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Kreslake JM, Aarvig K, Liu MS, Vallone DM, Hair EC. Pathways to Quitting E-cigarettes Among Youth and Young Adults: Evidence From the truth® Campaign. Am J Health Promot 2023:8901171231218492. [PMID: 38029725 DOI: 10.1177/08901171231218492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE This study examines the pathways through which e-cigarette users' awareness of the truth® campaign influences e-cigarette use frequency over time. DESIGN AND SETTING Data included four waves (2020-2023) of the Truth Longitudinal Cohort, a probability-based, nationally representative survey. PARTICIPANTS The analytic sample was 15-24-year-olds who reported current e-cigarette use at baseline (N = 718). Wave-by-wave retention rates were 64% to 69%. MEASURES Respondents' cumulative awareness of truth® ads was calculated (Waves 1-2). Strength of agreement with campaign-targeted attitudes was measured on five-point scales (Wave 2). The outcome was change in the 4-level frequency of e-cigarette use (Waves 2-4). ANALYSIS Latent growth structural equation modeling examined the pathway from cumulative ad awareness to the frequency of e-cigarette use via campaign-targeted attitudes. RESULTS Model fit estimates identified a three-step pathway by which awareness of the campaign reduced e-cigarette use. Ad awareness was significantly associated with stronger campaign-targeted attitudes: perceived risk (β = .20, P < .0001); anti-vape industry (β = .13, P = .003); independence from addiction (β = .13, P = .004); and affinity with groups that reject vaping (β = .18, P < .0001). Each attitude was significantly associated with stronger perceived norms against e-cigarette use (respectively: β = .25, P < .0001; β = .15, P < .0001; β = .12, P = .018; β = .27, P < .0001). Perceived norms against e-cigarette use had a significant negative relationship with growth in e-cigarette use frequency over time (β = -.23, P < .0001). CONCLUSION Greater truth® anti-vaping ad awareness strengthens campaign-targeted attitudes among current users, increasing perceived norms against e-cigarette use and reducing use over time.
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Affiliation(s)
- Jennifer M Kreslake
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | | | | | - Donna M Vallone
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
- New York University, College of Global Public Health, New York, NY, USA
| | - Elizabeth C Hair
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
- New York University, College of Global Public Health, New York, NY, USA
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The Impact of the Tips from Former Smokers® Campaign on Reducing Cigarette Smoking Relapse. J Smok Cessat 2022; 2022:3435462. [PMID: 36568904 PMCID: PMC9708364 DOI: 10.1155/2022/3435462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
Evidence-based mass-reach health communication campaigns can increase tobacco cessation, use of cessation resources such as quitlines, and change tobacco-related social norms. These interventions have been associated with a lower likelihood of cigarette smoking relapse in studies conducted internationally; however, no studies have assessed this outcome for a national campaign in the United States. This study examined the relationship between Tips from Former Smokers® (Tips®) campaign exposure and the odds of cigarette smoking relapse among adults who formerly smoked. Using data from the 2014 to 2019 Tips longitudinal campaign surveys, we estimated first episode of relapse (versus remaining a former smoker) as a function of Tips gross rating points (GRPs, a measure of media exposure). Higher levels of Tips GRPs were associated with lower odds of relapse (aOR = 0.63, 95% CI: 0.50-0.78). These results suggest that the Tips campaign may reduce smoking relapse, in addition to the established effect of increasing smoking cessation. Former smokers can be considered a secondary target audience for smoking cessation mass media campaigns, and mass media campaigns could be considered a component of smoking relapse prevention efforts.
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Slocum E, Xie Y, Colston DC, Emery S, Patrick ME, Thrasher JF, Elliott MR, Fleischer NL. Impact of the Tips From Former Smokers Anti-Smoking Media Campaign on Youth Smoking Behaviors and Anti-Tobacco Attitudes. Nicotine Tob Res 2022; 24:1927-1936. [PMID: 35749779 PMCID: PMC9653086 DOI: 10.1093/ntr/ntac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/03/2022] [Accepted: 06/22/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Anti-tobacco media campaigns can prevent youth smoking, but there is little research on how adult-targeted campaigns affect youth. We investigated the association between the Tips From Former Smokers (Tips) campaign and youth smoking behaviors and anti-tobacco attitudes, and variation by sex, race and/or ethnicity, or socioeconomic status. AIMS AND METHODS We used data from the monitoring of the future study, a nationally representative survey on 8th, 10th, and 12th graders, from 2013-2015. Quartiles of Tips gross rating points (GRPs) were used to estimate exposure. Youth smoking behavior outcomes included smoking prevalence, initiation, and susceptibility. The anti-tobacco attitude outcomes included the extent that anti-tobacco ads made participants (1) less favorable towards smoking or (2) less likely to smoke cigarettes. Modified Poisson regression models estimated average marginal effects; separate additive interactions between Tips GRP exposure and sex, race and/or ethnicity, parents' highest education, and college plans (12th graders only) were used to test for effect modification. RESULTS Tips GRPs were not associated with smoking behaviors within any grade. However, 12th graders in the highest quartile of Tips had a 7.0 percentage point higher probability (95% CI = 0.023-0.116) of responding that anti-tobacco ads made them less likely to smoke. Tips GRPs were associated with a lower probability of past 30-day smoking prevalence among 10th grade females, but not males (joint P-value = .002). No additional statistically significant interactions were found for any other outcomes for any grade. CONCLUSIONS This study revealed the potential for adult-targeted campaigns to increase youth's anti-smoking attitudes, but campaign exposure was not associated with smoking behaviors. IMPLICATIONS Few studies have examined the potential for anti-smoking media campaigns to influence audiences outside their targeted audience. In this study, we show the potential for adult-targeted campaigns to impact youth and suggest that Tips exposure may promote anti-smoking attitudes among youth.
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Affiliation(s)
- Elizabeth Slocum
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights Ann Arbor, MI 48109, USA
| | - Yanmei Xie
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights Ann Arbor, MI 48109, USA
| | - David C Colston
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights Ann Arbor, MI 48109, USA
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sherry Emery
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL 60603, USA
| | - Megan E Patrick
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Washington Heights Ann Arbor, MI 48109, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
| | - Nancy L Fleischer
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights Ann Arbor, MI 48109, USA
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Lin C, Cheng W, Liu X, Li H, Song Y. The global, regional, national burden of laryngeal cancer and its attributable risk factors (1990-2019) and predictions to 2035. Eur J Cancer Care (Engl) 2022; 31:e13689. [PMID: 35980023 DOI: 10.1111/ecc.13689] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2022] [Accepted: 08/02/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We aim to report the incidence, mortality and disability-adjusted life years (DALYs) between 1990 and 2019 and provide predictions to 2035. METHODS We use estimates from Global Burden of Disease, Injuries and Risk Factors Study 2019 to analyse the incidence, mortality and DALYs. RESULTS In 2019, there were more than 209,149 incidence cases, with age-standardised rates (ASRs) of 2.5. Laryngeal cancer accounted for 123,356 death cases, with ASRs of 1.5. Laryngeal cancer was also responsible for 3.26 million (3,034,634 to 3,511,354) DALYs, with ASRs of 38.8 (36.1 to 41.8). In 2019, Central Europe had the highest age-standardised incidence rate. At the national level, the highest incidence rate was observed in Mongolia. Total number and rate were significantly higher among males than females across all age groups. DALYs were attributable to Alcohol use, Smoking, Occupational exposure to sulfuric acid and asbestos. The age-standardised incidence rates in seven GBD regions and 59 countries are projected to increase between 2019 and 2035. CONCLUSIONS Despite the current and predicted decline in age-standardised incidence globally, the absolute number of estimates continue to increase. Prevention programmes should concentrate on modifiable risk factors, especially among the males across all age groups.
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Affiliation(s)
- Changwei Lin
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Wenwei Cheng
- Medical Department, The Third Xiangya Hospital of Central South University, Changsha, China.,Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiajing Liu
- Graduate School of Guilin Medical University, Guilin, China
| | - Heqing Li
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yexun Song
- Department of Otolaryngology-Head Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
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Wang Y, Duan Z, Emery SL, Weaver SR, Self-Brown SR, Ashley DL, Huang J. Intentions and Attempts to Quit Smoking Among Sexual Minoritized Adult Smokers After Exposure to the Tips From Former Smokers Campaign. JAMA Netw Open 2022; 5:e2211060. [PMID: 35532934 PMCID: PMC9086838 DOI: 10.1001/jamanetworkopen.2022.11060] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Significant disparities exist in smoking behaviors by sexual minority status in the US. OBJECTIVE To examine potential differences in the associations between exposure to the Tips From Former Smokers (Tips) campaign and intentions and attempts to quit smoking by sexual minority status. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the wave 5 survey of the Population Assessment of Tobacco and Health study. Data from 8072 adults who were currently established cigarette smokers were collected from December 2018 to November 2019 and analyzed in August 2021. The Population Assessment of Tobacco and Health study is an ongoing cohort study representative of the noninstitutionalized US population. Sample weights were applied to account for the complex sampling strategies. EXPOSURES Dichotomized self-reported frequent Tips exposure (often and very often) and infrequent exposure (never, rarely, and sometimes). MAIN OUTCOMES AND MEASURES Outcomes were intention to quit within 12 months, any serious quit attempts in the past 12 months, and number of serious quit attempts in the past 12 months. Multivariate logistic and ordinal logistic regressions were used to estimate the weighted associations between exposure and each outcome. Interactions between Tips exposure and sexual minority status were examined to explore potential differences. RESULTS A total of 8072 participants (mean [SD] age, 44.7 [14.8] years; 3888 [53.2%] male; 4962 [67.4%] non-Hispanic White; and 915 [9.5%] sexual minoritized individuals [ie, those who identified as lesbian, gay, bisexual, or another minoritized sexual identity]) were included. Frequent Tips exposure was associated with higher odds of quit intentions and attempts overall (adjusted odds ratio [aOR], 1.25; 95% CI, 1.07-1.46 for intention to quit within 12 months; aOR, 1.26; 95% CI, 1.08-1.47 for serious quit attempts in the past 12 months; and aOR, 1.24; 95% CI, 1.06-1.44 for number of serious quit attempts in the past 12 months). These associations were significantly stronger for heterosexual smokers than sexual minoritized smokers, as indicated by the significant interaction terms (aOR, 0.58; 95% CI, 0.36-0.96 for intention to quit within 12 months; aOR, 0.41; 95% CI, 0.24-0.70 for serious quit attempts in the past 12 months; and aOR, 0.40; 95% CI, 0.24-0.67 for number of serious quit attempts in the past 12 months). Subgroup analysis showed that heterosexual smokers who reported frequent Tips exposure were more likely to intend to quit within 12 months (aOR, 1.29; 95% CI, 1.10-1.53), have had any serious quit attempts in the past 12 months (aOR, 1.34; 95% CI, 1.13-1.58), and have had more serious quit attempts (aOR, 1.32; 95% CI, 1.12-1.54) than heterosexual smokers who reported infrequent exposure. In contrast, there was no association for sexual minoritized smokers (aOR, 0.82; 95% CI, 0.52-1.30 for intention to quit within 12 months; aOR, 0.65; 95% CI, 0.39-1.07 for serious quit attempts in the past 12 months; and aOR, 0.62; 95% CI, 0.38-1.00 for number of serious quit attempts in the past 12 months). CONCLUSIONS AND RELEVANCE These findings suggest that significant differences exist in the associations between Tips exposure and quit intentions or attempts by sexual minority status. More targeted campaign content for sexual minoritized smokers may be needed to increase quit intentions and attempts among this group.
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Affiliation(s)
- Yu Wang
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta
| | - Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Sherry L. Emery
- National Opinion Research Center at University of Chicago, Chicago, Illinois
| | - Scott R. Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta
| | - Shannon R. Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta
| | - David L. Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta
| | - Jidong Huang
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta
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Monshi SS, Wu J, Collins BN, Ibrahim JK. Youth susceptibility to tobacco use in the Gulf Cooperation Council Countries, 2001–2018. Prev Med Rep 2022; 26:101711. [PMID: 35145839 PMCID: PMC8819131 DOI: 10.1016/j.pmedr.2022.101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/05/2022] [Accepted: 01/23/2022] [Indexed: 11/30/2022] Open
Abstract
Analysis of the susceptibility to initiating tobacco use identifies youth at higher risk of initiating tobacco. Susceptibility to initiate tobacco use in increased in the United Arab Emirates while decreased in Bahrain and Qatar. FCTC may have an independent impact on initiating tobacco use among youth. The study helps policymakers identify impactful policies and prioritize resources accordingly.
The Gulf Cooperation Council (GCC) countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) – ratified the Framework Convention on Tobacco Control (FCTC) in 2006. Yet, GCC countries predict a slight reduction in tobacco use compared to the Eastern Mediterranean region’s significant downward trend. The purpose of this study was to examine changes in self-reported intention to initiating tobacco use (susceptibility) among youth over time in five GCC countries and the relationship between susceptibility and key FCTC provisions. Complex sample logistic regression analyses were conducted using data from the 2001 to 2018 Global Youth Tobacco Survey (n = 349,878 adolescents). Since the ratification of FCTC in GCC countries, susceptibility to initiate tobacco use significantly decreased in Bahrain and Qatar while it increased in UAE (P < 0.001). Exposure to smoking in public places increased the odds of susceptibility to tobacco use in Bahrain (AOR = 1.6, 95% CI = [1.2–2.2), Kuwait (AOR = 1.6, 95% CI = [1.2–2.0]), Qatar (AOR = 1.9, 95% CI = [1.4–2.6]), and UAE (AOR = 2.1, 95% CI = [1.6–2.7]). Susceptibility to tobacco use was significantly associated with exposure to tobacco imagery in media in the UAE (AOR = 1.7, 95% CI = [1.2–2.3]) and with tobacco industry activities like promotion in Bahrain (AOR = 2.8, 95% CI = [1.9–4.2]) and Kuwait (AOR = 2.2, 95% CI = [1.5–3.1]). In conclusion, the impact of FCTC provisions on tobacco use differs across countries. Findings suggested that the implementation of tobacco control policies may independently influence the initiation of tobacco use.
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Affiliation(s)
- Sarah S. Monshi
- Department of Health Services Administration and Policy, Temple University, Philadelphia, PA, USA
- Department of Health Services Management, Umm Al-Qura University, Mecca, Saudi Arabia
- Corresponding author at: Department of Health Services Administration & Policy, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122, USA.
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
| | - Bradley N. Collins
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Jennifer K. Ibrahim
- Department of Health Services Administration and Policy, Temple University, Philadelphia, PA, USA
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Fiore MC, Baker TB. Ten Million Calls and Counting: Progress and Promise of Tobacco Quitlines in the U.S. Am J Prev Med 2021; 60:S103-S106. [PMID: 33663696 PMCID: PMC8189745 DOI: 10.1016/j.amepre.2020.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Michael C Fiore
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Timothy B Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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Chan L, O'Hara B, Phongsavan P, Bauman A, Freeman B. Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns. J Med Internet Res 2020; 22:e17432. [PMID: 32348272 PMCID: PMC7448186 DOI: 10.2196/17432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/12/2020] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Mass media campaigns for public health are increasingly using digital media platforms, such as web-based advertising and social media; however, there is a lack of evidence on how to best use these digital platforms for public health campaigns. To generate this evidence, appropriate campaign evaluations are needed, but with the proliferation of digital media-related metrics, there is no clear consensus on which evaluation metrics should be used. Public health campaigns are diverse in nature, so to facilitate analysis, this review has selected tobacco control campaigns as the scope of the study. OBJECTIVE This literature review aimed to examine how tobacco control campaigns that use traditional and digital media platforms have been evaluated. METHODS Medicine and science databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus), and a marketing case study database (World Advertising Research Center) were searched for articles published between 2013 and 2018. Two authors established the eligibility criteria and reviewed articles for inclusion. Individual campaigns were identified from the articles, and information on campaigns and their evaluations were supplemented with searches on Google, Google Scholar, and social media platforms. Data about campaign evaluations were tabulated and mapped to a conceptual framework. RESULTS In total, 17 campaigns were included in this review, with evaluations reported on by 51 articles, 17 marketing reports, and 4 grey literature reports. Most campaigns were from English-speaking countries, with behavioral change as the primary objective. In the process evaluations, a wide range of metrics were used to assess the reach of digital campaign activities, making comparison between campaigns difficult. Every campaign in the review, except one, reported some type of engagement impact measure, with website visits being the most commonly reported metric (11 of the 17 campaigns). Other commonly reported evaluation measures identified in this review include engagement on social media, changes in attitudes, and number of people contacting smoking cessation services. Of note, only 7 of the 17 campaigns attempted to measure media platform attribution, for example, by asking participants where they recalled seeing the campaign or using unique website tracking codes for ads on different media platforms. CONCLUSIONS One of the key findings of this review is the numerous and diverse range of measures and metrics used in tobacco control campaign evaluations. To address this issue, we propose principles to guide the selection of digital media-related metrics for campaign evaluations, and also outline a conceptual framework to provide a coherent organization to the diverse range of metrics. Future research is needed to specifically investigate whether engagement metrics are associated with desired campaign outcomes, to determine whether reporting of engagement metrics is meaningful in campaign evaluations.
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Affiliation(s)
- Lilian Chan
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Blythe O'Hara
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Adrian Bauman
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
| | - Becky Freeman
- Sydney School of Public Health and Charles Perkins Centre, Prevention Research Collaboration, The University of Sydney, Camperdown, Australia
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Prochaska JJ, Gates EF, Davis KC, Gutierrez K, Prutzman Y, Rodes R. The 2016 Tips From Former Smokers® Campaign: Associations With Quit Intentions and Quit Attempts Among Smokers With and Without Mental Health Conditions. Nicotine Tob Res 2020; 21:576-583. [PMID: 30496491 DOI: 10.1093/ntr/nty241] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/07/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION People living with mental health conditions (MH+) are more likely to smoke cigarettes than people without mental health conditions (MH-) and to experience tobacco-related disparities. The Tips From Former Smokers® (Tips®) campaign is a proven population-level strategy for motivating smokers to quit. In 2016, Tips included ads featuring Rebecca, a former smoker with depression. We evaluated self-reported frequency of exposure to the Rebecca and other Tips ads in association with quit intentions and quit attempts among MH+ and MH- smokers. METHODS Intentions to quit and past 6-month quit attempts lasting at least 24 hours were reported from a two-wave longitudinal online survey conducted before and after the 2016 Tips campaign with a nationally representative sample of US adult cigarette smokers with (MH+, N = 777) and without (MH-, N = 1806) lifetime mental health conditions. RESULTS In 2016, among MH+ respondents, greater exposure to the Rebecca ads was significantly associated with increased odds of intending to quit in the next 30 days (adjusted odds ratio [AOR] = 1.40, p < .05) and with reporting a quit attempt in the past 6 months (AOR = 1.25, p < .05). Among MH- respondents, greater exposure to the other Tips ads was associated with increased odds of making a quit attempt (AOR = 1.19, p < .05). CONCLUSIONS Exposure to the Rebecca ads was associated with a greater likelihood of intentions to quit and quit attempts among MH+ smokers; whereas, exposure to the other (non-mental-health-related) Tips ads was associated with a greater likelihood of quit attempts among MH- smokers. IMPLICATIONS National media campaigns are an important population-level strategy for reaching specific population groups who are experiencing tobacco-related disparities. The findings support the inclusion of ads featuring people living with mental health conditions in national tobacco education media campaigns, such as Tips.
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Affiliation(s)
| | - Emily F Gates
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College, Chestnut Hill, MA
| | - Kevin C Davis
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC
| | | | - Yvonne Prutzman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Robert Rodes
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
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Awareness of and Receptivity to the Fresh Empire Tobacco Public Education Campaign Among Hip Hop Youth. J Adolesc Health 2020; 66:301-307. [PMID: 31704108 DOI: 10.1016/j.jadohealth.2019.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/21/2019] [Accepted: 09/08/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to assess awareness of and receptivity to the U.S. Food and Drug Administration's Fresh Empire tobacco public education campaign designed to reach Hip Hop-identified youth, who are at higher smoking risk. METHODS The evaluation uses a randomized treatment-control design with 15 campaign-targeted treatment and 15 control markets. We conducted surveys among 12- to 17-year-olds before campaign launch and at approximately 6-month intervals. Analyses explore treatment-control differences in Fresh Empire brand and video advertisement awareness at individual survey rounds and over time and perceived effectiveness of advertisements. RESULTS Awareness of the Fresh Empire brand was higher among youth in treatment than control markets following campaign launch (ps < .01). Awareness of the Fresh Empire brand increased more in treatment than control over time (adjusted odds ratio = 3.26, 95% confidence interval = 1.90-5.58). At follow-ups 1 and 3, youth in treatment (vs. control) were more likely to report high and less likely to report low awareness of video advertisements (ps < .05). There were no treatment-control differences in video awareness at follow-up 2 (not significant). Fresh Empire video advertisements had perceived effectiveness scores ranging from 3.66 to 4.11 (1-5 scale) across three survey rounds. CONCLUSIONS Among the campaign audience of Hip Hop-identified youth, awareness of the Fresh Empire campaign was higher in treatment than control markets at individual survey rounds, and increases in campaign awareness were greater in treatment than control markets over time. Campaign advertisements also elicited positive audience reactions. Findings suggest that heavily digital campaigns may take longer to achieve Centers for Disease Control and Prevention-recommended 75% quarterly awareness.
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Adults' favorability toward prohibiting flavors in all tobacco products in the United States. Prev Med 2019; 129:105862. [PMID: 31655175 DOI: 10.1016/j.ypmed.2019.105862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/18/2019] [Accepted: 10/11/2019] [Indexed: 12/25/2022]
Abstract
In November 2018, US Food and Drug Administration announced its intent to prohibit menthol in combustible tobacco products, prohibit flavored cigars, and prohibit flavored e-cigarettes unless they are sold in age-restricted, in-person locations. This study assessed adult attitudes toward prohibiting flavors in all tobacco products, including e-cigarettes. Data were from the 2016 Summer Styles survey of 4203 US adults aged ≥18 years. Respondents were asked whether they favored or opposed prohibiting flavors (e.g., menthol, spicy, sweet, or fruity flavor) in all tobacco products. Prevalence and correlates of favorability were assessed using weighted percentages and adjusted prevalence ratios (aPR) respectively. Assessed correlates were: sex, age, race/ethnicity, income, US Census region, marital status, children <18 years living in the home, perceptions toward e-cigarette advertising, and current (past 30-day) tobacco product use. Overall, 47.3% of adults reported favorable attitudes toward prohibiting flavors in all tobacco products. By tobacco product use status, prevalence was 52.0%, 48.4%, and 34.8% among never, former, and current users, respectively (p < .05). Among current tobacco product users, favorability was more likely among adults who believed e-cigarette ads exposure makes youth think about smoking (aPR = 1.82; 95% CI = 1.20-2.78) and those with any children aged <18 years in their household (aPR = 1.38; 95% CI = 1.05-1.82). To conclude, nearly half of adults favored prohibiting flavors in all tobacco products, including e-cigarettes. Prohibiting flavors in tobacco products could benefit public health by reducing both individual-level and population-level harms, including tobacco use initiation especially among youth.
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Mann N, Nonnemaker J, Davis K, Chapman L, Thompson J, Juster HR. The Potential Impact of the New York State Smokers' Quitline on Population-Level Smoking Rates in New York. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224477. [PMID: 31739413 PMCID: PMC6887956 DOI: 10.3390/ijerph16224477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 11/16/2022]
Abstract
Receiving smoking cessation services from telephone quitlines significantly increases quit success compared with no intervention or other quitting methods. To affect population-level smoking, quitlines must provide a sufficient proportion of smokers with effective interventions. Nationally, quitlines reach around 1% of adult smokers annually. From 2011 through 2016, the average annual reach of the New York State Smokers' Quitline (NYSSQL) was 2.9%. We used data on the reach and cessation outcomes of NYSSQL to estimate its current impact on population-level smoking prevalence and to estimate how much reach would have to increase to achieve population-level smoking prevalence reductions. We estimate NYSSQL is associated with a 0.02 to 0.04 percentage point reduction in smoking prevalence in New York annually. If NYSSQL achieved the recommended annual reach of 8% (CDC Best Practices) and 16% (NAQC), state-level prevalence would decrease by an estimated 0.07-0.12 and 0.13-0.24 percentage points per year, respectively. To achieve those recommended levels of reach, NYSSQL would need to provide services to approximately 3.5 to 6.9 times more smokers annually. Given their reach, quitlines are limited in their ability to affect population-level smoking. Increasing quitline reach may not be feasible and would likely be cost-prohibitive. It may be necessary to re-think the role of quitlines in tobacco control efforts. In New York, the quitline is being integrated into larger efforts to promote cessation through health systems change.
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Affiliation(s)
- Nathan Mann
- RTI International, Research Triangle Park, NC 27709, USA; (J.N.); (K.D.); (L.C.); (J.T.)
- Correspondence: ; Tel.: +(919)-485-5584; Fax: +(919)-541-6683
| | - James Nonnemaker
- RTI International, Research Triangle Park, NC 27709, USA; (J.N.); (K.D.); (L.C.); (J.T.)
| | - Kevin Davis
- RTI International, Research Triangle Park, NC 27709, USA; (J.N.); (K.D.); (L.C.); (J.T.)
| | - LeTonya Chapman
- RTI International, Research Triangle Park, NC 27709, USA; (J.N.); (K.D.); (L.C.); (J.T.)
| | - Jesse Thompson
- RTI International, Research Triangle Park, NC 27709, USA; (J.N.); (K.D.); (L.C.); (J.T.)
| | - Harlan R. Juster
- Bureau of Tobacco Control, New York State Department of Health, Albany, NY 12242, USA;
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Strong DR, Leas E, Elton-Marshall T, Wackowski OA, Travers M, Bansal-Travers M, Hyland A, White M, Noble M, Cummings KM, Taylor K, Kaufman AR, Choi K, Pierce JP. Harm perceptions and tobacco use initiation among youth in Wave 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study. Prev Med 2019; 123:185-191. [PMID: 30878572 PMCID: PMC7443099 DOI: 10.1016/j.ypmed.2019.03.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 11/29/2022]
Abstract
In the US, youth attribute higher levels of harm and addictiveness to cigarettes relative to other tobacco products. Monitoring harm perceptions across a range of tobacco products is important when forecasting risk for experimentation. This study examined data from US youth (N = 10,081) ages 12-17 from the Population Assessment of Tobacco and Health (PATH) Study who completed both Wave 1 (2013-2014) and Wave 2 (2014-2015) interviews. Analyses assessed: (1) trends in perceived harm and addictiveness of products over time, (2) whether perceived harm and addictiveness of a product at Wave 1 predicted trying that product for the first time by Wave 2, and (3) whether trying a product between Waves 1 and 2 predicted a decrease in one's perceived harm and addictiveness of that product. Levels of perceived harmfulness and addictiveness significantly increased between Wave 1 and Wave 2 for all products (χ2 (range): 7.8-109.2; p's ≤ 0.02). Compared to those with "high" perceived harmfulness of a tobacco product at Wave 1, those with "low" and "medium" perceived harmfulness had a significantly increased probability of use of that product at Wave 2. For all products, Wave 1 youth never tobacco users who tried a product (vs. did not) at Wave 2 had a significantly higher probability of being in the "low" category of perceived harmfulness at Wave 2. Among US youth, there is a bidirectional relationship between harm perceptions and product use. Understanding how changes in perceptions translate to changes in tobacco use could inform efforts to prevent tobacco initiation in youth.
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Affiliation(s)
- David R Strong
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States of America; Department of Family Medicine and Public Health, University of California, San Diego, United States of America.
| | - Eric Leas
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States of America; Department of Family Medicine and Public Health, University of California, San Diego, United States of America
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Affiliated Scientist, Ontario Tobacco Research Unit, Toronto, Ontario, Canada
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers School of Public Health, Piscataway, NJ, United States of America
| | - Mark Travers
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, NY, United States of America
| | - Maansi Bansal-Travers
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, NY, United States of America
| | - Andrew Hyland
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, NY, United States of America
| | - Martha White
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States of America; Department of Family Medicine and Public Health, University of California, San Diego, United States of America
| | - Madison Noble
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States of America; Department of Family Medicine and Public Health, University of California, San Diego, United States of America
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | | | - Annette R Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, United States of America
| | - Kelvin Choi
- Division of Intramural Research, National Institutes on Minority Health and Health Disparities, Bethesda, MD, United States of America
| | - John P Pierce
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, United States of America; Department of Family Medicine and Public Health, University of California, San Diego, United States of America
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14
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Huang X, Fu W, Zhang H, Li H, Li X, Yang Y, Wang F, Gao J, Zheng P, Fu H, Chapman S, Ding D. Why are male Chinese smokers unwilling to quit? A multicentre cross-sectional study on smoking rationalisation and intention to quit. BMJ Open 2019; 9:e025285. [PMID: 30782929 PMCID: PMC6368028 DOI: 10.1136/bmjopen-2018-025285] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/29/2018] [Accepted: 12/13/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We aimed to describe the rationalisation beliefs endorsed by Chinese male smokers and to examine the association between rationalisation and the intention to quit. SETTING Questionnaires were conducted among male smokers in three cities (Shanghai, Nanning and Mudanjiang) which represent different geographical locations, economic development levels and legislative status of tobacco control in China. DESIGN AND PARTICIPANTS It was a multicentre cross-sectional survey involved a total of 3710 male smokers over 18 years. OUTCOME MEASURES Primary outcomes were intention to quit, smoking rationalisation scores and sub scores in six dimensions. Smoking rationalisation was assessed using a newly developed Chinese rationalisation scale. Multivariable logistic regression was performed to examine the relationship between rationalisation and intention to quit. RESULTS On average, smokers scored 3.3 out of 5 on the smoking rationalisation scale. With a one point increase in total rationalisation scale, the odds for intention to quit in the next 6 months decreased by 48% (OR=0.52, 95% CI: 0.44 to 0.61; p<0.001). Separate logistic regressions for six subscales of rationalisation shown consistent inverse associations with intention to quit (all p values <0.001). Believing that smoking was socially acceptable was the strongest predictor (OR=0.62, 95% CI: 0.55 to 0.71; p<0.001). CONCLUSIONS Rationalisation beliefs could be important barriers to smoking cessation. Some beliefs have stronger association with quit intention than others. Eroding rationalisation beliefs endorsed by smokers is a potential strategy for smoking cessation intervention.
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Affiliation(s)
- Xinyuan Huang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Wenjie Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Haiying Zhang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Hong Li
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Xiaoxia Li
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Yong Yang
- School of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Fan Wang
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
- Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Simon Chapman
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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15
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Rosen LJ, Rier DA, Schwartz R, Talitman M, Zwanziger L. Knowledge and risk perceptions of Israelis towards combustible cigarettes: the need for immediate remedial action. Isr J Health Policy Res 2019; 8:10. [PMID: 30642402 PMCID: PMC6330745 DOI: 10.1186/s13584-018-0276-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Devastation from the tobacco epidemic continues, with strong government tobacco control policy absent in most countries. Knowledge of the full scope of tobacco harm in populations may form the basis for healthier behavior, de-normalization of smoking, and a consensus about necessary public policy. However, many populations may be poorly-informed about the risks, and this ignorance may undermine both effective policy-making and implementation of tobacco control policies. We present knowledge and risk perceptions about smoking tobacco smoke exposure in Israel. METHODS A nationally-representative phone survey was conducted in Israel (n = 505; response rate = 61%). We assessed knowledge about active and passive smoking using four questions, three of which addressed knowledge about harm, and one of which addressed knowledge of tobacco-related harm relative to knowledge of harm due to traffic accidents. The three questions which addressed knowledge of harm were combined into a composite score. We also asked four risk perception questions concerning tobacco smoke exposure, which were measured on a 7-point Likert scale and then combined. Multivariable logistic regression and linear models were used to identify whether smoking status or socio-demographic variables were associated with knowledge of harm, comparative knowledge of harm, and risk perceptions. RESULTS Just two in five respondents, and one in five respondents who were current smokers, accurately answered three simple questions about harms of smoking. Fewer than three in ten respondents, and fewer than one in five smokers, knew that smoking causes more damage than traffic accidents. Many (30.3%) were unaware that tobacco smoke exposure causes both lung cancer and heart disease, 27.7% did not know that smoking both shortens life and injures quality of life, and 31.1% did not know that smoking-attributable health problems will afflict all or most heavy smokers. Overall, risk perceptions regarding tobacco smoke exposure were high (mean = 24.5, SD:4.5, on a scale of 7-28, with 28 the indicating highest level). Smoking status was consistently associated with lower levels of knowledge, comparative knowledge, and risk perceptions, with current smokers having the lowest levels of knowledge and the lowest risk perceptions. CONCLUSIONS Like many others, Israelis, and particularly Israeli smokers, do not fully grasp tobacco's true dangers. Effective communication of the full range of tobacco risks to the public, with a focus on communication with smokers, is an essential component of comprehensive tobacco control policy.
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Affiliation(s)
- Laura J. Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, 69978 Ramat Aviv, Israel
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - David A. Rier
- Department of Sociology and Anthropology, Bar Ilan University, 5290002 Ramat-Gan, Israel
| | | | - Michal Talitman
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, 69978 Ramat Aviv, Israel
- Department of Statistics, Tel Aviv University, 69978 Ramat Aviv, Israel
| | - Lior Zwanziger
- Sackler Medical School, Tel Aviv University, 69978 Ramat Aviv, Israel
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16
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Hair EC, Cantrell J, Pitzer L, Bennett MA, Romberg AR, Xiao H, Rath JM, Halenar MJ, Vallone D. Estimating the Pathways of an Antitobacco Campaign. J Adolesc Health 2018; 63:401-406. [PMID: 30055845 DOI: 10.1016/j.jadohealth.2018.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study examined mechanisms through which the truth campaign, a national mass media antismoking campaign, influences smoking-related attitudes, and progression of tobacco use over time in youth and young adults. METHODS Structural equation modeling tested causal pathways derived from formative research and behavioral theory with a nationally representative longitudinal sample of 15-21-year-olds (n = 8747) over 24 months. Data were collected from 2014 to 2016, and analyses were conducted in 2017. RESULTS Greater ad awareness predicted strengthening of attitudes targeted by the campaign (i.e., feelings of independence from tobacco, antitobacco industry sentiment, decreasing acceptance of social smoking, and decreasing acceptance of smoking imagery), and attitude changes were significantly associated with greater support for an antitobacco social movement (e.g., agreement to the item "I would be part of a movement to end smoking"). Greater social movement support predicted a slower rate of progression on smoking intensity after two years of the campaign. CONCLUSIONS Findings suggest that engaging youth and young adults in a cause-based social movement for promoting health can be a powerful strategy to drive positive behavior change. Messages targeting attitudes that resonate with values important to this age group, including independence and connectedness, are particularly effective. Investments in national antitobacco public education campaigns are key policy interventions which continue to help prevent tobacco use among youth and young adults.
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Affiliation(s)
- Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Jennifer Cantrell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; College of Global Public Health, New York University, New York, New York
| | - Lindsay Pitzer
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Morgane A Bennett
- Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Alexa R Romberg
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Haijun Xiao
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Jessica M Rath
- Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michael J Halenar
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Donna Vallone
- Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; College of Global Public Health, New York University, New York, New York
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17
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Murphy-Hoefer R, Davis KC, Beistle D, King BA, Duke J, Rodes R, Graffunder C. Impact of the Tips From Former Smokers Campaign on Population-Level Smoking Cessation, 2012-2015. Prev Chronic Dis 2018; 15:E71. [PMID: 29862960 PMCID: PMC5985905 DOI: 10.5888/pcd15.180051] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This study provides estimates of the long-term cumulative impact of the Centers for Disease Control and Prevention’s national tobacco education campaign, Tips From Former Smokers (Tips), on population-level smoking cessation. We used recently published estimates of the association between increased Tips campaign media doses and quit attempts to calculate campaign-attributable population sustained (6-month) quits during 2012–2015. Tips led to approximately 522,000 sustained quits during 2012–2015. These findings indicate that the Tips campaign’s comprehensive approach to combining evidence-based messages with the promotion of cessation resources was successful in achieving substantial long-term cigarette cessation at the population level over multiple years.
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Affiliation(s)
- Rebecca Murphy-Hoefer
- Centers for Disease Control and Prevention, Office on Smoking and Health, Mailstop F-79, 4770 Buford Hwy NE, Atlanta, GA, 30341-3717.
| | - Kevin C Davis
- RTI International, Center for Health Policy Science and Tobacco Research, Research Triangle Park, North Carolina
| | - Diane Beistle
- Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, Georgia
| | - Brian A King
- Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, Georgia
| | - Jennifer Duke
- RTI International, Center for Health Policy Science and Tobacco Research, Research Triangle Park, North Carolina
| | - Robert Rodes
- Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, Georgia
| | - Corinne Graffunder
- Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, Georgia
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Abstract
BACKGROUND Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. OBJECTIVES To assess the effectiveness of mass media interventions in reducing smoking among adults. SEARCH METHODS The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in November 2016. SELECTION CRITERIA Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series.Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included.Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes.The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, or odds of being a smoker. DATA COLLECTION AND ANALYSIS Two authors independently assessed all studies for inclusion criteria and for study quality (MB, LS, RTM). One author (MB) extracted data, and a second author (LS) checked them.Results were not pooled due to heterogeneity of the included studies and are presented narratively and in table form. MAIN RESULTS Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among seven campaigns reporting smoking prevalence, significant decreases were observed in the California and Massachusetts statewide tobacco control campaigns compared with the rest of the USA. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobacco consumption found statistically significant decreases. Among the eight studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. AUTHORS' CONCLUSIONS There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.
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Affiliation(s)
- Malgorzata M Bala
- Jagiellonian University Medical CollegeChair of Epidemiology and Preventive Medicine; Department of Hygiene and Dietetics; Systematic Reviews Unit ‐ Polish Cochrane BranchKopernika 7KrakowPoland31‐034
| | | | - Roman Topor‐Madry
- Institute of Public Health, Jagiellonian University Medical CollegeDepartment of Epidemiology and Population StudiesGrzegórzecka 20KrakowPoland31‐531
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Farrelly MC, Chaloupka FJ, Berg CJ, Emery SL, Henriksen L, Ling P, Leischow SJ, Luke DA, Kegler MC, Zhu SH, Ginexi EM. Taking Stock of Tobacco Control Program and Policy Science and Impact in the United States. JOURNAL OF ADDICTIVE BEHAVIORS AND THERAPY 2017; 1:8. [PMID: 30198028 PMCID: PMC6124688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The 60% decline in the prevalence of cigarette smoking among U.S. adults over the past 50 years represents a significant public health achievement. This decline was steered in part by national, state, and local tobacco control programs and policies, such as public education campaigns; widespread smoke-free air laws; higher cigarette prices that have been driven by large increases in federal, state, and local cigarette excise taxes; and other tobacco control policy and systems-level changes that discourage smoking. Using the MPOWER framework informed by the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health and the World Health Organization (WHO), this paper reviews these accomplishments and identifies gaps in tobacco control policy implementation and additional research needed to extend these historic successes.
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Affiliation(s)
- Matthew C Farrelly
- Center for Health Policy Science and Tobacco Research, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Frank J Chaloupka
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, 444 Westside Research Office Bldg. 1747 West Roosevelt Road Chicago, IL 60608, United States
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Sherry L Emery
- Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, 444 Westside Research Office Bldg. 1747 West Roosevelt Road Chicago, IL 60608, United States
- NORC at the University of Chicago, 55 East Monroe Street, 30th Floor Chicago, IL 60603 United States
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Suite 353, Palo Alto, CA 94304, United States
| | - Pamela Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine. University of California San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, United States
| | - Scott J Leischow
- Public Health Program, College of Health Solutions, Arizona State University, 550 North 3rd Street, Room 512E Phoenix, Arizona 85004, United States
| | - Douglas A Luke
- George Warren Brown School of Social Work, Washington University in St. Louis, 700 Rosedale Ave, St. Louis, MO 63112-1408, United States
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0905, La Jolla, CA 92093, United States
| | - Elizabeth M Ginexi
- National Cancer Institute, National Institutes of Health, 31 Center Dr., Room B1C19, Bethesda, MD 20892, United States
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20
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Cartocci G, Caratù M, Modica E, Maglione AG, Rossi D, Cherubino P, Babiloni F. Electroencephalographic, Heart Rate, and Galvanic Skin Response Assessment for an Advertising Perception Study: Application to Antismoking Public Service Announcements. J Vis Exp 2017. [PMID: 28872117 PMCID: PMC5614368 DOI: 10.3791/55872] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The evaluation of advertising, products, and packaging is traditionally performed through methods based on self-reports and focus groups, but these approaches often appear poorly accurate in scientific terms. Neuroscience is increasingly applied to the investigation of the neurophysiological bases of the perception of and reaction to commercial stimuli to support traditional marketing methods. In this context, a particular sector or marketing is represented by public service announcements (PSAs). The objective of this protocol is to apply electroencephalography (EEG) and autonomic signal analysis to study responses to selected antismoking PSAs. Two EEG indices were employed: the frontal alpha band EEG asymmetry (the Approach Withdrawal (AW) index) and the frontal theta (effort index). Furthermore, the autonomic Emotional Index (EI) was calculated, as derived from the Galvanic Skin Response (GSR) and Heart Rate (HR) signals. The present protocol describes a series of operational and computational steps required to properly estimate, through the aforementioned indices, the emotional and cerebral reaction of a group of subjects towards a selected number of antismoking PSAs. In particular, a campaign characterized by a symbolic communication style (classified as "awarded" on the basis of the prizes received by specialized committees) obtained the highest approach values, as estimated by the AW index. A spot and an image belonging to the same PSA campaign based on the "fear arousing appeal" and with a narrative/experiential communication style (classified as "effective" on the basis of the economical/health-related improvements promoted) reported the lowest and highest effort values, respectively. This is probably due to the complexity of the storytelling (spot) and to the immediateness of the image (a lady who underwent a tracheotomy). Finally, the same "effective" campaign showed the highest EI values, possibly because of the empathy induced by the testimonial and the explicitness of the message.
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Affiliation(s)
- Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome;
| | - Myriam Caratù
- Department of Communication and Social Research, Sapienza University of Rome
| | - Enrica Modica
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome
| | | | - Dario Rossi
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University of Rome
| | | | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome
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Mann N, Nonnemaker J, Chapman L, Shaikh A, Thompson J, Juster H. Comparing the New York State Smokers' Quitline Reach, Services Offered, and Quit Outcomes to 44 Other State Quitlines, 2010 to 2015. Am J Health Promot 2017; 32:1264-1272. [PMID: 28805074 DOI: 10.1177/0890117117724898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To summarize the reach, services offered, and cessation outcomes of the New York Quitline and compare with other state quitlines. DESIGN Descriptive study. SETTING Forty-five US states. PARTICIPANTS State-sponsored tobacco cessation quitlines in 45 US states that provided complete data to the Centers for Disease Control and Prevention's National Quitline Data Warehouse (NQDW) for 24 quarters over 6 years (2010-Q1 through 2015-Q4). INTERVENTION Telephone quitlines that offer tobacco use cessation services, including counseling, self-help materials, and nicotine replacement therapy (NRT), to smokers at no cost to them. MEASURES Percentage of adult tobacco users in the state who received counseling and/or free NRT from state quitlines (reach), services offered by state quitlines, and cessation outcomes among quitline clients 7 months after using quitline services. ANALYSIS Reach, services offered, and cessation outcomes for the New York Quitline were compared with similar measures for the other 44 state quitlines with complete NQDW data for all quarters from 2010 through 2015. RESULTS New York's average annual quitline reach from 2010 through 2015 was 3.0% per year compared to 1.1% per year for the other 44 states examined. CONCLUSION Although the New York Quitline was open fewer hours per week and offered fewer counseling sessions and a smaller amount of free NRT than most of the other 44 state quitlines, the New York Quitline had similar quit rates to most of those state quitlines.
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Affiliation(s)
- Nathan Mann
- 1 RTI International, Research Triangle Park, NC, USA
| | | | | | - Asma Shaikh
- 1 RTI International, Research Triangle Park, NC, USA
| | | | - Harlan Juster
- 2 The New York State Department of Health, Albany, NY, USA
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22
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Vallone D, Cantrell J, Bennett M, Smith A, Rath JM, Xiao H, Greenberg M, Hair EC. Evidence of the Impact of the truth FinishIt Campaign. Nicotine Tob Res 2017; 20:543-551. [DOI: 10.1093/ntr/ntx119] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 05/25/2017] [Indexed: 11/14/2022]
Affiliation(s)
- Donna Vallone
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- College of Global Public Health, New York University, New York, NY, USA
| | - Jennifer Cantrell
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Morgane Bennett
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Alexandria Smith
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
| | - Jessica M Rath
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Haijun Xiao
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
| | - Marisa Greenberg
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
| | - Elizabeth C Hair
- Evaulation Science and Research, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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23
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Davis KC, Patel D, Shafer P, Duke J, Glover-Kudon R, Ridgeway W, Cox S. Association Between Media Doses of the Tips From Former Smokers Campaign and Cessation Behaviors and Intentions to Quit Among Cigarette Smokers, 2012-2015. HEALTH EDUCATION & BEHAVIOR 2017; 45:52-60. [PMID: 28497703 DOI: 10.1177/1090198117709316] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since 2012, the Centers for Disease Control and Prevention (CDC) has implemented Tips From Former Smokers ( Tips), the first federally funded tobacco education campaign in the United States. To date, there are no evaluations of its long-term impact. AIMS To assess the impact of varied doses of the Tips campaign from 2012 through 2015 on cessation-related behaviors and intentions among U.S. smokers. METHOD We used a national probability-based online survey of cigarette smokers ( n = 22,189) and recent quitters ( n = 776) to examine associations between doses of Tips advertising, measured by gross rating points (GRPs), and intentions to quit smoking in the next 30 days and quit attempts within the past 3 months. A curvilinear (i.e., square root) functional form of GRPs was used to capture patterns of diminishing effects at higher GRP levels. RESULTS An increase of 1,000 quarterly Tips GRPs at the media market level was associated with increased odds of making a quit attempt in the past 3 months (adjusted odds ratio = 1.23, p < .001) and increased odds of intending to quit in the next 30 days (adjusted odds ratio = 1.17, p = .030). DISCUSSION Results suggest that CDC-recommended media buys of 800 to 1,000 GRPs per quarter are sufficient to generate statistically significant increases in the likelihood of quit attempts in the past quarter. CONCLUSIONS The Tips campaign has had a substantial impact on cessation behaviors among U.S. adult smokers over time. These data support the continued use of graphic and/or emotional media campaigns that encourage smokers to quit to further reduce tobacco use in the United States.
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Affiliation(s)
- Kevin C Davis
- 1 RTI International, Research Triangle Park, NC, USA
| | - Deesha Patel
- 2 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Shafer
- 1 RTI International, Research Triangle Park, NC, USA
| | - Jennifer Duke
- 1 RTI International, Research Triangle Park, NC, USA
| | | | | | - Shanna Cox
- 2 Centers for Disease Control and Prevention, Atlanta, GA, USA
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24
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Cantrell J, Hair EC, Smith A, Bennett M, Rath JM, Thomas RK, Fahimi M, Dennis JM, Vallone D. Recruiting and retaining youth and young adults: challenges and opportunities in survey research for tobacco control. Tob Control 2017; 27:147-154. [PMID: 28432211 DOI: 10.1136/tobaccocontrol-2016-053504] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/28/2017] [Accepted: 03/10/2017] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21. METHODS We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness RESULTS: Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates. CONCLUSIONS This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe.
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Affiliation(s)
- Jennifer Cantrell
- Evaluation and Science Research, Truth Initiative, Washington DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth C Hair
- Evaluation and Science Research, Truth Initiative, Washington DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alexandria Smith
- Evaluation and Science Research, Truth Initiative, Washington DC, USA
| | - Morgane Bennett
- Evaluation and Science Research, Truth Initiative, Washington DC, USA
| | - Jessica Miller Rath
- Evaluation and Science Research, Truth Initiative, Washington DC, USA.,Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Donna Vallone
- Evaluation and Science Research, Truth Initiative, Washington DC, USA.,Global Institute of Public Health, New York University, New York, NY, USA
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25
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Cardarelli R, Roper KL, Cardarelli K, Feltner FJ, Prater S, Ledford KM, Justice B, Reese DR, Wagner P, Cantrell C. Identifying Community Perspectives for a Lung Cancer Screening Awareness Campaign in Appalachia Kentucky: The Terminate Lung Cancer (TLC) Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:125-134. [PMID: 26411308 PMCID: PMC5569580 DOI: 10.1007/s13187-015-0914-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Lung cancer screening with low-dose computed tomography (LDCT) scan is now covered by Centers for Medicare & Medicaid Services following an evidence-based recommendation, but a shared decision making process should inform patients of risks and limitations. An awareness campaign promoting LDCT screenings is an opportunity to elicit patient engagement with health providers about the risks and benefits. Focus groups representing three regions of Appalachian Kentucky known for high lung cancer rates discussed development of a lung cancer screening campaign. Recommendations included messaging content, appeals or design, campaign implementation, and trusted information or communication sources. Community health workers (CHWs) from three Eastern Kentucky regions recruited individuals from their local communities using established client files. CHWs hosted six total focus groups (7-11 participants each) using questions guided by the Communication-Persuasion Matrix framework. All sessions were recorded and transcribed for independent content analysis. A total of 54 individuals (61.1 % female; >55 pack year history) were participated. Prior to discussion, most participants had not heard of lung cancer screening. Cited needs for content of a campaign included benefits of early detection and payment information. Messages considered most persuasive were those that include personal testimony, messages of hope, prolonged life, and an emphasis on family and the ambition to survive. Having information come from one's family doctor or specialty provider was considered important to message communication. Messages about survivorship, family, and prolonged life should be considered in lung cancer screening awareness campaigns. Our results provide community input about messages regarding screening options.
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Affiliation(s)
- Roberto Cardarelli
- Department of Family & Community Medicine, University of Kentucky College of Medicine, 2195 Harrodsburg Road, Lexington, KY, 40504-3504, USA
| | - Karen L Roper
- Department of Family & Community Medicine, University of Kentucky College of Medicine, 2195 Harrodsburg Road, Lexington, KY, 40504-3504, USA.
| | - Kathryn Cardarelli
- University of Kentucky College of Public Health, 111 Washington Ave, Suite 120, Lexington, KY, 40536, USA
| | - Frances J Feltner
- University of Kentucky Center of Excellence in Rural Health & Kentucky Homeplace, 750 Morton Blvd., Hazard, KY, 41701, USA
| | - Shirley Prater
- University of Kentucky Center of Excellence in Rural Health & Kentucky Homeplace, 750 Morton Blvd., Hazard, KY, 41701, USA
| | - Karen Michelle Ledford
- University of Kentucky Center of Excellence in Rural Health & Kentucky Homeplace, 750 Morton Blvd., Hazard, KY, 41701, USA
| | - Barbara Justice
- University of Kentucky Center of Excellence in Rural Health & Kentucky Homeplace, 750 Morton Blvd., Hazard, KY, 41701, USA
| | - David R Reese
- Appalachian Osteopathic Postgraduate Training Institute Consortium, 147 Sycamore Street, Pikeville, KY, 41501, USA
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26
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Zhao X, Cai X. The association between exposure to "Tips" and smoking-related outcomes among adolescents in the United States. HEALTH EDUCATION RESEARCH 2016; 31:614-623. [PMID: 27422897 DOI: 10.1093/her/cyw037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 06/25/2016] [Indexed: 06/06/2023]
Abstract
The Tips From Former Smokers ("Tips") campaign in the United States primarily targets adult smokers, but considers adolescents an important secondary audience. This study examines the association between exposure to Tips and smoking outcomes in the adolescent population in the United States. We analyzed data from the 2013 National Youth Tobacco Survey, a nationally representative, cross-sectional survey of middle- and high-school students in the United States (n = 18 406). Multivariate logistic regression was used to assess the relationships between exposure to Tips advertisements and quitting intentions among current smokers and smoking susceptibility among experimenters and never smokers. Among current smokers, exposure to one Tips ad (versus no exposure) was positively associated with intending to quit. Similar associations also emerged for higher levels of exposure but did not reach significance. Among never smokers, exposure to four and more ads (versus no exposure) was associated with lower smoking susceptibility. Exposure to Tips ads was unrelated to smoking susceptibility among experimenters. The associations observed in the study suggest an intricate, and generally favorable, relationship between campaign exposure and smoking-related outcomes among current smokers and never smokers. Close monitoring of the Tips' impact on the adolescent population is needed.
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Affiliation(s)
- Xiaoquan Zhao
- Department of Communication, George Mason University, MS 3D6, 4400 University Drive, Fairfax, VA 22030, USA
| | - Xiaomei Cai
- Department of Communication, George Mason University, MS 3D6, 4400 University Drive, Fairfax, VA 22030, USA
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27
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Neff LJ, Patel D, Davis K, Ridgeway W, Shafer P, Cox S. Evaluation of the National Tips From Former Smokers Campaign: the 2014 Longitudinal Cohort. Prev Chronic Dis 2016; 13:E42. [PMID: 27010845 PMCID: PMC4807436 DOI: 10.5888/pcd13.150556] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Since 2012, the Centers for Disease Control and Prevention has aired a national tobacco education campaign to encourage quitting, Tips From Former Smokers (Tips), which consists of graphic antismoking advertisements that feature former cigarette smokers. We evaluated phase 2 of the 2014 campaign by using a nationally representative longitudinal cohort. Methods Cigarette smokers who participated in a baseline survey were re-contacted for follow-up (n = 4,248) approximately 4 months later, immediately after the campaign’s conclusion. The primary outcomes were incidence of a quit attempt in the previous 3 months, intention to quit within 30 days, and intention to quit within 6 months during the postcampaign period. We used multivariate logistic regression models to estimate the odds of each outcome. We also stratified models by race/ethnicity, education, and mental health status. Postcampaign rates of quit attempts, intentions to quit, and sustained quits were also estimated. Results Exposure to the campaign was associated with increased odds of a quit attempt in the previous 3 months (OR, 1.17; P = .03) among baseline smokers and intentions to quit within the next 6 months (OR, 1.28; P = .01) among current smokers at follow-up. The Tips campaign was associated with an estimated 1.83 million additional quit attempts, 1.73 million additional smokers intending to quit within 6 months, and 104,000 sustained quits of at least 6 months. Conclusion The Tips campaign continued to have a significant impact on cessation-related behaviors, providing further justification for the continued use of tobacco education campaigns to accelerate progress toward the goal of reducing adult smoking in the United States.
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Affiliation(s)
- Linda J Neff
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341.
| | - Deesha Patel
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kevin Davis
- RTI International, Research Triangle Park, North Carolina
| | | | - Paul Shafer
- RTI International, Research Triangle Park, North Carolina
| | - Shanna Cox
- Centers for Disease Control and Prevention, Atlanta, Georgia
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28
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Kim A, Hansen H, Duke J, Davis K, Alexander R, Rowland A, Mitchko J. Does Digital Ad Exposure Influence Information-Seeking Behavior Online? Evidence From the 2012 Tips From Former Smokers National Tobacco Prevention Campaign. J Med Internet Res 2016; 18:e64. [PMID: 26983849 PMCID: PMC4814686 DOI: 10.2196/jmir.4299] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 09/18/2015] [Accepted: 01/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background Measuring the impact of online health campaigns is challenging. Ad click-through rates are traditionally used to measure campaign reach, but few Internet users ever click on ads. Alternatively, self-reported exposure to digital ads would be prone to recall bias. Furthermore, there may be latency effects whereby people do not click on ads when exposed but visit the promoted website or conduct campaign-related searches later. Online panels that unobtrusively collect panelists’ Web behavior data and link ad exposure to website visits and searches can more reliably assess the impact of digital ad exposure. From March to June 2012, the Centers for Disease Control and Prevention aired the national Tips From Former Smokers (Tips 2012) media campaign designed to encourage current smokers to quit. Advertisements ran across media channels, and the digital ads directed users to the Tips 2012 campaign website. Objective Our aim was to examine whether exposure to Tips 2012 digital ads influenced information-seeking behaviors online. Methods ComScore mined its panelists’ Web behavior data for unique codes that would indicate exposure to Tips 2012 ads, regardless of whether panelists clicked the ad or not. A total of 15,319 US adults were identified as having been exposed to a Tips 2012 campaign ad. An equal number of unexposed adults (N=15,319) were identified and matched on demographics and Internet use behavior to the exposed group. Panelists’ Web behavior data were mined for up to 4 weeks after initial Tips 2012 ad exposure to determine whether they visited the Tips 2012 campaign website or other cessation-related websites (eg, nicotine replacement therapy site) or conducted searches for campaign-related topics (eg, quit smoking). Results The proportion of exposed adults visiting the Tips 2012 sites increased from 0.4% in Week 1 to 0.9% 4 weeks after ad exposure, and these rates were significantly higher than in the unexposed group (0.1% in Week 1 to 0.4% in Week 4, P<.001) across all weeks examined. The proportion of exposed panelists visiting other cessation websites increased from 0.2% in Week 1 to 0.3% 4 weeks after initial ad exposure, and these rates were significantly higher than in the unexposed group (0.0% in Week 1 to 0.2% in Week 4, P=.001 to P=.019) across all weeks examined. There were no significant differences in searches for campaign-related topics between the exposed and unexposed group during most of the weeks examined. Conclusions These results suggest that online ad exposure is associated with confirmed visits to the Tips 2012 campaign sites and visits to other cessation websites and that these information-seeking behaviors occur up to several weeks after ad exposure. Web behavior data from online panels are useful for examining exposure and behavioral responses to digital campaign ads.
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Affiliation(s)
- Annice Kim
- RTI International, Research Triangle Park, NC, United States.
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29
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McAfee T, Davis KC, Shafer P, Patel D, Alexander R, Bunnell R. Increasing the dose of television advertising in a national antismoking media campaign: results from a randomised field trial. Tob Control 2015; 26:19-28. [PMID: 26678518 PMCID: PMC5108680 DOI: 10.1136/tobaccocontrol-2015-052517] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/30/2015] [Indexed: 11/06/2022]
Abstract
Background While antismoking media campaigns have demonstrated effectiveness, less is known about the country-level effects of increased media dosing. The 2012 US Tips From Former Smokers (Tips) campaign generated approximately 1.6 million quit attempts overall; however, the specific dose–response from the campaign was only assessed by self-report. Objective Assess the impact of higher ad exposure during the 2013 Tips campaign on quit-related behaviours and intentions, campaign awareness, communication about campaign, and disease knowledge. Methods A 3-month national media buy was supplemented within 67 (of 190) randomly selected local media markets. Higher-dose markets received media buys 3 times that of standard-dose markets. We compared outcomes of interest using data collected via web-based surveys from nationally representative, address-based probability samples of 5733 cigarette smokers and 2843 non-smokers. Results In higher-dose markets, 87.2% of smokers and 83.9% of non-smokers recalled television campaign exposure versus 75.0% of smokers and 73.9% of non-smokers in standard-dose markets. Among smokers overall, the relative quit attempt rate was 11% higher in higher-dose markets (38.8% vs 34.9%; p<0.04). The higher-dose increase was larger in African-Americans (50.9% vs 31.8%; p<0.01). Smokers in higher-dose markets without a mental health condition, with a chronic health condition, or with only some college education made quit attempts at a higher rate than those in standard-dose markets. Non-smokers in higher-dose markets were more likely to talk with family or friends about smoking dangers (43.1% vs 35.7%; p<0.01) and had greater knowledge of smoking-related diseases. Conclusions The US 2013 Tips antismoking media campaign compared standard and higher doses by randomisation of local media markets. Results demonstrate the effectiveness of a higher dose for engaging non-smokers and further increasing quit attempts among smokers, especially African-Americans.
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Affiliation(s)
- Tim McAfee
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kevin C Davis
- Center for Health Policy Science and Tobacco Research RTI International, Research Triangle Park, North Carolina, USA
| | - Paul Shafer
- Center for Health Policy Science and Tobacco Research RTI International, Research Triangle Park, North Carolina, USA
| | - Deesha Patel
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert Alexander
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Bunnell
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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30
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Zhao X, Cai X. Exposure to the Tips From Former Smokers Campaign Among Adolescents in the United States. Nicotine Tob Res 2015; 18:971-5. [DOI: 10.1093/ntr/ntv265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 11/28/2015] [Indexed: 11/12/2022]
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31
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McAfee T, Davis KC, Cox SN, Beistle DM. Google Searches or Quit Attempts as a Success Measure for an Antismoking Campaign. Am J Prev Med 2015; 49:e131-2. [PMID: 26456878 PMCID: PMC5316515 DOI: 10.1016/j.amepre.2015.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 07/20/2015] [Accepted: 08/12/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Tim McAfee
- Office on Smoking and Health, CDC, Atlanta, Georgia
| | - Kevin C Davis
- RTI International, Research Triangle Park, North Carolina
| | - Shanna N Cox
- Office on Smoking and Health, CDC, Atlanta, Georgia
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