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Vogel EA, Unger JB, Vassey J, Barrington-Trimis JL. Effects of a nicotine warning label and vaping cessation resources on young adults' perceptions of pro-vaping instagram influencer posts. Addict Behav 2024; 149:107888. [PMID: 37857044 PMCID: PMC10841614 DOI: 10.1016/j.addbeh.2023.107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Exposure to social media content promoting e-cigarette use ("vaping") is associated with subsequent tobacco use among young adults. Adding features to pro-vaping Instagram influencer posts, such as a nicotine warning label and vaping cessation resources, could help counteract posts' negative influence. METHODS Young adults (N = 2,179; Mage = 22.6 [SD = 0.4]; 53.0 % cisgender women, 45.1 % Hispanic) completed an online experiment in 2021-2022 through an ongoing prospective cohort study. Participants viewed three simulated pro-vaping Instagram influencer posts in a four-group, between-subjects design. Post features differed by experimental condition: "label-only" (nicotine warning label on post), "link-only" (link to vaping cessation resources under post), "L&L" (label and link), or "control" (neither). Participants rated each influencer's traits (honest, trustworthy, informed, smart, attractive, popular; 0-100 %). After viewing all three posts, participants reported use intentions, susceptibility, positive and negative expectancies, and harm perceptions around the fictitious advertised vaping product. Past-month vapers additionally reported their desire and self-efficacy for quitting. RESULTS L&L (versus control and link-only) participants viewed influencers as more honest, trustworthy, and informed. L&L (versus control) participants had lower odds of susceptibility to using the advertised product, lower positive expectancies, and greater negative expectancies. The label and link did not significantly affect participants' intentions to use the product, perceived harm of the product, or desire or self-efficacy for quitting vaping. CONCLUSIONS Providing a nicotine warning label and link to vaping cessation resources on influencers' Instagram posts may have the unintended effect of increasing positive perceptions of the influencer. However, they may reduce susceptibility to product use.
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Affiliation(s)
- Erin A Vogel
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA.
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA 90033, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA 90033, USA
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Struik L, Sharma RH, Rodberg D, Christianson K, Lewis S. A Content Analysis of Behavior Change Techniques Employed in North American Vaping Prevention Interventions. AJPM FOCUS 2023; 2:100126. [PMID: 37790953 PMCID: PMC10546602 DOI: 10.1016/j.focus.2023.100126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Vaping among North American youth has surfaced as a concerning public health epidemic. Increasing evidence of harms associated with E-cigarette use, especially among the young, has prompted urgency in addressing vaping. Although a number of individual behavior change campaigns have arisen as a result, little is known about which behavior change techniques are being employed to influence youth vaping behavior. In this study, we aimed to code all North American vaping prevention campaigns using the behavior change technique taxonomy (Version 1) to determine which behavior change techniques are being used. Methods We identified the sample of campaigns through systematic searches using Google. After applying the exclusion criteria, the campaigns were reviewed and coded for behavior change techniques. Results In total, 46 unique vaping prevention campaigns were identified, including 2 federal (1 from Canada, 1 from the U.S.), 43 U.S. state-level, and 1 Canadian provincial-level campaign(s). The number of behavior change technique categories and behavior change techniques in a campaign ranged from 0 to 5 (mean=1.56) and 0 to 6 (mean=2.13), respectively. Of the 16 possible behavior change technique categories, 4 were utilized across the campaigns, which included 5. Natural consequences (89%), 6. Comparison of behavior (22%), 13. Identity (20%), and 3. Social support (11%). Conclusions Only a small number of behavior change techniques were used in North American vaping prevention campaigns, with a heavy and often sole reliance on communicating the health consequences of use. Incorporating other promising behavior change techniques into future campaigns is likely a productive way forward to tackling the complex and multifaceted issue of youth vaping.
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Affiliation(s)
- Laura Struik
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Ramona H. Sharma
- Department of Health and Exercise Sciences, School of Social Work, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Danielle Rodberg
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyla Christianson
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Shannon Lewis
- Department of Health and Exercise Sciences, School of Social Work, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
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Feliu A, Quintero A, Peruga A, Carnicer-Pont D, Antón L, Rey-Pino JM, Fernández E. Changes in tobacco imagery and smokers' depiction in Spanish top-grossing films before and after the implementation of a comprehensive tobacco control policy in Spain. Tob Induc Dis 2023; 21:66. [PMID: 37215193 PMCID: PMC10198122 DOI: 10.18332/tid/162700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION As more restrictions on tobacco marketing communication are implemented, tobacco marketing has persisted through smoking in films. Our aims were to assess changes in tobacco imagery exposure in Spanish top-grossing films before and after the banning of tobacco advertising in Spain, and to determine whether the depiction of smoking characters has changed over the years. METHODS A repeated cross-sectional study measured the tobacco content in the 10 Spanish top-grossing films in 2005, 2010 and 2015 (n=30) before and after a complete tobacco advertising ban. We conducted a descriptive and regression analysis of changes in tobacco impressions by year. RESULTS The 30 films contained 1378 tobacco occurrences (90.2% positive for tobacco) with a median length of eight seconds onscreen. Total tobacco occurrences deemed positive for tobacco interests significantly increased in 2010 and 2015 compared to 2005. However, we observed decreased odds of tobacco brands appearances (OR=0.25; p<0.001) in 2010 and of implied tobacco use (OR=0.44; p=0.002), and tobacco brands appearances (OR=0.36; p<0.001) in 2015 compared to 2005. There was a change of pattern in the type of role smokers played from a leading role to a supporting one (p<0.001). The population reach of positive for tobacco occurrence in Spanish top-grossing films decreased from 15.9 (95% CI: 15.86-15.86) per 1000 spectators in 2005 to 0.8 (95% CI: 0.82-0.82) in 2015. CONCLUSIONS The implementation of a ban on complete tobacco product advertising was followed by a decrease in tobacco incidents across top-grossing Spanish films. Yet, exposure to smoking in films is still unacceptably high.
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Affiliation(s)
- Ariadna Feliu
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Alex Quintero
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
| | - Armando Peruga
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
- Centro de Epidemiologia y Politicas de Salud, Facultad de Medicina Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Dolors Carnicer-Pont
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Laura Antón
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
| | - Juan M. Rey-Pino
- Departamento de Comercializacion e Investigacion de Mercados, Facultad de Ciencias Economicas y Empresariales, Universidad de Granada, Granada, Espana
| | - Esteve Fernández
- Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Catala d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Espana
- Grupo de Investigacion en Control del Tabaco, Institut d'Investigacio Biomedica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Espana
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, (CIBERES), Madrid, Espana
- Departamento de Ciencias Clinicas, Facultad de Medicina, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Espana
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Stalgaitis CA, Jordan JW, Djakaria M, Saggese DJ, Bruce HR. Psychographic segmentation to identify higher-risk teen peer crowds for health communications: Validation of Virginia's Mindset Lens Survey. Front Public Health 2022; 10:871864. [PMID: 35937230 PMCID: PMC9355138 DOI: 10.3389/fpubh.2022.871864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Audience segmentation is necessary in health communications to ensure equitable resource distribution. Peer crowds, which are macro-level teen subcultures, are effective psychographic segments for health communications because each crowd has unique mindsets, values, norms, and health behavior profiles. These mindsets affect behaviors, and can be used to develop targeted health communication campaigns to reach those in greatest need. Though peer crowd research is plentiful, no existing peer crowd measurement tool has been formally validated. As such, we developed and validated Virginia's Mindset Lens Survey (V-MLS), a mindset-based teen peer crowd segmentation survey to support health communication efforts. Using an online convenience sample of teens (N = 1,113), we assessed convergent and discriminant validity by comparing the V-MLS against an existing, widely-used peer crowd survey (I-Base Survey®) utilizing a multi-trait multi-method matrix. We also examined the V-MLS's predictive ability through a series of regressions using peer crowd scores to predict behaviors, experiences, and traits relevant to health communication campaign planning. The V-MLS demonstrated reliability and convergent and discriminant validity. Additionally, the V-MLS effectively distinguished teen peer crowds with unique health behaviors, experiences, and personal traits. When combined with appropriate information processing and campaign development frameworks, this new tool can complement existing instruments to inform message framing, tone, and style for campaigns that target at-risk teens to increase campaign equity and reach.
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Guillory J, Curry L, Farrelly M, Henes A, Homsi G, Saunders M, MacMonegle A, Fiacco L, Alexander T, Delahanty J, Mekos D, Hoffman L, Ganz O. Reach, Receptivity, And Beliefs Associated With the Fresh Empire Campaign to Prevent and Reduce Cigarette Use Among Youth in the United States. Am J Health Promot 2022; 36:789-800. [PMID: 35081751 PMCID: PMC9258634 DOI: 10.1177/08901171211069991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the association between exposure to FDA's Fresh Empire tobacco public education campaign and tobacco-related beliefs. DESIGN Repeated cross-sectional data collection design with embedded longitudinal cohort over six data collection waves. SETTING 30 US evaluation markets. SAMPLE Hip Hop peer crowd-identified US youth aged 12-18 (N = 5,378). MEASURES Self-reported brand and video ad awareness (saw any ad at least sometimes) and perceived effectiveness (1-5 scale) to describe campaign awareness and receptivity. Exogenous exposure was measured using population-adjusted broadcast and digital video impressions. Tobacco-related beliefs included beliefs about smoking risks, attitudes towards tobacco-free people and lifestyles, and normative beliefs about smoking. ANALYSIS Descriptive analyses of awareness, receptivity, and agreement with tobacco-related beliefs. Logistic regression models to determine the relationship between broadcast and digital video impressions and beliefs. INTERVENTION Fresh Empire campaign. RESULTS The campaign generated a high level of reach (71% brand and 66% video ad awareness at final wave) and messages were well-received (across waves 3.5-4.1 mean perceived effectiveness scores). Higher broadcast television exposure was associated with increased agreement with five beliefs related to addiction/control, being a bad influence on family/friends, and cosmetic effects of smoking (breath and attractiveness) (ORs = 1.16-1.27, (Ps < .05)). CONCLUSION Fresh Empire successfully reached and resonated with Hip Hop-identified youth. The campaign was associated with a limited number of targeted beliefs.
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Affiliation(s)
| | | | | | - Amy Henes
- RTI International, Research Triangle Park, NC, USA
| | - Ghada Homsi
- RTI International, Research Triangle Park, NC, USA
| | | | | | - Leah Fiacco
- RTI International, Research Triangle Park, NC, USA
| | - Tesfa Alexander
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Janine Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Debra Mekos
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | | | - Ollie Ganz
- Rutgers University, New Brunswick, NJ, USA
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Chinopfukutwa VS, Hektner JM. Peer crowd affiliations as predictors of prosocial and risky behaviors among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1231-1240. [PMID: 32703093 DOI: 10.1080/07448481.2020.1790574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/30/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
ObjectivesTo examine college peer crowd affiliations and prosocial and risky behaviors (academic, sexual, drug, and alcohol related risks) as well as to investigate gender as a moderator of these relations. Participants: 527 students at a public university in the Midwest in Fall 2018 (M age = 19.67, SD = 1.84). Method: Students' peer crowd affiliations were reported using an online survey. Four peer crowd dimensions were confirmed using Factor Analysis: Social (popular partiers and Greek organization members), Athletic, Arts/Diverse (students identifying strongly with a countercultural group, their race/ethnic group, and/or performing arts); and Scholastic (academic achievement and leadership). Results: Social crowd affiliations positively predicted all risk-related behaviors. Social and Scholastic affiliations positively predicted prosocial behaviors. Finally, gender significantly moderated the relations between peer crowd affiliations and risk and prosociality. Conclusions: These findings demonstrate that peer crowd affiliation and gender are important when promoting positive behaviors on campus.
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Affiliation(s)
- Vimbayi S Chinopfukutwa
- Human Development and Family Science Department, North Dakota State University, Fargo, North Dakota, USA
| | - Joel M Hektner
- Human Development and Family Science Department, North Dakota State University, Fargo, North Dakota, USA
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Crankshaw E, Gaber J, Guillory J, Curry L, Farrelly M, Saunders M, Hoffman L, Ganz O, Delahanty J, Mekos D, Alexander T. Final Evaluation Findings for This Free Life, a 3-Year, Multi-Market Tobacco Public Education Campaign for Gender and Sexual Minority Young Adults in the United States. Nicotine Tob Res 2022; 24:109-117. [PMID: 34270739 PMCID: PMC8666114 DOI: 10.1093/ntr/ntab146] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/14/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This Free Life was the first multi-market, primarily digital campaign designed to change tobacco-related beliefs among lesbian, gay, bisexual, and transgender (LGBT) young adults. Our evaluation sought to determine whether campaign exposure resulted in changes in tobacco-related beliefs. We summarize awareness and receptivity at the conclusion of the campaign and assess the effect of campaign exposure on tobacco-related beliefs in campaign treatment markets compared with control markets. AIMS AND METHODS Twenty-four US designated market areas were selected to receive the campaign or serve as control markets. A baseline survey was conducted in 2016, with six follow-up surveys conducted approximately 6 months apart over the course of the 3-year campaign. 12 324 LGBT young adult survey participants were recruited via intercept interviews and social media. Campaign effects on outcomes were estimated using difference-in-difference panel regression models, with p-values corrected for multiple comparisons. RESULTS Brand and ad awareness peaked in treatment markets approximately 2.5 years into the 3-year campaign and were significantly higher in treatment than control markets. Brand equity and ad receptivity were generally high and similar across LGBT subgroups. There were small but significant campaign effects on five tobacco-related beliefs, with difference-in-difference estimates ranging from 1.9 to 5.6 percentage points. CONCLUSIONS This Free Life, the first multi-market tobacco public education campaign for LGBT young adults, reached and resonated with a large and diverse population, and had a small effect on beliefs involving social aspects of smoking. These findings should inform future communication efforts aimed at reducing tobacco use among LGBT young adults. IMPLICATIONS Modest overall campaign effects suggest that further research on effective campaign messaging and delivery to LGBT young adults is needed. Campaign messaging style, delivery channels, and targeted outcomes likely contributed to these findings. Health communication efforts for LGBT young adults should consider the limitations of digital media in achieving sufficient exposure. Ad style and content optimized for a digital environment is an area that will benefit from further development.
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Affiliation(s)
- Erik Crankshaw
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - Jennifer Gaber
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | | | - Laurel Curry
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - Matthew Farrelly
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | - McKinley Saunders
- RTI International, Center for Health Analytics, Media, and Policy, Durham, NC, USA
| | | | - Ollie Ganz
- Rutgers School of Public Health, Piscataway, NJ, USA
| | - Janine Delahanty
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
| | - Debra Mekos
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
| | - Tesfa Alexander
- Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA
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Kurani SS, Lampman MA, Funni SA, Giblon RE, Inselman JW, Shah ND, Allen S, Rushlow D, McCoy RG. Association Between Area-Level Socioeconomic Deprivation and Diabetes Care Quality in US Primary Care Practices. JAMA Netw Open 2021; 4:e2138438. [PMID: 34964856 PMCID: PMC8717098 DOI: 10.1001/jamanetworkopen.2021.38438] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Diabetes management operates under a complex interrelationship between behavioral, social, and economic factors that affect a patient's ability to self-manage and access care. OBJECTIVE To examine the association between 2 complementary area-based metrics, area deprivation index (ADI) score and rurality, and optimal diabetes care. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed the electronic health records of patients who were receiving care at any of the 75 Mayo Clinic or Mayo Clinic Health System primary care practices in Minnesota, Iowa, and Wisconsin in 2019. Participants were adults with diabetes aged 18 to 75 years. All data were abstracted and analyzed between June 1 and November 30, 2020. MAIN OUTCOMES AND MEASURES The primary outcome was the attainment of all 5 components of the D5 metric of optimal diabetes care: glycemic control (hemoglobin A1c <8.0%), blood pressure (BP) control (systolic BP <140 mm Hg and diastolic BP <90 mm Hg), lipid control (use of statin therapy according to recommended guidelines), aspirin use (for patients with ischemic vascular disease), and no tobacco use. The proportion of patients receiving optimal diabetes care was calculated as a function of block group-level ADI score (a composite measure of 17 US Census indicators) and zip code-level rurality (calculated using Rural-Urban Commuting Area codes). Odds of achieving the D5 metric and its components were assessed using logistic regression that was adjusted for demographic characteristics, coronary artery disease history, and primary care team specialty. RESULTS Among the 31 934 patients included in the study (mean [SD] age, 59 [11.7] years; 17 645 men [55.3%]), 13 138 (41.1%) achieved the D5 metric of optimal diabetes care. Overall, 4090 patients (12.8%) resided in the least deprived quintile (quintile 1) of block groups and 1614 (5.1%) lived in the most deprived quintile (quintile 5), while 9193 patients (28.8%) lived in rural areas and 2299 (7.2%) in highly rural areas. The odds of meeting the D5 metric were lower for individuals residing in quintile 5 vs quintile 1 block groups (odds ratio [OR], 0.72; 95% CI, 0.67-0.78). Patients residing in rural (OR, 0.84; 95% CI, 0.73-0.97) and highly rural (OR, 0.81; 95% CI, 0.72-0.91) zip codes were also less likely to attain the D5 metric compared with those in urban areas. CONCLUSIONS AND RELEVANCE This cross-sectional study found that patients living in more deprived and rural areas were significantly less likely to attain high-quality diabetes care compared with those living in less deprived and urban areas. The results call for geographically targeted population health management efforts by health systems, public health agencies, and payers.
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Affiliation(s)
- Shaheen Shiraz Kurani
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Michelle A. Lampman
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Shealeigh A. Funni
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Rachel E. Giblon
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
| | - Jonathan W. Inselman
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Nilay D. Shah
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Summer Allen
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
| | - David Rushlow
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
| | - Rozalina G. McCoy
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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Toledo G, McQuoid J, Ling PM. "It's Not Too Aggressive": Key Features of Social Branding Anti-Tobacco Interventions for High-Risk Young Adults. Health Promot Pract 2021; 22:423-432. [PMID: 32111139 PMCID: PMC7483222 DOI: 10.1177/1524839920910372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose. Peer crowd-targeted campaigns are a novel approach to engage high-risk young adults in tobacco use prevention and cessation. We elicited the perspectives of young adult key informants to understand how and why two social branding interventions were effective: (1) "COMMUNE," designed for "Hipsters" as a movement of artists and musicians against Big Tobacco, and (2) "HAVOC," designed for "Partiers" as an exclusive, smoke-free clubbing experience. Design. Qualitative study (27 semistructured qualitative phone interviews). Setting. Intervention events held in bars in multiple U.S. cities. Participants: Twenty-seven key informants involved in COMMUNE or HAVOC as organizers (e.g., musicians, event coordinators) or event attendees. Measures. We conducted semistructured, in-depth interviews. Participants described intervention events and features that worked or did not work well. Analysis. We used an inductive-deductive approach to thematically code interview transcripts, integrating concepts from intervention design literature and emergent themes. Results: Participants emphasized the importance of fun, interactive, social environments that encouraged a sense of belonging. Anti-tobacco messaging was subtle and nonjudgmental and resonated with their interests, values, and aesthetics. Young adults who represented the intervention were admired and influential among peers, and intervention promotional materials encouraged brand recognition and social status. Conclusion. Anti-tobacco interventions for high-risk young adults should encourage fun experiences; resonate with their interests, values, and aesthetics; and use subtle, nonjudgmental messaging.
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Affiliation(s)
- Gabriela Toledo
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
- University of California San Francisco, San Francisco, CA, USA
| | - Julia McQuoid
- University of California San Francisco, San Francisco, CA, USA
| | - Pamela M. Ling
- University of California San Francisco, San Francisco, CA, USA
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Duarte D, Choi K. Psychographic Profiling of Adult Tobacco Users and Implications for Mediated Message Tailoring. Am J Health Promot 2021; 35:483-490. [PMID: 33084349 PMCID: PMC9347182 DOI: 10.1177/0890117120967193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate variations of psychographic profiles in adult tobacco users to inform message tailoring. DESIGN A cross-sectional design used data from the Simmons 2015 National Consumer Study. SETTING Data were voluntarily provided by US families through a mail survey on media, products, and services, brands, and attitudes. SUBJECTS US adult tobacco users (N = 4,609). MEASURES Participants answered questions about general opinion/attitudes and provided demographic and tobacco use information. ANALYSIS A factor analysis was conducted to determine the "best" latent psychographic factor structure based on model fit, factor loadings, and interpretability. A structural equation model was then applied to assess the associations between demographics, tobacco product use, and latent psychographic factors. RESULTS We identified 9 latent psychographic factors: (1) helplessness, (2) happiness, (3) achievements, (4) religion, (5) interest in art and culture, (6) conscience, (7) conformity, (8) family indulgence, and (9) creativity. Endorsement of these factors varied by demographics and tobacco product use. E.g. low income tobacco users showed stronger endorsement for "helplessness" (Adjusted Standardized Regression Coefficient [ASRC]: 0.42; 95% CI: 0.33, 0.51) and "religion" (ASRC: 0.24; 95% CI: 0.14, 0.33). Less educated tobacco users showed stronger endorsement for "conformity" (ASRC: 0.16; 95% CI: 0.07, 0.24). Young adults had significant positive associations for "achievements" (ASRC: 0.57; 95% CI: 0.48, 0.67). CONCLUSION Psychographic profiles of tobacco users vary by demographics and product use. Tailored anti-tobacco media campaigns to specific disparity groups matching their psychographic profiles may improve message effectiveness and reduce tobacco use disparities.
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Affiliation(s)
- Danielle Duarte
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Kumboyono K, Hamid AYS, Sahar J, Bardosono S. Community response to the initiation of smoking in Indonesian early adolescents: a qualitative study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2020. [DOI: 10.1080/02673843.2019.1608273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Kumboyono Kumboyono
- School of Nursing, Brawijaya University , Malang, Indonesia
- Faculty of Nursing, Universitas Indonesia , Depok, Indonesia
| | | | - Junaiti Sahar
- Faculty of Nursing, Universitas Indonesia , Depok, Indonesia
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Nguyen N, Holmes LM, Kim M, Ling PM. Using Peer Crowd Affiliation to Address Dual Use of Cigarettes and E-Cigarettes among San Francisco Bay Area Young Adults: A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7643. [PMID: 33092106 PMCID: PMC7588881 DOI: 10.3390/ijerph17207643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022]
Abstract
Given the emerging tobacco landscape, dual use of cigarettes and e-cigarettes has increased among young adults, but little is known about its associated factors. Peer crowds, defined as macro-level connections between individuals with similar core values (e.g., "Hip Hop" describing a group that prefers hip hop music and values strength, honor, and respect), are a promising way to understand tobacco use patterns. We examined associations between peer crowds and tobacco use patterns by using data from a cross sectional survey of 1340 young adults in the San Francisco Bay Area in 2014. Outcomes were the past 30-day use of: neither cigarettes nor e-cigarettes; cigarettes but not e-cigarettes; e-cigarettes but not cigarettes; and both cigarettes and e-cigarettes. Peer crowds included Hipster, Hip Hop, Country, Partier, Homebody, and Young Professional. Multinomial regression analysis indicated that peer crowds were significantly associated with different tobacco use patterns. Compared to Young Professionals, Hip Hop and Hipster crowds were more likely to dual use; Hipsters were more likely to use e-cigarettes only, and Country participants were more likely to smoke cigarettes only. These findings suggest that tobacco control campaigns and cessation interventions should be tailored to different young adult peer crowds and address poly-tobacco use.
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
| | - Louisa M. Holmes
- Departments of Geography & Demography, and the Social Science Research Institute, Penn State University, University Park, PA 16802, USA;
| | - Minji Kim
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
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Stalgaitis CA, Djakaria M, Jordan JW. The Vaping Teenager: Understanding the Psychographics and Interests of Adolescent Vape Users to Inform Health Communication Campaigns. Tob Use Insights 2020; 13:1179173X20945695. [PMID: 32843842 PMCID: PMC7418471 DOI: 10.1177/1179173x20945695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 06/17/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Adolescent vaping continues to rise, yet little is known about teen vape users beyond demographics. Effective intervention requires a deeper understanding of the psychographics and interests of adolescent vape users to facilitate targeted communication campaigns. Methods: We analyzed the 2017-2018 weighted cross-sectional online survey data from Virginia high school students (N = 1594) to identify and describe subgroups of adolescents who vaped. Participants reported 30-day vape use, identification with 5 peer crowds (Alternative, Country, Hip Hop, Mainstream, Popular), social prioritization, agreement with personal values statements, social media and smartphone use, and television and event preferences. We compared vaping rates and frequency by peer crowd using a chi-square analysis with follow-up testing to identify higher-risk crowds and confirmed associations using binary and multinomial logistic regression models with peer crowd scores predicting vaping, controlling for demographics. We then used chi-square and t tests to describe the psychographics, media use, and interests of higher-risk peer crowds and current vape users within those crowds. Results: Any current vaping was the highest among those with Hip Hop peer crowd identification (25.4%), then Popular (21.3%). Stronger peer crowd identification was associated with increased odds of any current vaping for both crowds, vaping on 1 to 19 days for both crowds, and vaping on 20 to 30 days for Hip Hop only. Compared with other peer crowds and non-users, Hip Hop and Popular youth and current vape users reported greater social prioritization and agreement with values related to being social and fashionable. Hip Hop and Popular youth and current vape users reported heavy Instagram and Snapchat use, as well as unique television show and event preferences. Conclusions: Hip Hop and Popular adolescents are most likely to vape and should be priority audiences for vaping prevention campaigns. Findings should guide the development of targeted health communication campaigns delivered via carefully designed media strategies.
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Affiliation(s)
| | - Mayo Djakaria
- Research Department, Rescue Agency, San Diego, CA, USA
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Abstract
More than half of young adult (YA) (ages 18-26) smokers are non-daily smokers. While standard cessation methods are generally successful with adults and daily smokers, there is evidence that they are not as successful among non-daily smokers or young adults. Additionally, YA smokers are also in a transition period to regular smoking, making research on understanding how interpersonal and environmental factors affect this group of smokers critical. Randomized time location sampling was used to create a sample of New York City YA bar patrons between June and November 2013, who completed a self-administered survey (1,916 surveys). Questions were asked about perceived smoking social norms, stigma, behaviors, and demographics. Overall, almost half of the YA reported being current smokers (44.1%); one-third were non-daily smokers (36.7%) and less than ten percent were daily smokers (7.4%). Non-daily smokers compared with daily smokers had greater odds of believing New Yorkers disapproved of smoking [adjusted odds ratio (ORadj 1.76, 95 % CI 1.10-2.79)], keeping tobacco a secret from certain people (ORadj 1.84, 1.14-2.96) and feeling guilty when smoking (ORadj: 2.54; 1.45-4.45). Non-daily smokers had 41% lower odds of reporting how people who are important to you disapproved of smoking than daily smokers (ORadj: 0.59; 0.38-0.94). Further studies of interpersonal/environmental factors among YA smokers may support modifications to cessation programs that result in more successful YA quit attempts.
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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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Leas EC, Trinidad DR, Pierce JP, Benmarhnia T. The effect of college attendance on young adult cigarette, e-cigarette, cigarillo, hookah and smokeless tobacco use and its potential for addressing tobacco-related health disparities. Prev Med 2020; 132:105954. [PMID: 31917304 PMCID: PMC7104572 DOI: 10.1016/j.ypmed.2019.105954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/03/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
The goal of this study was to assess the effect of college attendance on tobacco use among young adults and across subpopulations with disparities in tobacco use. Using a cohort of US youth (<18 years) who aged into young adulthood (18-24 years) in the Population Assessment of Tobacco and Health (2013-14, 2015-16, n = 3619) and propensity score matching we estimated the effect of college attendance on past 30-day use of cigarettes, e-cigarettes, cigarillos, hookah and smokeless tobacco. In unmatched analysis, college attenders (vs. nonattenders) had lower risk of using any form of tobacco (Risk Difference (RD): -10.0; 95% CI: -13.2, -7.0), cigarettes (RD: -13.0; 95% CI: -15.4, -10.5), e-cigarettes (RD: -4.1; 95% CI: -6.8, -1.7), cigarillos (RD: -5.7; 95% CI: -7.6, -3.8), and smokeless tobacco (RD: -2.0; 95% CI: -3.4, -0.6), but not hookah (RD: -0.2; 95% CI: -2.1, 1.6). In matched analysis, these associations were all near-null, with the exception of cigarettes (matched RD: -7.1; 95% CI: -10.3, -3.9). The effect of college attendance on cigarette smoking was stable for all subpopulations we assessed including among those identifying as non-Hispanic Black or Lesbian, Gay or Bisexual as well as among those living in the South, Midwest or whose parents did not attend college. The results suggest that college attendance may reduce young adults' risk of cigarette smoking but may not reduce the risk of using other tobacco products.
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Affiliation(s)
- Eric C Leas
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States.
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, United States
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Ling PM, Lisha NE, Neilands TB, Jordan JW. Join the Commune: A Controlled Study of Social Branding Influencers to Decrease Smoking Among Young Adult Hipsters. Am J Health Promot 2020; 34:754-761. [PMID: 32077305 DOI: 10.1177/0890117120904917] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior. DESIGN Quasi-experimental controlled study. SETTING Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control). PARTICIPANTS "Hipster" young adults (age 18-26) attending bars and nightclubs. INTERVENTION Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media. MEASURES A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking. ANALYSIS Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions. RESULTS Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) (P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking. CONCLUSION This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.
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Affiliation(s)
- Pamela M Ling
- Division of General Internal Medicine and Center for Tobacco Control Research and Education, Department of Medicine, 8785University of California, San Francisco, CA, USA
| | - Nadra E Lisha
- Division of General Internal Medicine and Center for Tobacco Control Research and Education, Department of Medicine, 8785University of California, San Francisco, CA, USA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, 8785University of California, San Francisco, CA, USA
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Peer crowd-based targeting in E-cigarette advertisements: a qualitative study to inform counter-marketing. BMC Public Health 2020; 20:32. [PMID: 31969114 PMCID: PMC6977342 DOI: 10.1186/s12889-019-8126-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/24/2019] [Indexed: 12/01/2022] Open
Abstract
Background Cigarette lifestyle marketing with psychographic targeting has been well documented, but few studies address non-cigarette tobacco products. This study examined how young adults respond to e-cigarette advertisements featuring diverse peer crowds – peer groups with shared identities and lifestyles – to inform tobacco counter-marketing design. Methods Fifty-nine young adult tobacco users in California participated in interviews and viewed four to five e-cigarette advertisements that featured characters from various peer crowd groups. For each participant, half of the advertisements they viewed showed characters from the same peer crowd as their own, and the other half of the advertisements featured characters from a different peer crowd. Advertisements were presented in random order. Questions probed what types of cues are noticed in the advertisements, and whether and how much participants liked or disliked the advertisements. Results Results suggest that participants liked and provided richer descriptions of characters and social situations in the advertisements featuring their own peer crowd more than the advertisements featuring a different peer crowd. Mismatching age or device type was also noted: participants reported advertisements showing older adults were not intended for them. Participants who used larger vaporizers tended to dislike cigalike advertisements even if they featured a matching peer crowd. Conclusion Peer crowd and lifestyle cues, age and device type are all salient features of e-cigarette advertising for young adults. Similarly, educational campaigns about e-cigarettes should employ peer crowd-based targeting to engage young adults, though messages should be carefully tested to ensure authentic and realistic portrayals.
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Kemp BJ, Parrish AM, Cliff DP. 'Social screens' and 'the mainstream': longitudinal competitors of non-organized physical activity in the transition from childhood to adolescence. Int J Behav Nutr Phys Act 2020; 17:5. [PMID: 31937315 PMCID: PMC7050814 DOI: 10.1186/s12966-019-0908-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background Physical activity (PA) tends to decline during late childhood and adolescence. In Australia, this decline has been shown to occur particularly in non-organized PA (e.g. active play and informal sport). Using a social marketing approach, segments of youth may be identified and targeted based on their profile of alternative activities that compete with non-organized PA during the transition to adolescence. The objectives of this study were to identify and describe segments of youth whose participation in non-organized PA declined between 11 and 13 years, based on changes in other potential competing activities during this period. Methods Data were sourced from Waves 4 and 5 of the Longitudinal Study of Australian Children. Participation in non-organized PA and thirteen alternative activities (e.g. video games, homework, sleep) were measured using 24-h time-use diaries. Analyses were limited to participants whose non-organized PA had declined between 11 and 13 years (n = 1043). Two-stage cluster analysis was conducted and segments were described using chi-square and t-tests. Results Among the analytic sample, average non-organized PA participation declined by 87 min/day between 11y and 13y (p < 0.001). Two segments were identified (κ = 0.66). The ‘Social Screens’ segment (n = 143) had large increases in texting, emailing and social media use (+ 56 min/day, p < 0.001) and other internet use (+ 32 min/day, p < 0.001). Conversely, ‘the Mainstream’ segment (n = 900) had smaller increases in a wider range of activities, including other PA (organized PA, active transport, active chores/work) (+ 16.0 min/day, p < 0.001), homework/study (+ 9.5 min/day, p < 0.001) and electronic gaming (+ 6.7 min/day, p < 0.05). ‘Social Screens’ were more likely to attend public school, live in urban areas and have more advanced pubertal development (girls only). ‘The Mainstream’ were more likely to participate in PA and out-of-school activities. Conclusions The ‘Social Screens’ segment had a much larger increase in texting, emailing, social media and other internet use, and lower participation in overall PA and out-of-school activities, compared with ‘the Mainstream’. Future research may trial PA promotion strategies to replace benefits that this segment may seek in competing activities (e.g. social PA apps).
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Affiliation(s)
- Byron J Kemp
- Early Start, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia. .,School of Health and Society, Faculty of Social Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
| | - Anne-Maree Parrish
- Early Start, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.,School of Health and Society, Faculty of Social Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Dylan P Cliff
- Early Start, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.,School of Education, Faculty of Social Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
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Guo M, Ganz O, Cruse B, Navarro M, Wagner D, Tate B, Delahanty J, Benoza G. Keeping It Fresh With Hip-Hop Teens: Promising Targeting Strategies for Delivering Public Health Messages to Hard-to-Reach Audiences. Health Promot Pract 2020; 21:61S-71S. [PMID: 31908198 DOI: 10.1177/1524839919884545] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Despite overall declines in youth cigarette use, tobacco use inequities exist by race/ethnicity. Health communication campaigns can be effective in changing tobacco-related attitudes, intentions, and behaviors and can be used to address tobacco use inequities by targeting young people who are at high risk for tobacco use. In 2015, the U.S. Food and Drug Administration launched Fresh Empire, the first tobacco public education campaign designed to reach primarily African American, Hispanic, and/or Asian American/Pacific Islander youth ages 12 to 17 years who identify with the Hip-Hop peer crowd. This article presents an overview of two targeting strategies-(a) influencers on social media and (b) paid digital and social media advertisements-that Fresh Empire uses to reach its audience and increase message credibility that can inform future campaigns targeting hard-to-reach populations. These strategies help the campaign expand its reach, be authentic, and increase engagement with the target audience. Microinfluencers are selected for their alignment with Hip-Hop values and high engagement rates; local influencers are teens recruited to promote the campaign in their communities; and digital and social ads are purchased with a minimum number of in-target guaranteed impressions. Across both strategies, metrics have met or exceeded expectations, including a sentiment analysis that revealed 87.3% of comments on microinfluencer posts were positive. Initial findings suggest that the tobacco prevention messages have reached the target population and resonated positively, which may help to increase message credibility and improve receptivity to tobacco prevention messages.
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Affiliation(s)
- Merrybelle Guo
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | - Ollie Ganz
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | | | - Mario Navarro
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | | | | | - Janine Delahanty
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | - Gem Benoza
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
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Stalgaitis CA, Navarro MA, Wagner DE, Walker MW. Who Uses Tobacco Products? Using Peer Crowd Segmentation to Identify Youth at Risk for Cigarettes, Cigar Products, Hookah, and E-Cigarettes. Subst Use Misuse 2020; 55:1045-1053. [PMID: 32024418 DOI: 10.1080/10826084.2020.1722698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Understanding which adolescents are at greatest risk for cigarettes and other tobacco products is critical to inform tailored and targeted interventions. Objectives: We used peer crowds (macro-level subcultures) to identify subgroups of adolescents at-risk for using and being open to using cigarettes; cigars, cigarillos, and little cigars (cigar products); hookah; e-cigarettes; any tobacco product; and multiple products. Methods: In 2017, youth ages 12-17 in five U.S. states completed cross-sectional surveys (n = 1,167). Participants provided data on cigarette use (experimentation) and openness to use (susceptibility); cigar product, hookah, and e-cigarette use (ever use) and openness to use (curiosity); and identification with five peer crowds (Alternative, Country, Hip Hop, Mainstream, Popular). We used chi-square tests to compare rates by peer crowd, and multivariate logistic regressions to assess odds of use and openness for each crowd (reference: Mainstream). Results: Risk differed by peer crowd. Hip Hop youth reported high rates of use, ranging from 12.8% (cigarettes) to 33.4% (e-cigarettes). Regressions revealed increased odds of use for Hip Hop compared to Mainstream for all products, especially cigar products and multi-product use. Popular (cigar products, e-cigarettes) and Alternative (cigarettes) demonstrated increased odds of use compared to Mainstream. We also observed elevated odds of cigarette openness among Alternative, Country, and Hip Hop youth, and of hookah openness among Hip Hop and Popular youth compared to Mainstream. Conclusions/Importance: Peer crowd-tailored cigarette education campaigns can be extended to address other tobacco product risk, especially for higher-risk peer crowds such as Hip Hop.
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Affiliation(s)
| | - Mario A Navarro
- Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | | | - Matthew W Walker
- Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, Maryland, USA
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Navarro MA, Stalgaitis CA, Walker MW, Wagner DE. Youth peer crowds and risk of cigarette use: The effects of dual peer crowd identification among hip hop youth. Addict Behav Rep 2019; 10:100204. [PMID: 31388555 PMCID: PMC6675938 DOI: 10.1016/j.abrep.2019.100204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Recent research has found that the Hip Hop peer crowd has a strong link to risky health behaviors, including tobacco use. The current study expands on previous research on the Hip Hop peer crowd by investigating the nuances of the effects on cigarette risk that Hip Hop identification has in combination with other peer crowds. Methods Targeted social media advertisements were used to recruit youth to complete an online survey. Participants (n = 4681) self-reported peer crowd identification via the I-Base Survey™, and cigarette smoking status. Smoking status was compared between peer crowd groups consisting of participants who had identification with only one peer crowd, and those who had identification with the Hip Hop peer crowd and one other crowd (i.e., Hip Hop dual peer crowd identification). Results Significant differences in cigarette status were observed among the dual and single peer crowd groups. Specifically, differences in cigarette Non-susceptible Non-triers and Experimenters demonstrated that youth who identified as Mainstream Only were at lowest risk while youth who identified as Hip Hop/Alternative had the highest rates of cigarette experimentation. There were no differences between peer crowd groups on proportions of Susceptible Non-triers. Conclusions Examining dual peer crowd identifications provides a nuanced understanding of risk. Dual identification with Hip Hop seems to have differential effects compared to solo identification with other crowds, whereby Hip Hop identification may increase cigarette experimentation when combined with another peer crowd. Findings demonstrate the potential of considering multiple peer crowd identification to inform public education campaign development. Peer crowds have previously investigated the Hip Hop peer crowd in isolation. FDA's multicultural youth tobacco education campaign tailors messages Hip Hop peer crowd. Data comes from the first nationally-recruited sample of youth peer crowd and smoking. Peer crowds had differential levels of risk based on dual membership. Hip Hop peer crowd targeting should consider the effects of other peer crowds.
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Affiliation(s)
- Mario A Navarro
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | | | - Matthew W Walker
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Dana E Wagner
- Rescue Agency, 2437 Morena Boulevard, San Diego, CA 92110, USA
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Moran MB, Villanti AC, Johnson A, Rath J. Patterns of Alcohol, Tobacco, and Substance Use Among Young Adult Peer Crowds. Am J Prev Med 2019; 56:e185-e193. [PMID: 31104724 PMCID: PMC6538284 DOI: 10.1016/j.amepre.2019.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The association between peer crowd identification and substance use is well documented among adolescents, but less is known about substance use among young adult peer crowds. METHODS This study leverages data from the Truth Initiative Young Adult Cohort Study (Wave 8, June-July 2015), a nationally representative cohort sample of young adults aged 18-34 years. The current cross-sectional analyses (conducted in 2018) focused on 1,341 individuals aged 18-24 years in this sample. Participants reported their peer crowd identification and current use of alcohol, marijuana, other drugs, and tobacco (cigarettes, little cigars/cigarillos, e-cigarettes, hookah, smokeless tobacco). Adjusted logistic regression models assessed associations between peer crowd identification and substance use. RESULTS In general, young adults who identified as homebody, young professional, or religious had lower odds of substance use than their counterparts. Young adults who identified as social/partier were more likely to be current users of alcohol, marijuana, any tobacco, cigarettes, and e-cigarettes than those who did not identify as social/partier. Those who identified as alternative were more likely to be current users of marijuana and other drugs than those not identified as alternative. Those who identified as country were more likely than those not identified as country to be current users of cigarettes and smokeless tobacco. Those who identified as hip hop were more likely to be current users of marijuana and e-cigarettes. CONCLUSIONS Peer crowd identification is associated with substance use among young adults. These findings can help identify target populations for prevention and cessation interventions and inform intervention design and delivery.
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Affiliation(s)
- Meghan Bridgid Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Andrea C Villanti
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington, Vermont; Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Amanda Johnson
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Jessica Rath
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
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Thrul J, Gubner NR, Tice CL, Lisha NE, Ling PM. Young adults report increased pleasure from using e-cigarettes and smoking tobacco cigarettes when drinking alcohol. Addict Behav 2019; 93:135-140. [PMID: 30710807 DOI: 10.1016/j.addbeh.2019.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cigarettes share a high rate of co-use with alcohol, particularly among young adults. Studies have demonstrated greater perceived pleasure from smoking cigarettes when drinking alcohol. However, little is known about co-use of electronic cigarettes (e-cigs) and alcohol. The current study sought to compare extent of use and perceived pleasure from cigarettes and e-cigs when drinking alcohol. METHODS Young adult bar patrons in California cities (San Diego, Los Angeles, and San Francisco) were recruited in 2015-16 using randomized time-location sampling. Participants completed cross-sectional surveys in bars, reporting the percent of cigarette smoking/e-cig use that occurred under the influence of alcohol, and reported if pleasure from smoking cigarettes/using e-cigs changed when drinking alcohol. Analyses are limited to participants reporting current (past 30-day) use of cigarettes, e-cigs, and alcohol (N = 269; M age = 24.1; 40.1% female, 36.1% Non-Hispanic White). RESULTS Participants reported a greater percentage of cigarette smoking compared to e-cig use under the influence of alcohol (cigarettes M = 63.6%; e-cigs M = 46.7%; p < .001). Participants also reported increased pleasure both from smoking cigarettes (M = 3.9; [compared to midpoint of scale 3 - "no change"] p < .001) and using e-cigs (M = 3.3; p < .001) when drinking alcohol. The increase in pleasure was more pronounced for cigarettes compared to e-cigs (p < .001). CONCLUSIONS Drinking alcohol is associated with increases in perceived rewarding effects of both cigarettes and e-cigs and thus may increase their abuse liability. This effect may be stronger for cigarettes, which could be an important barrier to switching completely from smoking cigarettes to using e-cigs, or quitting both entirely.
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Lee YO, Curry LE, Fiacco L, Henes A, Farrelly MC, Nonnemaker JM, Hoffman L, Walker MW. Peer crowd segmentation for targeting public education campaigns: Hip hop youth and tobacco use. Prev Med Rep 2019; 14:100843. [PMID: 30997323 PMCID: PMC6453823 DOI: 10.1016/j.pmedr.2019.100843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/11/2019] [Accepted: 03/14/2019] [Indexed: 11/30/2022] Open
Abstract
This study examines the potential association between strength of Hip Hop peer crowd identification and tobacco use in one of the first large samples of Hip Hop youth in the United States. Data are from a geographically-targeted, address-based convenience sample of 2194 youths aged 12–17 who identify with the Hip Hop peer crowd collected via in-person and web interviews in 30 U.S. media markets in 2015. We examined strength of Hip Hop peer crowd identification, perceived peer tobacco use, and tobacco use outcomes. Overall, 18.3% of Hip Hop youth reported current blunt (cigar with added marijuana) use, followed by electronic cigarettes (e-cigarettes) (11.6%), cigar (without added marijuana) (8.8%), hookah (6.5%), and cigarette (5.6%) use. Stronger Hip Hop peer crowd identification was associated with increased odds of using cigarettes (OR = 2.25, p < 0.05), cigars (OR = 2.14, p < 0.05), and blunts (OR = 1.61, p < 0.05), controlling for demographic characteristics and perceived peer tobacco use. Results suggest that a Hip Hop peer crowd–targeted public education prevention campaign for youth can be promising for a variety of tobacco products.
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Affiliation(s)
- Youn Ok Lee
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Laurel E Curry
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Leah Fiacco
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Amy Henes
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Matthew C Farrelly
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - James M Nonnemaker
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Leah Hoffman
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States of America
| | - Matthew W Walker
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States of America
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van der Eijk Y, Lee JK, Ling P. How Menthol Is Key to the Tobacco Industry's Strategy of Recruiting and Retaining Young Smokers in Singapore. J Adolesc Health 2019; 64:347-354. [PMID: 30392860 PMCID: PMC6493328 DOI: 10.1016/j.jadohealth.2018.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 08/25/2018] [Accepted: 09/05/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Singapore has a strong and well-established tobacco control policy, but smoking rates among young Singaporeans remain relatively high. In other countries, tobacco companies have used menthol to encourage smoking among young people. Singapore still permits the sale of menthol tobacco products and little is known about the tobacco industry's internal strategy and motivation for marketing menthol tobacco in Singapore. METHODS Tobacco industry documents analysis using the Truth Tobacco Industry Documents Library. Findings were triangulated with Euromonitor market data on menthol tobacco in Singapore, and trend data on smoking prevalence in Singapore from the First National Morbidity Survey, Labour Force Survey, National Health Survey, and National Health Surveillance Survey. RESULTS Menthol tobacco products became popular among young Singaporeans in the early 1980s, largely due to a health-consciousness trend among young people and the misperception that menthol tobacco products were "safer." Philip Morris, in an attempt to compete with R.J. Reynolds for starter smokers, developed and launched several menthol brands designed to appeal to youth. While many brands initially failed, as of February 2018, menthol tobacco products comprise 48% of Singapore's total tobacco market. CONCLUSIONS Menthol is key to the tobacco industry's strategy of recruiting and retaining young smokers in Singapore. Banning the sale of menthol tobacco products will be an important part of preventing smoking in Singapore's younger generation.
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Affiliation(s)
- Yvette van der Eijk
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Avenue #366, San Francisco, CA 94143-1390, USA
| | - Jeong Kyu Lee
- Saw Swee Hock School of Public Health, National University of Singapore
| | - Pamela Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Avenue #366, San Francisco, CA 94143-1390, USA
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Nguyen N, Lisha NE, Neilands TB, Jordan JW, Ling PM. Differential Associations Between Anti-Tobacco Industry Attitudes and Intention to Quit Smoking Across Young Adult Peer Crowds. Am J Health Promot 2019; 33:876-885. [PMID: 30754982 DOI: 10.1177/0890117119829676] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To compare the relationship between anti-tobacco industry attitudes and intention and attempts to quit smoking across 6 young adult peer crowds. DESIGN A cross-sectional bar survey in 2015. SETTING Seven US cities (Albuquerque, Los Angeles, Nashville, Oklahoma City, San Diego, San Francisco, and Tucson). PARTICIPANTS Two thousand eight hundred seventeen young adult bar patrons who were currently smoking. MEASURES Intention to quit in the next 6 months and having made a quit attempt in the last 12 months were binary outcomes. Anti-industry attitudes were measured by 3 items indicating support for action against the tobacco industry. Peer crowd affiliation was measured using the I-Base Survey. ANALYSIS Adjusted multivariable logistic regression models examined the association between anti-industry attitudes and the outcomes for the total sample and for each peer crowd. RESULTS Overall, anti-industry attitudes were positively associated with both intention to quit (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.24-1.52) and attempt to quit (OR = 1.14, 95% CI = 1.03-1.27). Intriguingly, the relationship between anti-industry attitudes and intention to quit differed by peer crowd affiliation, with significant associations for Homebody, Partier, Hipster, and Hip Hop, but not for Young Professional and Country. CONCLUSIONS Developing health communication messages that resonate with unique peer crowd values can enhance the relevance of public health campaigns. Tobacco control practitioners should tailor anti-industry messages to promote intention to quit smoking among the highest risk young adults.
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Affiliation(s)
- Nhung Nguyen
- 1 Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Nadra E Lisha
- 1 Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Torsten B Neilands
- 2 Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | | | - Pamela M Ling
- 1 Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA.,4 Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Thai CL, Taber JM, Oh A, Segar M, Blake K, Patrick H. "Keep it Realistic": Reactions to and Recommendations for Physical Activity Promotion Messages From Focus Groups of Women. Am J Health Promot 2019; 33:903-911. [PMID: 30704265 DOI: 10.1177/0890117119826870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Less than half of US adults meet the recommended guidelines of 150 minutes of exercise each week. Health promotion messages are frequently used to promote physical activity (PA); however, this messaging may be ineffective if it does not resonate with the target audience. The purpose of this exploratory study is to understand how women respond to examples of PA promotion messages. APPROACH/DESIGN A qualitative study. SETTING Washington DC Metro Area. PARTICIPANTS Forty women, stratified by race/ethnicity (white, black, Latina) and level of self-reported PA (active, inactive). METHOD Eight focus groups were conducted in which participants were shown 3 PA promotion messages representative of typical messaging strategies. Three researchers conducted a thematic analysis to code the data for emergent themes. RESULTS Current PA promotion messaging strategies do not resonate with women. Women want to see individuals with "realistic" bodies who look similar to them (eg, body shape, age, race/ethnicity), and for PA messaging to include daily activities as a way to be active. CONCLUSIONS Public health practitioners who promote PA to women should consider developing messages that better resonate with women's dynamic roles and lifestyles. Successful strategies may include depicting busy lifestyles that PA may be physically and logistically difficult to fit into and using models with diverse body shapes.
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Affiliation(s)
- Chan L Thai
- 1 Department of Communication, Santa Clara University, Santa Clara, CA, USA
| | - Jennifer M Taber
- 2 Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - April Oh
- 3 Health Communication and Informatics Research Branch, National Cancer Institute, USA
| | - Michelle Segar
- 4 Sport, Health, and Activity Research and Policy (SHARP) Center, University of Michigan, Ann Arbor, MI, USA
| | - Kelly Blake
- 3 Health Communication and Informatics Research Branch, National Cancer Institute, USA
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Lisha NE, Thrul J, Ling PM. Latent Class Analysis to Examine Patterns of Smoking and Other Tobacco Products in Young Adult Bar Patrons. J Adolesc Health 2019; 64:93-98. [PMID: 30254010 PMCID: PMC6309635 DOI: 10.1016/j.jadohealth.2018.06.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE Use of multiple tobacco products is increasing, particularly among young adults. Latent class analysis of substance-use patterns provides a framework for understanding the heterogeneity of use. We sought to identify different patterns of cigarette, e-cigarette, hookah, cigarillo, and smokeless tobacco use among young adult bar patrons. METHODS We conducted repeated cross-sectional surveys of randomized time location samples of young adult California bar patrons in 2013 and 2014. Latent class analysis was used to examine patterns of use among current (past 30-day) tobacco users. Classes were compared on demographic characteristics and tobacco use correlates. RESULTS Overall 84.4% of the current tobacco users were cigarette smokers, 38.7% used electronic cigarettes, 35.9% used hookah, 30.1% smoked cigars/cigarillos, and 15.4% used smokeless tobacco in the past 30 days. We extracted six latent classes: "Cigarette only" (n = 1690), "Hookah mostly" (n = 479), "High overall use" (n = 528), "Smokeless mostly" (n = 95), "E-cigarette mostly" (n = 439), "Cigars mostly" (n = 435). These classes differed in their risk profiles on both current use compared to no use, and number of days they used each tobacco product. Differences between classes emerged on demographics (age, sex, race/ethnicity) and tobacco correlates including perceived peer smoking, antitobacco industry attitudes, prioritizing social activities, and advertising receptivity. CONCLUSIONS Understanding different patterns of multiple tobacco product use may inform both prevention and cessation programming for young adults. It may be efficient to tailor messages to different latent classes and address the distinct demographic and attitudinal profiles of groups of multiple tobacco product users.
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Affiliation(s)
- Nadra E Lisha
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, University of California, San Francisco, California
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, University of California, San Francisco, California.
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Wagner DE, Fernandez P, Jordan JW, Saggese DJ. Freedom From Chew: Using Social Branding to Reduce Chewing Tobacco Use Among Country Peer Crowd Teens. HEALTH EDUCATION & BEHAVIOR 2018; 46:286-294. [DOI: 10.1177/1090198118806966] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Peer crowds are macro-level, reputation-based subcultures with shared preferences, values, and behavior. The Country peer crowd has been the focus of tobacco industry research and marketing but has yet to be the primary focus of public health research. The current study explores the utility of Down and Dirty, a Social Branding tobacco education campaign, in changing Virginia Country teens’ chewing tobacco-related attitudes and behavior. The relationship between chew use and Country peer crowd identification was also explored. Method. To evaluate the campaign, a cross-sectional survey was administered online for 3 years from 2014 to 2016. Responses were collected via social media advertisements targeting 13- to 18-year-old Country youth from Virginia (total n = 1,264). Participants reported peer crowd identification, chew-related attitudes and behavior, and campaign engagement and appeal. Results. Compared with Wave 1, Waves 2 and 3 Country teens who engaged with Down and Dirty had greater odds of holding strong attitudes against chew. Among campaign-engaged Country teens, odds of chew use were lower at Waves 2 and 3, and lower odds were associated with liking the campaign. Related to chew prevalence, Country teens demonstrated greater odds of past 30-day chew use compared to non-Country teens, and higher Country identification was associated with greater odds of chew use. Discussion. Down and Dirty is a promising intervention associated with positive attitudinal and behavioral outcomes for high-risk Country teens. Additionally, this study helps document tobacco-related behavioral patterns of the Country peer crowd, a priority for ongoing tobacco education, especially around chew.
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The Hip Hop peer crowd: An opportunity for intervention to reduce tobacco use among at-risk youth. Addict Behav 2018; 82:28-34. [PMID: 29477904 DOI: 10.1016/j.addbeh.2018.02.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/03/2018] [Accepted: 02/09/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Peer crowds, peer groups with macro-level connections and shared norms that transcend geography and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop peer crowd identification, which is common among multicultural youth, is associated with increased risk of tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco education campaign tailored for Hip Hop youth aged 12-17 who are multicultural (Hispanic, African American, Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream, Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally recruited sample. METHODS Youth were recruited via targeted social media advertisements. Participants aged 13-17 (n = 5153) self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific differences. RESULTS Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country youth, and more likely to be Experimenters than Popular and Mainstream youth. CONCLUSIONS Representative studies show that Alternative is relatively small compared to other high-risk crowds, such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored to larger at-risk crowds for campaigns like Fresh Empire.
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Guillory J, Wiant KF, Farrelly M, Fiacco L, Alam I, Hoffman L, Crankshaw E, Delahanty J, Alexander TN. Recruiting Hard-to-Reach Populations for Survey Research: Using Facebook and Instagram Advertisements and In-Person Intercept in LGBT Bars and Nightclubs to Recruit LGBT Young Adults. J Med Internet Res 2018; 20:e197. [PMID: 29914861 PMCID: PMC6028767 DOI: 10.2196/jmir.9461] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/10/2018] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Abstract
Background Tobacco public education campaigns focus increasingly on hard-to-reach populations at higher risk for smoking, prompting campaign creators and evaluators to develop strategies to reach hard-to-reach populations in virtual and physical spaces where they spend time. Objective The aim of this study was to describe two novel recruitment strategies (in-person intercept interviews in lesbian, gay, bisexual, and transgender [LGBT] social venues and targeted social media ads) and compares characteristics of participants recruited via these strategies for the US Food and Drug Administration’s This Free Life campaign evaluation targeting LGBT young adults who smoke cigarettes occasionally. Methods We recruited LGBT adults aged 18-24 years in the United States via Facebook and Instagram ads (N=1709, mean age 20.94, SD 1.94) or intercept in LGBT social venues (N=2348, mean age 21.98, SD 1.69) for the baseline evaluation survey. Covariates related to recruitment strategy were age; race or ethnicity; LGBT identity; education; pride event attendance; and alcohol, cigarette, and social media use. Results Lesbian or gay women (adjusted odds ratio, AOR 1.88, 95% CI 1.54-2.29, P<.001), bisexual men and women (AOR 1.46, 95% CI 1.17-1.82, P=.001), gender minorities (AOR 1.68, 95% CI 1.26-2.25, P<.001), and other sexual minorities (AOR 2.48, 95% CI 1.62-3.80, P<.001) were more likely than gay men to be recruited via social media (than intercept). Hispanic (AOR 0.73, 95% CI 0.61-0.89, P=.001) and other or multiracial, non-Hispanic participants (AOR 0.70, 95% CI 0.54-0.90, P=.006) were less likely than white, non-Hispanic participants to be recruited via social media. As age increased, odds of recruitment via social media decreased (AOR 0.76, 95% CI 0.72-0.80, P<.001). Participants with some college education (AOR 1.27, 95% CI 1.03-1.56, P=.03) were more likely than those with a college degree to be recruited via social media. Participants reporting past 30-day alcohol use were less likely to be recruited via social media (AOR 0.33, 95% CI 0.24-0.44, P<.001). Participants who reported past-year pride event attendance were more likely to be recruited via social media (AOR 1.31, 95% CI 1.06-1.64, P=.02), as well as those who used Facebook at least once daily (AOR 1.43, 95% CI 1.14-1.80, P=.002). Participants who reported using Instagram at least once daily were less likely to be recruited via social media (AOR 0.73, 95% CI 0.62-0.86, P<.001). Social media recruitment was faster (incidence rate ratio, IRR=3.31, 95% CI 3.11-3.52, P<.001) and less expensive (2.2% of combined social media and intercept recruitment cost) but had greater data quality issues—a larger percentage of social media respondents were lost because of duplicate and low-quality responses (374/4446, 8.41%) compared with intercept respondents lost to interviewer misrepresentation (15/4446, 0.34%; P<.001). Conclusions Social media combined with intercept provided access to important LGBT subpopulations (eg, gender and other sexual minorities) and a more diverse sample. Social media methods have more data quality issues but are faster and less expensive than intercept. Recruiting hard-to-reach populations via audience-tailored strategies enabled recruitment of one of the largest LGBT young adult samples, suggesting these methods’ promise for accessing hard-to-reach populations.
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Affiliation(s)
- Jamie Guillory
- RTI International, Research Triangle Park, NC, United States
| | | | | | - Leah Fiacco
- RTI International, Research Triangle Park, NC, United States
| | - Ishrat Alam
- RTI International, Research Triangle Park, NC, United States
| | - Leah Hoffman
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, United States
| | - Erik Crankshaw
- RTI International, Research Triangle Park, NC, United States
| | - Janine Delahanty
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, United States
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Berger I, Mooney-Somers J. Smoking Cessation Programs for Lesbian, Gay, Bisexual, Transgender, and Intersex People: A Content-Based Systematic Review. Nicotine Tob Res 2018; 19:1408-1417. [PMID: 27613909 DOI: 10.1093/ntr/ntw216] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 08/26/2016] [Indexed: 12/24/2022]
Abstract
Introduction Tobacco use among lesbian, gay, bisexual, and transgender (LGBT) people is double the general population. Limited evidence suggests high smoking rates among intersex people. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people are a priority population in Australian health policy, particularly mental health and aging. Despite associations between smoking and noncommunicable diseases relevant to aging and mental health, LGBTI-targeted smoking cessation interventions in Australia have been limited to people living with HIV. Applying existing interventions to marginalized populations without modification and evaluation may fail and exacerbate inequities. Aims To assess outcomes and characterize the populations served, cultural modifications, and behavior change techniques (BCTs) of interventions to reduce LGBTI smoking. Methods We searched MEDLINE, six additional databases, and contacted authors to retrieve published and unpublished program evaluations. Results We retrieved 19 studies (3663 participants). None used control groups. Overall quit rate was 61.0% at the end of interventions and stabilized at 38.6% at 3-6 months. All studies included gay men, 13 included lesbians, 13 "LGBT," 12 bisexual people, five transgender people, and none included intersex people. Transgender people comprised 3% of participants. Of programs open to women, 27.8% of participants were women. Cultural modifications were used by 17 (89.5%) studies, commonly meeting in LGBT spaces, discussing social justice, and discussing LGBT-specific triggers. Common BCTs included providing normative information, boosting motivation/self-efficacy, relapse prevention, social support, action planning, and discussing consequences. Conclusions Quit rates were high; using control groups would improve evaluation. Existing programs may fail to reach groups other than gay men. Implications This review examines the evidence for LGBTI-targeted smoking cessation interventions. Populations within LGBTI are not proportionally represented in smoking cessation research, and no study addressed intersex smoking. Overall, LGBT-targeted interventions appear to be effective, and simply having an LGBT-specific group may be more effective than groups for the general population. More rigorous research is necessary to draw firm conclusions. Our study space analysis provides suggestions for areas of more targeted research on mechanisms underlying these complex interventions' success.
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Affiliation(s)
- Israel Berger
- Centre for Values, Ethics and Law in Medicine (VELiM), Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Julie Mooney-Somers
- Centre for Values, Ethics and Law in Medicine (VELiM), Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
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Kearns CE, Lisha NE, Ling PM. Soda intake and tobacco use among young adult bar patrons: A cross-sectional study in seven cities. Prev Med Rep 2018; 10:195-199. [PMID: 29868367 PMCID: PMC5984229 DOI: 10.1016/j.pmedr.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 02/13/2018] [Accepted: 03/14/2018] [Indexed: 01/10/2023] Open
Abstract
Young adults are among the greatest consumers of sugar sweetened beverages, and they also have high smoking rates. However, few studies address the relationship between these risk behaviors; this study examined the relationship between soda consumption and smoking among young adult bar patrons, a high-risk understudied population. A cross-sectional survey of young adult bar patrons (between January 2014 and October 2015) was conducted using randomized time location sampling (N = 8712) in Albuquerque, NM, Los Angeles, CA Nashville, TN, Oklahoma City, OK, San Diego, CA, San Francisco, CA, and Tucson, AZ. The survey found the prevalences of daily regular soda intake ranged from 32% in San Diego to 51% in Oklahoma City and current smoking ranged from 36% in Los Angeles, CA to 49% in Albuquerque, NM. In multinomial multivariate models with no soda consumption as the reference group and controlling for demographics and location, non-daily (OR = 1.24, 95% CI = 1.05, 1.47) and daily smokers (OR = 1.34, 95% CI = 1.08, 1.66) were both more likely to drink regular soda compared to not drinking any soda. No effects were found for diet soda consumption. These linked risks suggest that comprehensive health promotion efforts to decrease sugar sweetened beverage consumption and tobacco use, among other risky behaviors, may be effective in this population. Young adult (YA) bar patrons who smoke consume more regular soda than nonsmokers. Being a non-daily or a daily-smoker increased odds of drinking regular soda. Prevalence of smoking among YA bar patrons who were regular soda drinkers varied by region. YA bar patrons attending or graduated from college were less likely to drink soda.
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Affiliation(s)
- Cristin E Kearns
- Philip R. Lee Institute for Health Policy Studies and Division of Oral Epidemiology and Dental Public Health, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, 3333 California St, Box 0936, San Francisco, CA 94143, USA
| | - Nadra E Lisha
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California San Francisco, Box 1390, San Francisco, CA 94143, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California San Francisco, Box 1390, San Francisco, CA 94143, USA
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Jordan JW, Stalgaitis CA, Charles J, Madden PA, Radhakrishnan AG, Saggese D. Peer Crowd Identification and Adolescent Health Behaviors: Results From a Statewide Representative Study. HEALTH EDUCATION & BEHAVIOR 2018. [DOI: 10.1177/1090198118759148] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose. Peer crowds are macro-level subcultures that share similarities across geographic areas. Over the past decade, dozens of studies have explored the association between adolescent peer crowds and risk behaviors, and how they can inform public health efforts. However, despite the interest, researchers have not yet reported on crowd size and risk levels from a representative sample, making it difficult for practitioners to apply peer crowd science to interventions. The current study reports findings from the first statewide representative sample of adolescent peer crowd identification and health behaviors. Methods. Weighted data were analyzed from the 2015 Virginia Youth Survey of Health Behaviors ( n = 4,367). Peer crowds were measured via the I-Base Survey™, a photo-based peer crowd survey instrument. Frequencies and confidence intervals of select behaviors including tobacco use, substance use, nutrition, physical activity, and violence were examined to identify high- and low-risk crowds. Logistic regression was used to calculate adjusted odds ratios for each crowd and behavior. Results. Risky behaviors clustered in two peer crowds. Hip Hop crowd identification was associated with substance use, violence, and some depression and suicidal behaviors. Alternative crowd identification was associated with increased risk for some substance use behaviors, depression and suicide, bullying, physical inactivity, and obesity. Mainstream and, to a lesser extent, Popular, identities were associated with decreased risk for most behaviors. Conclusions. Findings from the first representative study of peer crowds and adolescent behavior identify two high-risk groups, providing critical insights for practitioners seeking to maximize public health interventions by targeting high-risk crowds.
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Affiliation(s)
| | | | | | | | | | - Daniel Saggese
- Virginia Foundation for Healthy Youth, Richmond, VA, USA
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Drope J, Liber AC, Cahn Z, Stoklosa M, Kennedy R, Douglas CE, Henson R, Drope J. Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA Cancer J Clin 2018; 68:106-115. [PMID: 29384589 DOI: 10.3322/caac.21444] [Citation(s) in RCA: 238] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/16/2022] Open
Abstract
The continuing high prevalence of cigarette smoking among specific subpopulations, many of them vulnerable, is one of the most pressing challenges facing the tobacco control community. These populations include individuals in lower education and/or socioeconomic groups; from certain racial/ethnic groups; in the lesbian, gay, bisexual, and transgender community; with mental illness; and in the military, particularly among those in the lowest pay grades. Although traditional tobacco control measures are having positive health effects for most groups, the effects are not sufficient for others. More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities. CA Cancer J Clin 2018;68:106-115. © 2018 American Cancer Society.
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Affiliation(s)
- Jeffrey Drope
- Vice President, Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Alex C Liber
- Data Analyst, Economic and Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Zachary Cahn
- Director, Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Michal Stoklosa
- Senior Economist, Taxation and Health, Economic and Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Rosemary Kennedy
- Program Consultant, Global Cancer Prevention and Early Detection, American Cancer Society, Atlanta, GA
| | - Clifford E Douglas
- Vice President for Tobacco Control and Director, Center for Tobacco Control, American Cancer Society, Atlanta, GA
| | - Rosemarie Henson
- Senior Vice President for Prevention and Early Detection, American Cancer Society, Atlanta, GA
| | - Jacqui Drope
- Managing Director, Global Cancer Prevention and Early Detection, American Cancer Society, Atlanta, GA
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Lisha NE, Jordan JW, Ling PM. Peer crowd affiliation as a segmentation tool for young adult tobacco use. Tob Control 2018; 25:i83-i89. [PMID: 27697952 PMCID: PMC5099219 DOI: 10.1136/tobaccocontrol-2016-053086] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/12/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND In California, young adult tobacco prevention is of prime importance; 63% of smokers start by the age of 18 years, and 97% start by the age of 26 years. We examined social affiliation with 'peer crowd' (eg, Hipsters) as an innovative way to identify high-risk tobacco users. METHODS Cross-sectional surveys were conducted in 2014 (N=3368) among young adult bar patrons in 3 California cities. We examined use rates of five products (cigarettes, e-cigarettes, hookah, cigars and smokeless tobacco) by five race/ethnicity categories. Peer crowd affiliation was scored based on respondents' selecting pictures of young adults representing those most and least likely to be in their friend group. Respondents were classified into categories based on the highest score; the peer crowd score was also examined as a continuous predictor. Logistic regression models with each tobacco product as the outcome tested the unique contribution of peer crowd affiliation, controlling for race/ethnicity, age, sex, sexual orientation and city. RESULTS Respondents affiliating with Hip Hop and Hipster peer crowds reported significantly higher rates of tobacco use. As a categorical predictor, peer crowd was related to tobacco use, independent of associations with race/ethnicity. As a continuous predictor, Hip Hop peer crowd affiliation was also associated with tobacco use, and Young Professional affiliation was negatively associated, independent of demographic factors. CONCLUSIONS Tobacco product use is not the same across racial/ethnic groups or peer crowds, and peer crowd predicts tobacco use independent of race/ethnicity. Antitobacco interventions targeting peer crowds may be an effective way to reach young adult tobacco users. TRIAL REGISTRATION NUMBER NCT01686178, Pre-results.
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Affiliation(s)
- Nadra E Lisha
- Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | | | - Pamela M Ling
- Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
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Bruce Baskerville N, Wong K, Shuh A, Abramowicz A, Dash D, Esmail A, Kennedy R. A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: overarching themes and key learnings. BMC Public Health 2018; 18:155. [PMID: 29347920 PMCID: PMC5774159 DOI: 10.1186/s12889-018-5050-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/10/2018] [Indexed: 12/23/2022] Open
Abstract
Background Smoking prevalence is very high among lesbian, gay, bisexual, transgendered and queer (LGBTQ+) youth and young adults (YYA) compared to non-LGBTQ+ YYA. A knowledge gap exists on culturally appropriate and effective prevention and cessation efforts for members of this diverse community, as limited interventions have been developed with and for this population, and there are very few studies determining the impact of these interventions. This study identifies the most salient elements of LGBTQ+ cessation and prevention interventions from the perspective of LGBTQ+ YYA. Methods Three descriptions of interventions tailored for LGBTQ+ YYA (group cessation counselling, social marketing, and a mobile phone app with social media incorporated), were shared with LGBTQ+ YYA via 24 focus groups with 204 participants in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, and concerns about the culturally modified intervention descriptions. Framework analysis was used to identify overarching themes across all three intervention descriptions. Results The data revealed eight overarching themes across all three intervention descriptions. Smoking cessation and prevention interventions should have the following key attributes: 1) be LGBTQ+ − specific; 2) be accessible in terms of location, time, availability, and cost; 3) be inclusive, relatable, and highlight diversity; 4) incorporate LGBTQ+ peer support and counselling services; 5) integrate other activities beyond smoking; 6) be positive, motivational, uplifting, and empowering; 7) provide concrete coping mechanisms; and 8) integrate rewards and incentives. Conclusions LGBTQ+ YYA focus group participants expressed a desire for an intervention that can incorporate these key elements. The mobile phone app and social media campaign were noted as potential interventions that could include all the essential elements. Electronic supplementary material The online version of this article (10.1186/s12889-018-5050-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N Bruce Baskerville
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
| | - Katy Wong
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Alanna Shuh
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Aneta Abramowicz
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Darly Dash
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Aamer Esmail
- Sherbourne Health Centre, Toronto, Ontario, Canada
| | - Ryan Kennedy
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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Berg CJ, Haardörfer R, Getachew B, Johnston T, Foster B, Windle M. Fighting Fire With Fire: Using Industry Market Research to Identify Young Adults at Risk for Alternative Tobacco Product and Other Substance Use. SOCIAL MARKETING QUARTERLY 2017; 23:302-319. [PMID: 30271276 PMCID: PMC6159230 DOI: 10.1177/1524500417718533] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Limited public health research has used psychographic profiling to segment young adults and examine their substance use behaviors. We aimed to conduct market research to identify young adult market segments at risk for alternative tobacco products (ATPs), alcohol, and marijuana use. Substance use; psychographics per the Values, Attitudes, and Lifestyle Scale (VALS); and other key variables were assessed at baseline in a longitudinal study of 3,418 students aged 18-25 from seven colleges/universities in the state of Georgia. Cluster analysis was conducted on VALS factors to identify distinct segments. Regression examined segments in relation to substance use risk. Past 30-day use prevalence for each substance was as follows: cigarettes, 13.3%; little cigars/cigarillos (LCCs), 11.2%; smokeless tobacco (SLT), 3.6%; e-cigarettes, 10.9%; hookah, 12.2%; alcohol, 63.1%; and marijuana, 19.0%. Five segments were identified, created, and named: Conventionals, Simple Lifes, Open Minds, Confident Novelty-seekers, and Stoic Individualists. Controlling for sociodemographics, Open Minds, Confident Novelty-seekers, and Stoic Individualists (vs. Conventionals [referent]) were more likely to smoke cigarettes. Confident Novelty-seekers were more likely to use LCCs. Simple Lifes were less likely to use SLT. Open Minds and Confident Novelty-seekers were more likely to use e-cigarettes. Open Minds were more likely and Simple Lifes were less likely to use hookah. Open Minds were more likely to use alcohol; Simple Lifes and Stoic Individualists were less likely to use alcohol. Open Minds were more likely to use marijuana. Market research is an effective strategy for identifying young adults at risk for using distinct ATPs and can inform targeted health campaigns and cessation interventions.
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Affiliation(s)
- Carla J. Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Teresa Johnston
- Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, USA
| | - Bruce Foster
- Campus Life, Central Georgia Technical College, Warner Robins, GA, USA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
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Tan ASL, Bigman CA, Nagler RH, Minsky S, Viswanath K. Comparing perceived effectiveness of FDA-proposed cigarette packaging graphic health warnings between sexual and gender minorities and heterosexual adults. Cancer Causes Control 2017; 28:1143-1155. [PMID: 28866791 DOI: 10.1007/s10552-017-0954-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND In 2012, the U.S. Food and Drug Administration proposed nine graphic health warnings (GHWs) on cigarette packaging that were rated equally effective across racial/ethnic, education, or income groups of adult smokers. However, data on GHW effectiveness among sexual and gender minority (SGM) adults, who have higher smoking prevalence, are currently lacking. This study analyzed whether perceived effectiveness of GHWs differed by gender and sexual orientation. METHODS Data came from a randomized experiment among 1,200 adults with an oversample from low socioeconomic status groups, conducted between 2013 and 2014 in three Massachusetts communities. Participants viewed and rated the effectiveness of nine GHWs. Mixed effects regression models predicted perceived effectiveness with gender and sexual orientation, adjusting for repeated measurements, GHWs viewed, age, race, ethnicity, smoking status, and health status. RESULTS Female heterosexuals rated GHWs as more effective than male heterosexual, lesbian, and transgender and other gender respondents. There was no significant difference between female and male heterosexuals versus gay, male bisexual, or female bisexual respondents. Differences by gender and sexual orientation were consistent across all nine GHWs. Significant correlates of higher perceived effectiveness included certain GHWs, older age, being African-American (vs white), being Hispanic (vs non-Hispanic), having less than high school education (vs associate degree or higher), and being current smokers (vs non-smokers). CONCLUSIONS Perceived effectiveness of GHWs was lower in certain SGM groups. We recommend further studies to understand the underlying mechanisms for these findings and investments in research and policy to communicate anti-smoking messages more effectively to SGM populations.
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Affiliation(s)
- Andy S L Tan
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rebekah H Nagler
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN, USA
| | - Sara Minsky
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kasisomayajula Viswanath
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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Schillinger D, Ling PM, Fine S, Boyer CB, Rogers E, Vargas RA, Bibbins-Domingo K, Chou WYS. Reducing Cancer and Cancer Disparities: Lessons From a Youth-Generated Diabetes Prevention Campaign. Am J Prev Med 2017; 53:S103-S113. [PMID: 28818240 PMCID: PMC8491805 DOI: 10.1016/j.amepre.2017.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/04/2017] [Accepted: 05/11/2017] [Indexed: 01/28/2023]
Abstract
Adolescence and young adulthood, a period essential for determining exposures over the life-course, is an ideal time to intervene to lower cancer risk. This demographic group can be viewed as both the target audience and generator of messages for cancer prevention, such as skin cancer, obesity-, tobacco-, and human papillomavirus-related cancers. The purpose of this paper is to encourage innovative health communications that target youth; youth behavior; and the structural, environmental, and social determinants of youth behavior as critical areas of focus for cancer prevention and disparities reduction. The authors describe the rationale, processes, products, and early impacts of an award-winning youth diabetes prevention communication campaign model (The Bigger Picture) that harnesses spoken-word messages in school-based and social media presentations. The campaign supports minority adolescent and young adult artists to create content that aligns with values held closely by youth-values likely to resonate and affect change, such as defiance against authority, inclusion, and social justice. This campaign can be leveraged to prevent obesity, which is a cancer risk factor. Then, the authors propose concrete ways that The Bigger Picture's pedagogical model could be adapted for broader cancer prevention messaging for youth of color and youth stakeholders regarding tobacco-related cancers, skin cancers, and human papillomavirus-related cancers. The goal is to demonstrate how a youth-generated and youth-targeted prevention campaign can: (1) reframe conversations about cancer prevention, (2) increase awareness that cancer prevention is about social justice and health equity, and (3) catalyze action to change social norms and confront the social and environmental drivers of cancer disparities.
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Affiliation(s)
- Dean Schillinger
- University of California San Francisco Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California; Division of General Internal Medicine, University of California San Francisco, San Francisco, California.
| | - Pamela M Ling
- Division of General Internal Medicine, University of California San Francisco, San Francisco, California; University of California San Francisco Center for Tobacco Control Research and Education, San Francisco, California
| | - Sarah Fine
- University of California San Francisco Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California; Division of General Internal Medicine, University of California San Francisco, San Francisco, California
| | - Cherrie B Boyer
- Department of Medicine and Division of Adolescent Medicine, University of California San Francisco, San Francisco, California
| | - Elizabeth Rogers
- Departments of Internal Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Roberto Ariel Vargas
- Community Engagement and Health Policy Program, University of California San Francisco, San Francisco, California
| | - Kirsten Bibbins-Domingo
- University of California San Francisco Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California; Division of General Internal Medicine, University of California San Francisco, San Francisco, California
| | - Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, National Cancer Institute, NIH, Rockville, Maryland
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Bars, Nightclubs, and Cancer Prevention: New Approaches to Reduce Young Adult Cigarette Smoking. Am J Prev Med 2017; 53:S78-S85. [PMID: 28818250 PMCID: PMC5835447 DOI: 10.1016/j.amepre.2017.03.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/07/2017] [Accepted: 03/23/2017] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Tobacco contributes to multiple cancers, and it is largely preventable. As overall smoking prevalence in California declines, smoking has become concentrated among high-risk groups. Targeting social/cultural groups (i.e., "peer crowds") that share common values, aspirations, and activities in social venues like bars and nightclubs may reach high-risk young adult smokers. Lack of population data on young adult peer crowds limits the ability to assess the potential reach of such interventions. METHODS This multimodal population-based household survey included young adults residing in San Francisco and Alameda counties. Data were collected in 2014 and analyzed in 2016. Multivariable logistic regressions assessed smoking by sociodemographic factors, attitudes, self-rated health, peer crowd affiliation, and bar/nightclub attendance. RESULTS Smoking prevalence was 15.1% overall; 35.3% of respondents sometimes or frequently attended bars. In controlled analyses, bar attendance (AOR=2.13, 95% CI=1.00, 4.53) and binge drinking (AOR=3.17, 95% CI=1.59, 6.32) were associated with greater odds of smoking, as was affiliation with "Hip Hop" (AOR=4.32, 95% CI=1.48, 12.67) and "Country" (AOR=3.13, 95% CI=1.21, 8.09) peer crowds. Multivariable models controlling for demographics estimated a high probability of smoking among bar patrons affiliating with Hip Hop (47%) and Country (52%) peer crowds. CONCLUSIONS Bar attendance and affiliation with certain peer crowds confers significantly higher smoking risk. Interventions targeting Hip Hop and Country peer crowds could efficiently reach smokers, and peer crowd-tailored interventions have been associated with decreased smoking and binge drinking. Targeted interventions in bars and nightclubs may be an efficient way to address these cancer risks.
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Emerging adults’ self-identified peer crowd affiliations and college adjustment. SOCIAL PSYCHOLOGY OF EDUCATION 2017. [DOI: 10.1007/s11218-017-9390-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Palmedo PC, Dorfman L, Garza S, Murphy E, Freudenberg N. Countermarketing Alcohol and Unhealthy Food: An Effective Strategy for Preventing Noncommunicable Diseases? Lessons from Tobacco. Annu Rev Public Health 2017; 38:119-144. [PMID: 28384081 DOI: 10.1146/annurev-publhealth-031816-044303] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review describes common elements of tobacco countermarketing such as describing adverse health consequences, appealing to negative emotions, highlighting industry manipulation of consumers, and engaging users in the design or implementation of campaigns. It then assesses the potential for using these elements to reduce consumption of alcohol and unhealthy foods.
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Affiliation(s)
| | - Lori Dorfman
- Berkeley Media Studies Group, Berkeley, California 94704
| | - Sarah Garza
- School of Public Health, City University of New York, New York, NY 10027;
| | - Eleni Murphy
- School of Public Health, City University of New York, New York, NY 10027;
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Dutra LM, Glantz SA, Lisha NE, Song AV. Beyond experimentation: Five trajectories of cigarette smoking in a longitudinal sample of youth. PLoS One 2017; 12:e0171808. [PMID: 28182748 PMCID: PMC5300123 DOI: 10.1371/journal.pone.0171808] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 01/26/2017] [Indexed: 11/23/2022] Open
Abstract
The first goal of this study was to identify the most appropriate measure of cigarette smoking for identifying unique smoking trajectories among adolescents; the second goal was to describe the resulting trajectories and their characteristics. Using 15 annual waves of smoking data in the National Longitudinal Survey of Youth 1997 (NLSY97), we conducted an exploratory latent class growth analysis to determine the best of four outcome variables for yearly smoking (cigarettes per day on days smoked, days smoked per month, mean cigarettes per day, and total cigarettes per month) among individuals aged 12 to 30 (n = 8,791). Days smoked per month was the best outcome variable for identifying unique longitudinal trajectories of smoking and characteristics of these trajectories that could be used to target different types of smokers for prevention and cessation. Objective statistics were used to identify four trajectories in addition to never smokers (34.1%): experimenters (13.6%), quitters (8.1%), early established smokers (39.0%), and late escalators (5.2%). We identified a quitter and late escalator class not identified in the only other comparable latent class growth analysis. Logistic regressions were used to identify the characteristics of individuals in each trajectory. Compared with never smokers, all trajectories except late escalators were less likely to be black; experimenters were more likely to be out of school and unemployed and drink alcohol in adolescence; quitters were more likely to have a mother with a high school degree/GED or higher (versus none) and to use substances in adolescence and less likely to have ever married as a young adult; early established smokers were more likely to have a mother with a high school diploma or GED, be out of school and unemployed, not live with both parents, have used substances, be depressed, and have peers who smoked in adolescence and to have children as young adults and less likely to be Hispanic and to have ever married as young adults; and late escalators were more likely to be Hispanic, drink alcohol, and break rules in adolescence and less likely to have ever married as young adults. Because of the number of waves of data analyzed, this analysis provided a clearer temporal depiction of smoking behavior and more easily distinguishable smoking trajectories than previous analyses. Tobacco control interventions need to move beyond youth-focused approaches to reach all smokers.
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Affiliation(s)
- Lauren M. Dutra
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, United States of America
- Center for Health Policy Science and Tobacco Research, RTI International, Berkeley, California, United States of America
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, United States of America
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Nadra E. Lisha
- Center for Tobacco Control Research and Education, University of California, San Francisco, California, United States of America
| | - Anna V. Song
- Psychological Sciences, Health Sciences Research Institute, University of California, Merced, California, United States of America
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Moran MB, Walker MW, Alexander TN, Jordan JW, Wagner DE. Why Peer Crowds Matter: Incorporating Youth Subcultures and Values in Health Education Campaigns. Am J Public Health 2017; 107:389-395. [PMID: 28103067 DOI: 10.2105/ajph.2016.303595] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Grounded on research showing that peer crowds vary in risk behavior, several recent health behavior interventions, including the US Food and Drug Administration's Fresh Empire campaign, have targeted high-risk peer crowds. We establish the scientific foundations for using this approach. We introduce peer crowd targeting as a strategy for culturally targeting health behavior interventions to youths. We use social identity and social norms theory to explicate the theoretical underpinnings of this approach. We describe Fresh Empire to demonstrate how peer crowd targeting functions in a campaign and critically evaluate the benefits and limitations of this approach. By replacing unhealthy behavioral norms with desirable, healthy lifestyles, peer crowd-targeted interventions can create a lasting impact that resonates in the target audience's culture.
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Affiliation(s)
- Meghan B Moran
- Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Matthew W. Walker and Tesfa N. Alexander are with the Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD. Jeffrey W. Jordan and Dana E. Wagner are with Rescue, San Diego, CA
| | - Matthew W Walker
- Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Matthew W. Walker and Tesfa N. Alexander are with the Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD. Jeffrey W. Jordan and Dana E. Wagner are with Rescue, San Diego, CA
| | - Tesfa N Alexander
- Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Matthew W. Walker and Tesfa N. Alexander are with the Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD. Jeffrey W. Jordan and Dana E. Wagner are with Rescue, San Diego, CA
| | - Jeffrey W Jordan
- Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Matthew W. Walker and Tesfa N. Alexander are with the Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD. Jeffrey W. Jordan and Dana E. Wagner are with Rescue, San Diego, CA
| | - Dana E Wagner
- Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Matthew W. Walker and Tesfa N. Alexander are with the Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD. Jeffrey W. Jordan and Dana E. Wagner are with Rescue, San Diego, CA
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Lisha NE, Neilands TB, Jordan JW, Holmes LM, Ling PM. The Social Prioritization Index and Tobacco Use Among Young Adult Bar Patrons. HEALTH EDUCATION & BEHAVIOR 2016; 43:641-647. [PMID: 26706863 PMCID: PMC4930892 DOI: 10.1177/1090198115621867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Social benefits likely play a role in young adult tobacco use. The Social Prioritization Index (SPI) was developed to measure the degree to which young adults place a great importance on their social lives. We examined the usefulness of this measure as a potential predictor of tobacco use controlling for demographics and tobacco-related attitudes. Young adults completed cross-sectional surveys between 2012 and 2014 in bars in seven U.S. cities (N = 5,503). The SPI is a 13-item scale that includes personality items and information on how frequently participants attend bars and how late they stay out. Three step-by-step multinomial regression models were run using the SPI as a predictor of smoking status (nondaily and daily smoking vs. nonsmoking): (1) SPI as the sole predictor, (2) SPI and demographics, and (3) SPI, demographics, and tobacco-related attitude variables. Next, we conducted an exploratory factor analysis to examine if the number of items in SPI could be reduced and retain its strong relationship with smoking. Higher scores on the SPI were related to an increased probability of being a Nondaily Smoker (odds ratio = 1.09, 95% confidence interval [1.04, 1.14], p < .001) or Daily Smoker (odds ratio = 1.14, 95% confidence interval [1.07, 1.22], p < .0001) compared to a Nonsmoker, controlling for demographics and other tobacco-related attitudes. The SPI and reduced SPI were independently related to young adult tobacco use. The measure's brevity, ease of use, and strong association with tobacco use may make it useful to tobacco and other prevention researchers.
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Evaluation of Bar and Nightclub Intervention to Decrease Young Adult Smoking in New Mexico. J Adolesc Health 2016; 59:222-9. [PMID: 27265423 PMCID: PMC5131639 DOI: 10.1016/j.jadohealth.2016.04.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Over 20% of young adults in New Mexico currently smoke. We evaluated cigarette smoking prevalence of young adult bar patrons during an anti-tobacco Social Branding intervention. METHODS The Social Branding intervention used a smoke-free brand, "HAVOC," to compete with tobacco marketing within the "Partier" young adult peer crowd. A series of cross-sectional surveys were collected from adults aged 18-26 in bars and nightclubs in Albuquerque, New Mexico, from 2009 to 2013 using randomized time-location sampling. Multivariable multinomial regression using full information maximum likelihood estimation to account for missing data evaluated differences in daily and nondaily smoking during the intervention, controlling for demographics, other risk behaviors, and tobacco-related attitudes. RESULTS Data were collected from 1,069 individuals at Time 1, and 720, 1,142, and 1,149 participants at Times 2, 3, and 4, respectively. Current smoking rates decreased from 47.5% at Time 1 to 37.5% at Time 4 (p < .001). Among Partiers, the odds of daily smoking decreased significantly, but nondaily smoking was unchanged. Partiers that recalled, liked, and understood the smoke-free message of HAVOC had lower odds of nondaily (odds ratio: .48, 95% CI: .31-.75) and daily (odds ratio: .31, 95% CI: .14-.68) smoking than those who did not recall HAVOC. HAVOC recall was associated with attitudes that were also associated with smoking behavior. CONCLUSIONS The significant decrease in daily smoking among young adult Partiers in New Mexico was associated with HAVOC recall and understanding. Social Branding interventions efficiently target and may decrease tobacco use among young adult bar patrons.
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Jiang N, Cortese DK, Lewis MJ, Ling PM. Booze and butts: A content analysis of the presence of alcohol in tobacco industry's lifestyle magazines. Addict Behav Rep 2016; 3:14-20. [PMID: 26973865 PMCID: PMC4784715 DOI: 10.1016/j.abrep.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Advertising influences people's health behaviors. Tobacco companies have linked tobacco and alcohol in their marketing activities. We examined how depictions of alcohol were placed in lifestyle magazines produced by tobacco companies, and if these references differed depending on the magazine’s orientation, if it was towards men, women, or if it was unisex. Methods Content analysis of 6 different tobacco industry lifestyle magazines (73 issues), including 73 magazine covers, 1558 articles, 444 tobacco ads, and 695 non-tobacco ads. Results 14 of 73 (19%) magazine covers featured alcohol; 581 of 1558 (37%) magazine articles mentioned alcohol; 119 of 444 (27%) tobacco ads showed alcohol images; and 57 of 695 (8%) non-tobacco ads portrayed alcohol. Male-oriented magazines (Unlimited, CML, and Real Edge) contained the most alcohol references, and the references were mainly beer, mixed drinks, and liquor or spirits. Female-oriented magazines (All Woman and Flair) contained the fewest alcohol references, and wine and mixed drinks were the major types of alcoholic beverage portrayed. For the unisex magazine (P.S.), the frequency of alcohol references fell between the male- and female-oriented magazines, and the magazine most frequently mentioned mixed drinks. Conclusions Frequent depictions of smoking and drinking in tobacco industry lifestyle magazines might have reinforced norms about paired use of tobacco and alcohol among young adults. The pairing of tobacco and alcohol may particularly target young men. Anti-tobacco interventions need to address the co-use of tobacco and alcohol, change the social acceptability of smoking in social settings, and tailor anti-tobacco messaging by gender. Tobacco companies frequently portrayed alcohol in their lifestyle magazines. More alcohol references appeared in male-oriented magazines than female-oriented magazines. Frequent depictions of smoking and drinking may reinforce co-use norms. Interventions should reduce the social acceptability of tobacco and alcohol co-use.
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Affiliation(s)
- Nan Jiang
- University of California, San Francisco, Center for Tobacco Control Research and Education, The University of Hong Kong, School of Public Health, 5/ F William MW Mong Block, 21 Sassoon Road, Hong Kong
| | - Daniel K Cortese
- Governors State University, College of Arts and Sciences, 1 University Pkwy, University Park, IL 60484, USA
| | - M Jane Lewis
- Rutgers School of Public Health, 335 George St, Room 2100, New Brunswick, NJ 08903, USA
| | - Pamela M Ling
- University of California, San Francisco, Center for Tobacco Control Research and Education, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA
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Berg CJ, Haardörfer R, Lewis M, Getachew B, Lloyd SA, Thomas SF, Lanier A, Trepanier K, Johnston T, Grimsley L, Foster B, Benson S, Smith A, Barr DB, Windle M. DECOY: Documenting Experiences with Cigarettes and Other Tobacco in Young Adults. Am J Health Behav 2016; 40:310-21. [PMID: 27103410 PMCID: PMC4903022 DOI: 10.5993/ajhb.40.3.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We examined psychographic characteristics associated with tobacco use among Project DECOY participants. METHODS Project DECOY is a 2-year longitudinal mixed-methods study examining risk for tobacco use among 3418 young adults across 7 Georgia colleges/universities. Baseline measures included sociodemographics, tobacco use, and psychographics using the Values, Attitudes, and Lifestyle Scale. Bivariate and multivariable analyses were conducted to identify correlates of tobacco use. RESULTS Past 30-day use prevalence was: 13.3% cigarettes; 11.3% little cigars/cigarillos (LCCs); 3.6% smokeless tobacco; 10.9% e-cigarettes; and 12.2% hookah. Controlling for sociodemographics, correlates of cigarette use included greater novelty seeking (p < .001) and intellectual curiosity (p = .010) and less interest in tangible creation (p = .002) and social conservatism (p < .001). Correlates of LCC use included greater novelty seeking (p < .001) and greater fashion orientation (p = .007). Correlates of smokeless tobacco use included greater novelty seeking (p = .006) and less intellectual curiosity (p < .001). Correlates of e-cigarette use included greater novelty seeking (p < .001) and less social conservatism (p = .002). Correlates of hookah use included greater novelty seeking (p < .001), fashion orientation (p = .044), and self-focused thinking (p = .002), and less social conservatism (p < .001). CONCLUSIONS Psychographic characteristics distinguish users of different tobacco products.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael Lewis
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Steven A Lloyd
- Department of Psychological Science, University of North Georgia, Dahlonega, GA, USA
| | - Sarah Fretti Thomas
- Department of Exercise Physiology, Valdosta State University, Valdosta, GA, USA
| | - Angela Lanier
- Department of Kinesiology, Berry College, Mount Berry, GA, USA
| | | | - Teresa Johnston
- Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, USA
| | - Linda Grimsley
- Department of Nursing, Albany State University, Albany, GA, USA
| | - Bruce Foster
- Campus Life, Central Georgia Technical College, Warner Robins, GA, USA
| | | | - Alicia Smith
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Atlanta, GA, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Emory University School of Public Health, Atlanta, GA, USA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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