, and prefer to describe the EBP concept. We also examined whether caregiver perceptions of EBP vary by socio-demographic (race/ethnicity, income per capital, education level) and clinical (adolescent's history of therapy) characteristics. A total of 411 caregivers (86% women, 88% Non-Hispanic White) of adolescents age 12 to 19 (M age = 16.1, SD = 1.8, 82% Non-Hispanic White) completed an online survey. Caregivers answered a series of questions evaluating assumed definitions of EBP, underlying EBP principles, the appeal of EBP, and alternate terms to describe EBP. Chi-square analyses and multivariate logistic regressions were used to examine which variables were associated with the greatest likelihood of response selection. Results indicated that most parents defined EBP correctly, valued EBP principles, and found EBP appealing. However, caregivers from racial/ethnic minority groups, with lower income per capita, and lower education were more likely to define EBP incorrectly and have negative impressions of the concept. Education level was the strongest and most consistent predictor of caregiver perceptions. Clinical implications for the development of targeted, accessible marketing messages are discussed.
Collapse
Affiliation(s)
- Sara J Becker
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Brittany J Weeks
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Katherine I Escobar
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Oswaldo Moreno
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Cathryn R DeMarco
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Shelly A Gresko
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
23
|
Rose SW, Glasser AM, Zhou Y, Cruz TB, Cohn AM, Lienemann BA, Byron MJ, Huang LL, Meissner HI, Baezconde-Garbanati L, Unger JB. Adolescent tobacco coupon receipt, vulnerability characteristics and subsequent tobacco use: analysis of PATH Study, Waves 1 and 2. Tob Control 2018; 27:e50-e56. [PMID: 29472444 DOI: 10.1136/tobaccocontrol-2017-054141] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/12/2018] [Accepted: 02/07/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examine adolescent receipt of tobacco coupons and subsequent tobacco use. METHODS Data were from the Population Assessment of Tobacco and Health (PATH) Study (2013-2015). We identified correlates of coupon receipt at Wave 1 (youth sample age 12-17 ; n = 13 651) including demographics, additional vulnerability factors that may place youth at risk of tobacco use and correlates of coupon receipt by channel. We examined associations of Wave 1 coupon receipt with Wave 2 tobacco use using weighted multivariable models. RESULTS Overall, 7.6% of US youth received tobacco coupons in the 6 months before Wave 1. Coupon recipients were more likely to be women, living outside urban areas, living with a tobacco user, current and former (vs never) tobacco users, having high internalising mental health symptoms and having a favourite tobacco advertisement. Coupons were received primarily through direct mail (56%), product packs (28%) and online (25%). Never tobacco users at Wave 1 who received coupons were more likely to be ever users at Wave 2 (adjusted OR (aOR)=1.42; 95% CI 1.06 to 1.91). Coupon recipients were more likely to use a new tobacco product between waves (aOR=1.67; 95% CI 1.18 to 2.36) and report past 30-day tobacco use at Wave 2 (aOR=1.81; 95% CI 1.31 to 2.49). CONCLUSIONS One in 13 US youth (7.6%) received coupons. Vulnerable youth had the greatest odds of coupon receipt. Coupon recipients had greater odds of tobacco use among never users, trying a new tobacco product and current use. Coupon bans, limits on youth coupon exposure, stronger age verification, pack inserts or restricting coupon redemption may help reduce tobacco use among adolescents, particularly for those at greatest risk.
Collapse
Affiliation(s)
- Shyanika W Rose
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
| | - Allison M Glasser
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
| | - Yitong Zhou
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
| | - Tess Boley Cruz
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Amy M Cohn
- Battelle Memorial Institute, Arlington, Virginia, USA.,Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Brianna A Lienemann
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - M Justin Byron
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Li-Ling Huang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Master Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan.,Tobacco Regulatory Science Program, National Institutes of Health, Bethesda, Maryland, USA
| | - Helen I Meissner
- Master Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan.,Tobacco Regulatory Science Program, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Jennifer B Unger
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
24
|
Abstract
Objectives We used ecological momentary assessment (EMA) to examine young adults' attitudes towards pro-tobacco messages encountered in real time and their association with intentions to use tobacco. Methods Young adults (N = 92, ages 18-29) recorded sightings of marketing or social media related to tobacco in real time via mobile app for 28 days. Participants reported message characteristics, their attitudes towards the message, and intentions to use the depicted product for each submission. We used generalized linear mixed models to examine factors related to attitude towards message and intentions to use tobacco. Results Messages depicting e-cigarettes (p < .001) or hookah (p < .05) were associated with significantly more favorable attitudes compared with traditional cigarettes. Positive attitude towards the message was significantly associated with intention to use the depicted product (p < .001). Messages depicting e-cigarettes and hookah were significantly associated with higher intention to use. Message source was not significantly related to attitudes towards the message or product use intentions. Conclusions Marketing featuring e-cigarettes and hookah is an important target for future regulation. Given that pro-tobacco and e-cigarette messages are prevalent online, future research should consider the Internet and social media as important venues for counter-marketing and intervention efforts.
Collapse
|
25
|
Cavazos-Rehg PA, Krauss MJ, Sowles SJ, Bierut LJ. Marijuana-Related Posts on Instagram. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 17:710-20. [PMID: 27262456 DOI: 10.1007/s11121-016-0669-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use.
Collapse
Affiliation(s)
- Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA.
| | - Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Shaina J Sowles
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| |
Collapse
|
26
|
Rose SW, Anesetti-Rothermel A, Elmasry H, Niaura R. Young adult non-smokers' exposure to real-world tobacco marketing: results of an ecological momentary assessment pilot study. BMC Res Notes 2017; 10:435. [PMID: 28859667 PMCID: PMC5580291 DOI: 10.1186/s13104-017-2758-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/23/2017] [Indexed: 11/18/2022] Open
Abstract
Background The aims of this pilot study were to assess and characterize non-current smoking young adults’ exposure to tobacco marketing through an ecological momentary assessment protocol. Methods Ecological momentary assessment (EMA) consists of repeated measurement of momentary phenomena and is well-suited to capture sporadic experiences in the real-world, such as exposure to tobacco marketing. EMA has the potential to capture detailed information about real-world marketing exposures in ways that reduce recall bias and increase ecological validity. In this study, young adults (n = 31; ages 18–25) responded to random prompts regarding their momentary exposure to tobacco marketing via text messages on their smartphones for 14 days (n = 1798 observations). Unadjusted and adjusted analyses were conducted using multilevel logistic regression to assess the odds of exposure accounting for correlation of multiple repeated measures within individuals while controlling for variability between individuals. Results Respondents reported, on average, two momentary exposures to tobacco advertising in the 14-day study period. In adjusted analyses, African–American (aOR 3.36; 95% CI 1.07, 10.54) and Hispanic respondents (aOR 5.08; 95% CI 1.28, 20.13) were more likely to report exposure to tobacco advertising. Respondents were also more likely to report exposure when also exposed to others using tobacco products and when they were at stores compared with at home (aOR 14.82; 95% CI 3.61, 60.88). Conclusion Non-smoking young adults report exposure to tobacco marketing particularly at the point-of-sale, with the highest likelihood of exposure among African-American and Hispanic young people. EMA protocols can be effective in assessing the potential impact of point-of-sale tobacco marketing on young adults. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2758-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shyanika W Rose
- Schroeder Institute at Truth Initiative, Washington, DC, USA.
| | | | - Hoda Elmasry
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Ray Niaura
- Schroeder Institute at Truth Initiative, Washington, DC, USA.,College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
27
|
Owotomo O, Maslowsky J, Pasch KE. Historical declines and disparities in cigarette coupon saving among adolescents in the United States, 1997-2013. Prev Med 2017; 100:61-66. [PMID: 28392251 PMCID: PMC5480368 DOI: 10.1016/j.ypmed.2017.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/13/2017] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
Exposure to cigarette coupons is associated with smoking initiation and likelihood of cigarette purchase among adolescents. Some adolescents who are exposed to cigarette coupons take a step further by choosing to save or collect these coupons, a further risk factor for cigarette smoking. This study examines historical trends and disparities in cigarette coupon saving among adolescents in the United States from 1997 to 2013. National samples of 10th and 12th grade students (n=129,111) were obtained from Monitoring the Future surveys in 1997-2013. Prevalence of lifetime and current cigarette coupon saving was estimated in each year in the overall adolescent population, and in race/ethnicity, parent education level, sex, and urban/rural subgroups. Prevalence of lifetime and current cigarette coupon saving was then estimated in each year based on smoking status. Prevalence of cigarette coupon saving has decreased dramatically among adolescents; only 1.2% reported currently saving coupons in 2013. However, disparities in cigarette coupon saving remain with prevalence higher among rural, White, and low parental education level students. Adolescent smokers continue to save coupons at high rates; 21.2% had ever saved coupons and 6.9% currently saved coupons as of 2013. Despite overall declines in adolescent cigarette coupon saving, existing sociodemographic disparities and the considerably high prevalence of coupon saving among adolescent smokers suggest that cigarette coupons remain a threat to smoking prevention among youth. Additional research is needed to further elucidate longitudinal associations between cigarette coupon saving and smoking initiation and maintenance among adolescents.
Collapse
Affiliation(s)
- Olusegun Owotomo
- Department of Kinesiology & Health Education, University of Texas at Austin, TX, USA
| | - Julie Maslowsky
- Department of Kinesiology & Health Education, Population Research Center, University of Texas at Austin, TX, USA.
| | - Keryn E Pasch
- Department of Kinesiology & Health Education, University of Texas at Austin, TX, USA
| |
Collapse
|
28
|
Choi K, Taylor N, Forster J. Sources and Number of Coupons for Cigarettes and Snus Received by a Cohort of Young Adults. Am J Health Promot 2017; 32:153-160. [PMID: 29214838 DOI: 10.1177/0890117116686887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the sources of tobacco coupons and their influence on susceptibility to snus use. DESIGN Cohort study. SETTING Minnesota Adolescent Community Cohort Study. SUBJECTS A population-based sample of US Midwest young adults in 2011 to 2012 and 2012 to 2013 (aged 22-28; n = 2384). MEASURES Exposure to coupons for various tobacco products through various sources in the past 6 months, susceptibility to snus use. ANALYSIS Multiple logistic regressions. RESULTS During the 6 months prior to 2012 to 2013 survey, 11% of the sample received coupons for cigarettes, 5% received coupons for snus, 3% received coupons for other smokeless tobacco products, and <1% received coupons for little cigars. Direct mail was the most commonly cited source of cigarette and snus coupons. Tobacco product packaging provided the highest number of tobacco coupons for current and former smokers. Participants without a 4-year college education (compared to those who had a 4-year college education) were more likely to have received coupons for cigarettes and snus and received more coupons for both products ( P < .05). Racial/ethnic minority young adults (vs non-Hispanic white) received more cigarette and snus coupons ( P < .05). Receiving snus coupons was positively associated with susceptibility to snus use ( P < .05). CONCLUSION Tobacco companies are successful in reaching young adults using coupons for various tobacco products. Snus coupons may influence snus use, similar to how cigarette coupons influence smoking.
Collapse
Affiliation(s)
- Kelvin Choi
- 1 Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Naomi Taylor
- 2 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jean Forster
- 2 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
29
|
Abstract
OBJECTIVE Restricting tobacco marketing is a key element in the US Food and Drug Administration's (FDA) public health framework for regulating tobacco. Given the dearth of empirical data on direct marketing, the objective of this study was to assess the reach and impact of promotions on sales through snuff websites. METHODS Nine brands of snuff, representing more than 90% of market share, were monitored for content of coupons, sweepstakes, contests, and other promotions on their respective websites. Monthly sales data and website traffic for the 9 brands, corresponding to the 48-month period of January 2011 through December 2014, were obtained from proprietary sources. A time-series analysis, based on the autoregressive, integrated, moving average (ARIMA) method, was employed for testing the relationships among sales, website visits, and promotions. RESULTS Website traffic increased substantially during the promotion periods for most brands. Time-series analyses, however, revealed that promotion periods for 5 of 7 brands did not significantly correlate with monthly snuff sales. CONCLUSIONS The success in attracting tobacco consumers to website promotions demonstrates the marketing reach of snuff manufacturers. This form of direct marketing should be monitored by the FDA given evidence of adolescents' exposure to cigarette brand websites.
Collapse
|
30
|
Brock B, Carlson SC, Moilanen M, Schillo BA. Reaching consumers: How the tobacco industry uses email marketing. Prev Med Rep 2016; 4:103-6. [PMID: 27413669 PMCID: PMC4929071 DOI: 10.1016/j.pmedr.2016.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/09/2016] [Accepted: 05/29/2016] [Indexed: 12/02/2022] Open
Abstract
Tobacco companies are restricted from engaging in many traditional forms of marketing. Direct marketing is one way tobacco companies can reach consumers while complying with regulation and avoiding negative public perception. There is little research on this type of opt-in marketing, which includes mail marketing, email marketing, web marketing, and mobile marketing, and its impact is not well understood. This study examined 6990 tobacco company emails received by individuals living in the state of Minnesota, US between January 2010 and May 2015 to determine email frequency by brand. These emails were gathered as part of ongoing surveillance of tobacco industry direct marketing. A subset of these emails received between October 2014 and May 2015 (n = 1646) were content analyzed to identify the purpose of the email communication along with type of product promoted. Tobacco companies use email to communicate with consumers on a regular basis. This communication was observed to be as frequent as nine times per month. Emails are most commonly used to promote contests (54.1%), content on tobacco company websites (39.1%), and tobacco coupons (15.7%). Email promotion of menthol-flavored tobacco products was common and was associated with promotion of coupons. Emails promoting menthol had a 1.9 times higher prevalence of also promoting coupons (95% CI: 1.52–2.37). Little is known about tobacco company email marketing and this study fills an identified research gap. A deeper understanding of this type of marketing is needed in order to counter tobacco industry messaging and advance tobacco control.
Collapse
Affiliation(s)
- Betsy Brock
- Association for Nonsmokers-Minnesota, 2395 University Avenue West, Suite 310, Saint Paul, MN 55114, USA
- Corresponding author.
| | - Samantha C. Carlson
- Association for Nonsmokers-Minnesota, 2395 University Avenue West, Suite 310, Saint Paul, MN 55114, USA
| | - Molly Moilanen
- ClearWay Minnesota℠, Two Appletree Square, 8011 34th Ave, Suite 400, Minneapolis, MN 55425, USA
| | - Barbara A. Schillo
- ClearWay Minnesota℠, Two Appletree Square, 8011 34th Ave, Suite 400, Minneapolis, MN 55425, USA
| |
Collapse
|
31
|
Abstract
CONTEXTS Alcohol-branded merchandise (ABM) has a longer shelf-life than other forms of alcohol marketing and the potential to become integrated into children's self-identities. OBJECTIVE This review sought to explore the current literature on children's exposure to, and the impact of, ABM. DATA SOURCES PsycInfo, Proquest, Science Direct, and ABI-Inform databases were searched from the earliest available date to May 2015. Additional studies were identified by a manual review of the reference lists of retrieved articles and contacting the corresponding author of each included study. STUDY SELECTION Articles that reported on child or adolescent ownership of ABM and/or the relationship between ABM ownership and drinking were included. DATA EXTRACTION Data on key measures were tabulated; where data of interest were not reported, requests for further information were sent to the articles' authors. RESULTS Nine cross-sectional and 4 longitudinal studies were identified. ABM ownership ranged from 11% to 59% and was higher among older children and males. Seven cross-sectional studies reported associations between ABM ownership and drinking-related behaviors. All 4 longitudinal studies reported a significant relationship between ownership at baseline and drinking initiation at follow-up. LIMITATIONS The small number of available studies, with different measures of ABM ownership and of associations/effects. CONCLUSIONS The few studies exploring ABM ownership are consistent in showing high rates of ownership and associations between ownership and current and future drinking. There is a need for further research into specific aspects of ABM ownership. However, there is also a need for policy interventions to reduce children's access to and ownership of ABM.
Collapse
Affiliation(s)
- Sandra C Jones
- Centre for Health and Social Research, Australian Catholic University, Melbourne, Australia
| |
Collapse
|
32
|
Williams RJ, Knight RA, Wills TA. Why Children Smoke in 2015 and Prospects for Stopping Them: a Review of Current Literature. CURRENT CARDIOVASCULAR RISK REPORTS 2015. [DOI: 10.1007/s12170-015-0473-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
33
|
Lewis MJ, Ling PM. "Gone are the days of mass-media marketing plans and short term customer relationships": tobacco industry direct mail and database marketing strategies. Tob Control 2015; 25:430-6. [PMID: 26243810 DOI: 10.1136/tobaccocontrol-2015-052314] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/14/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND As limitations on traditional marketing tactics and scrutiny by tobacco control have increased, the tobacco industry has benefited from direct mail marketing which transmits marketing messages directly to carefully targeted consumers utilising extensive custom consumer databases. However, research in these areas has been limited. This is the first study to examine the development, purposes and extent of direct mail and customer databases. METHODS We examined direct mail and database marketing by RJ Reynolds and Philip Morris utilising internal tobacco industry documents from the Legacy Tobacco Document Library employing standard document research techniques. RESULTS Direct mail marketing utilising industry databases began in the 1970s and grew from the need for a promotional strategy to deal with declining smoking rates, growing numbers of products and a cluttered media landscape. Both RJ Reynolds and Philip Morris started with existing commercial consumer mailing lists, but subsequently decided to build their own databases of smokers' names, addresses, brand preferences, purchase patterns, interests and activities. By the mid-1990s both RJ Reynolds and Philip Morris databases contained at least 30 million smokers' names each. These companies valued direct mail/database marketing's flexibility, efficiency and unique ability to deliver specific messages to particular groups as well as direct mail's limited visibility to tobacco control, public health and regulators. CONCLUSIONS Database marketing is an important and increasingly sophisticated tobacco marketing strategy. Additional research is needed on the prevalence of receipt and exposure to direct mail items and their influence on receivers' perceptions and smoking behaviours.
Collapse
Affiliation(s)
- M Jane Lewis
- Center for Tobacco Studies Rutgers School of Public Health, New Brunswick, New Jersey, USA
| | - Pamela M Ling
- University of California, San Francisco, Center for Tobacco Control Research and Education, San Francisco, California, USA
| |
Collapse
|
34
|
Stapleton JL, Darabos K, Carpenter A, Lewis MJ, Greene K, Hudson SV. Indoor tanning users' experiences with tanning salon direct to consumer marketing. J Am Acad Dermatol 2015; 72:1092-4. [PMID: 25981012 DOI: 10.1016/j.jaad.2015.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; Department of Health Education and Behavioral Sciences, School of Public Health, Piscataway, Rutgers, The State University of New Jersey, New Jersey.
| | - Katie Darabos
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Amanda Carpenter
- Department of Communication, New Brunswick, Rutgers, The State University of New Jersey, New Jersey
| | - M Jane Lewis
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Sciences, School of Public Health, Piscataway, Rutgers, The State University of New Jersey, New Jersey
| | - Kathryn Greene
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Communication, New Brunswick, Rutgers, The State University of New Jersey, New Jersey
| | - Shawna V Hudson
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Family Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| |
Collapse
|
35
|
Choi K. The associations between exposure to tobacco coupons and predictors of smoking behaviours among US youth. Tob Control 2015; 25:232-5. [PMID: 25882686 DOI: 10.1136/tobaccocontrol-2014-052147] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/01/2015] [Indexed: 11/03/2022]
Abstract
INTRODUCTION A recent report showed that 13.1% of US middle and high school students were exposed to tobacco coupons in the past 30 days in 2012. The current study reanalysed data from the National Youth Tobacco Survey 2012 to examine the associations between exposure to tobacco coupons in the past 30 days and predictors of smoking among US youth, by smoking status. METHODS 24 658 middle and high school students were asked if and where they had received tobacco coupons in the past 30 days. Demographics, smoking behaviours, smoking-related beliefs, susceptibility to smoking and confidence in quitting smoking were assessed. Analyses were stratified by smoking status (never smokers, experimenters and current smokers). Data were weighted to be representative of the US youth. RESULTS Exposure to tobacco coupons was associated with lower likelihood of denying the social benefits of cigarette smoking and believing all tobacco products are dangerous; higher likelihood of being susceptible to smoking (among never smokers); lower likelihood to feel confident in quitting cigarettes completely (among current smokers); and higher likelihood to intend to purchase cigarettes in the next 30 days (among experimenters and current smokers; p<0.05). CONCLUSIONS Tobacco coupons may promote smoking and hinder smoking cessation among youth. Regulating tobacco coupons may reduce youth smoking in the USA. Further research is needed to determine the effect of tobacco coupons on youth tobacco use globally.
Collapse
|
36
|
Jane Lewis M, Bover Manderski MT, Delnevo CD. Tobacco industry direct mail receipt and coupon use among young adult smokers. Prev Med 2015; 71:37-9. [PMID: 25511177 PMCID: PMC4449137 DOI: 10.1016/j.ypmed.2014.11.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/28/2014] [Accepted: 11/29/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine young adult smokers' receipt of tobacco industry direct mail and use of coupons to purchase cigarettes. METHOD A total of 699 young adults from a 2011 national survey who reported smoking every day/some days provided self-report data on past-six month receipt of direct mail and past-six month use of coupons to purchase cigarettes. Multivariable logistic regression models were used to calculate adjusted odds of direct mail receipt and coupon use. RESULTS Overall, 25.1% of young adult smokers reported receiving direct mail from a tobacco company and 24.2% had used a coupon to buy cigarettes in the past 6 months. Direct mail receipt and coupon use to purchase cigarettes were significantly higher among females, daily smokers, and whites. Nearly 70% of smokers who received direct mail had also used a coupon to purchase cigarettes in the preceding 6 months. Brand websites were the most commonly reported means of joining a direct mailing list. CONCLUSION This study adds to limited research showing receipt of direct mail and use of price reducing coupons by young adults. Also, higher rates of direct mail receipt and coupon use among females suggest that these strategies may be especially effective in encouraging smoking in females.
Collapse
Affiliation(s)
- M Jane Lewis
- Center for Tobacco Studies, Rutgers-School of Public Health, New Brunswick, NJ, USA.
| | | | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers-School of Public Health, New Brunswick, NJ, USA.
| |
Collapse
|
37
|
Printz C. The impact of water pipe and tobacco marketing on young people. Cancer 2014; 120:2941. [DOI: 10.1002/cncr.29036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|