Tobacco Advertising Research Articles

Analysis of the causes of compulsive smoking behavior among adolescents in South Sumatra

This research aims to explore the causes and reasons behind smoking behavior in adolescents, which has become a compulsive behavior. The research method used is qualitative, employing a descriptive phenomenological approach. The findings reveal two factors contributing to the compulsive smoking behavior in adolescents, categorized into five aspects: knowledge about cigarettes, attitudes, the influence of cigarette advertisements, peer pressure, and family. It can be concluded that smoking behavior in adolescents is influenced by various factors that increase the prevalence of smoking and lead to compulsive behavior. In this study, peer influence has a significant impact on smoking behavior among adolescents

Exposure to tobacco advertising, promotion and sponsorship (TAPS) among Polish schoolchildren: Findings from the global youth tobacco survey, Poland 1999-2022

Exposure to tobacco advertising, promotion and sponsorship (TAPS) among Polish schoolchildren: Findings from the global youth tobacco survey, Poland 1999-2022

Reform of Article 46 Paragraph (3) Letter C of the Broadcasting Law Regarding the Phrase "Prohibition of Advertisements Demonstrating the Form of Cigarettes": Comparative Study With Singapore

<em>This study has been motivated by the weaknesses in the formulation of the Article 46 Paragraph (3) Letter c of Broadcasting Law No. 32 of 2002, which bans only those cigarette ads showing the shapes of cigarettes and leaves room for the tobacco industry to practice indirect advertisement. The focus of this research is to assess the enforcement of limitations on cigarette promotion in broadcasting law and to explore the legal modification of c of Broadcasting Law Article 46 paragraph 3. The method of the study is a normative juridical approach and comparative law method. The findings reveal that current laws in Indonesia have been ineffective in controlling the increase of the smoking population, among the youth in particular, due to a number of issues that the tobacco industry exploits. In contrast, smoking problems are much less prevalent in Singapore which has imposed more stringent policies. Most importantly, the research also discusses that ineffective regulation in Indonesia results from poor enforcement and light punishments offered for violations of the law. Therefore,there is need for restructuring section Article 46 Paragraph (3) Letter c of the Broadcasting Law, by promoting a bitter pill approach towards cigarette advertising, in addition to the current ineffectual position interrogated, to enhance public health.</em>

Secondhand smoke exposure among adolescents in the gulf cooperation council countries: analysis of global youth tobacco surveys

This study aimed to analyze patterns and predictors of secondhand smoke (SHS) exposure among adolescents (12–16 years old) in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Nationally representative data from the most recent Global Youth Tobacco Survey in each country were analyzed (N = 17,220). SHS exposure at home, in public places, and at school was assessed. Descriptive statistics summarized exposure prevalence overall and by sex. Multivariable logistic regression examined factors associated with each SHS exposure’s outcome. The results showed that SHS exposure was high overall, with exposure at home and school ranging from 12.7 to 20.7%, respectively, in Oman to 39.4% and 36.7%, respectively, in Kuwait. Almost half of the adolescents reported exposure to SHS in public places, with a prevalence of 40.8% in Saudi Arabia to 65.9% in Kuwait. The prevalence of exposure varied between countries, with the highest rates occurring in Kuwait. Girls had higher exposure at home, while boys had higher exposure in public and at school. Factors associated with higher exposure included parental smoking, friend smoking, and tobacco advertising. The belief that SHS is harmful was associated with lower home exposure. In conclusion, adolescents in the Gulf Cooperation Council countries are exposed to concerning levels of SHS, especially in public places. These findings underscore the urgent need for stronger tobacco control policies, including comprehensive smoke-free laws covering all public venues, to protect youth from SHS exposure. Additionally, the results support the development of targeted interventions promoting smoke-free homes and social norms against smoking.

Contingent Effects of E-Cigarette Warning Label Messages on Cognitive Elaboration and Fear Among U.S. Youth Ages 14-17 by Vaping Experience and Peer Vaping Behavior.

The U.S. Food and Drug Administration (FDA) currently requires a warning about the addictive nature of nicotine to be placed on electronic cigarette advertisements and packaging. To consider the value of additional warning messages on public health outcomes, this study examines the additive effect of new warnings that are based on recent claims from U.S. federal authorities. We conducted a secondary analysis of recent data from 1,202 U.S. youth ages 14-17 to test the impact of exposure to additional warnings placed on advertisements for vaping products on cognitive elaboration, fear, and willingness to vape and smoke. This investigation also looked closely at effects on youth who may have increased risk of future vaping due to prior vaping experiences or having friends who vape. Exposure to the alternative warnings did not amplify cognitive elaboration compared to the current FDA warning alone, but it did increase fear. Youth elaboration on both the benefits and risks of vaping was associated with willingness to both vape and smoke, but fear was not associated with either outcome. The effects of warning label exposure and cognitive elaboration varied by prior vaping experience and having at least one friend who vapes. We conclude by discussing the implications of this contingent pattern of effect and association.

Five years of discourse related to Indonesia tobacco control reform: a content analysis of online media coverage

BackgroundIn 2017, Indonesia initiated the amendment of its 11-year-old tobacco control regulation (PP 109/2012) to reduce smoking among youth, but the process was stalled. The proposed changes in the regulation...

Greenwashed Cigarette Ad Text and Imagery Produce Inaccurate Harm, Addictiveness, and Nicotine Content Perceptions: Results from a Randomized Online Experiment.

The tobacco industry has a long history of circumventing regulations to present their products, inaccurately, as less harmful. Greenwashing (portraying a product as natural/eco-friendly) is increasingly used by tobacco companies and may mislead consumers to believe that certain cigarettes are less harmful than others. This study assesses the effect of some common greenwashing tactics on consumer product perceptions. We conducted an online experiment with 1,504 participants ages 18-29, randomized to view a cigarette ad manipulated for presence/absence of a combination of 4 different greenwashing techniques: greenwashed ad text, greenwashed ad imagery, recycled paper ad background, and image of greenwashed cigarette pack. Participants rated perceived absolute harm, relative harm to other cigarettes, absolute addictiveness, relative addictiveness, and relative nicotine content. Participants who viewed ads containing greenwashed text were more likely to have inaccurate perceptions about absolute harm (AOR=1.72), relative harm (AOR=3.92), relative addictiveness (AOR=2.93) and nicotine content (AOR=2.08). Participants who viewed ads containing greenwashed imagery were more likely to have inaccurate perceptions of relative harm (AOR=1.55), absolute addictiveness (AOR=1.72), relative addictiveness (AOR=1.60) and nicotine content (AOR=1.48). Forty-two percent of those who saw an ad with all greenwashed features believed the product was less harmful than other cigarettes vs. 2% of those who saw an ad without greenwashed features. We found greenwashed text and imagery produced inaccurate risk perceptions. More active U.S. Food & Drug Administration (FDA) enforcement against such greenwashing and new FDA rulemaking to prohibit unnecessary imagery in tobacco advertising and establish plain packaging requirements would help protect consumers and public health. These findings provide evidence that greenwashing tactics used by the tobacco industry increase inaccurate product risk perceptions. These tactics could be a way for the industry to make implicit modified risk claims, despite applicable U.S. Family Smoking Prevention and Tobacco Control Act prohibitions. Findings from this study support the need for prohibitions on these tactics, and the potential for such prohibitions to help protect public health.

Disparities in Exposure to Tobacco on Television or Streaming Platforms

With the rise in popularity of streaming platforms concerns about exposure to tobacco advertising and promotion have emerged. While tobacco marketing and promotion through traditional television (TV) media channels has been extensively studied, less is known about exposure to tobacco through TV or streaming platforms and its associated factors. To examine the prevalence and factors associated with exposure to tobacco products advertised, marketed, or promoted on TV or streaming platforms among US adults. This cross-sectional study used data from the National Cancer Institute's Health Information National Trends Survey (HINTS 6), conducted from March 7 to November 8, 2022. The nationally representative survey included noninstitutionalized civilian US adults. The primary outcome was self-reported exposure to tobacco advertisements, marketing, or promotion on TV or streaming platforms in the past 3 months. Factors associated with exposure were explored using multivariable survey logistic regression. The study included 5775 participants (3415 females [weighted percentage, 50.5%], 970 Hispanic individuals [weighted percentage, 16.9%], 872 non-Hispanic Black or African American individuals [11.1%], 3144 non-White individuals [61.5%], and 632 individuals who currently smoke [12.0%]). The estimated exposure to tobacco advertisements, marketing, or promotion on television or streaming platforms was 12.4% (95% CI, 10.8%-14.2%). Multivariable logistic regression analysis revealed that exposure odds were higher among those who had a level of education of high school or less (adjusted odds ratio [aOR], 1.60; 95% CI, 1.08-2.37), individuals who currently smoke (aOR, 1.85; 95% CI, 1.06-3.25), non-Hispanic Black or African American respondents (aOR, 2.20; 95% CI, 1.40-3.45) and Hispanic respondents (aOR, 1.58; 95% CI, 1.04-2.42). In this study of the prevalence of exposure to tobacco advertisements on TV or streaming platforms among US adults, disparities in exposure by race or ethnicity, education level, and smoking status were identified. These findings underscore the need for targeted public health interventions and regulation to address these disparities and reduce the impact of tobacco advertisements on vulnerable populations.

Case-control Study: The Effect of Exposure to Cigarette Advertisements on Smoking Behavior in School-Age Children in Batu

Case-control Study: The Effect of Exposure to Cigarette Advertisements on Smoking Behavior in School-Age Children in Batu

Representation of feminine symbols in filter cigarette products

Background: Today, cigarettes are used as a consumer product by both men and women. In the past, smoking was often associated with its use by men. Over time, cigarette consumption has shifted culturally, with women becoming consumers of cigarettes with designs that emphasize elegance and a shift in consumer base. The tobacco industry adapted and began to release products aimed specifically at women, such as cigarettes with slimmer filters and more feminine packaging designs. This article discusses the changing role of filter cigarettes, which were originally associated as a symbol of femininity and are now increasingly used by men. Methods: The method used in this research is a literature study that collects, analyzes, and evaluates various relevant literature sources. Findings: This article illustrates how filter cigarettes have changed the representation of femininity and masculinity in tobacco consumption culture. Filter cigarettes were originally designed and promoted as a product that emphasized elegance, grace, and feminine imagery. However, filter cigarette consumption has shifted significantly over time, and more and more men are adopting filter cigarette products. Conclusion: Cigarette use is also influenced by the trend of e-cigarettes and the influence of social media on cigarette marketing which may lead to an increase in the number of female smokers. Novelty/Originality of this Study: This study investigates the symbolic representation of femininity in filter cigarettes, elucidating how the tobacco industry strategically employs gendered marketing to appeal to female consumers. By examining the evolution of these marketing strategies and their effects on gender norms and consumer behavior, the research offers a distinctive perspective on the intersection of gender and tobacco advertising.

Compliance with tobacco advertising and promotion laws at points-of-sale in Ethiopia: an observational study in 10 cities

BackgroundEthiopia enacted a comprehensive tobacco control law in 2019, which bans tobacco advertising and promotion activities. However, compliance with these laws at points-of-sale (PoS) has not been studied, resulting in a lack of research evidence on how the regulations are implemented. The purpose of the study was to assess compliance with tobacco advertising and promotion laws at PoS in 10 cities in Ethiopia.MethodsMulti-stage cluster sampling was used to select 1468 PoS (supermarkets, minimarkets, merchandise stores, regular shops, permanent kiosks, khat shops, street vendors, and food and drink wholesalers). Data were collected using standardized observational checklists. Tobacco advertising and promotion indicators were used to compute indoor and outdoor compliance. Poisson regression models with log link function and robust variance were used to assess factors associated with open display of cigarette packages and indoor non-compliance.ResultsThe average indoor compliance rate was 92.9% (95% CI:92.3–93.5). Supermarkets had the highest compliance (99.7%), while permanent kiosks showed the lowest compliance (89.8%). The highest average indoor compliance was observed at PoS in Addis Ababa (98.0%). About 60% of PoS were fully compliant in indoors. Indoor open display of cigarette packages was prevalent (32.5%, 95% CI:30.0-35.1). The average outdoor compliance was 99.6% (95% CI:99.5–99.7). Outdoor full compliance was 96.5%. Open display of cigarettes was significantly higher in permanent kiosks (adjusted prevalence ratio (adjPR) 6.73; 95% CI: 3.96–11.42), regular shops (adjPR 5.16; 95% CI: 3.05–8.75), and khat shops (adjPR 2.06; 95% CI: 1.11–3.83), while indoor non-compliance was significantly higher in these same types of PoS.ConclusionsWhile outdoor compliance rates were relatively high, the lower indoor compliance rates particularly due to the high prevalence of open cigarette package displays indicates a major area for improvement in enforcing anti-tobacco advertising and promotion laws.

Branding Mythology in Postmodern Culture Sampoerna Cigarette Advertising A-Mild version "Nanti juga lo Paham"

Advertising is an important instrument in Marketing Communication to build a Product Image. However, with the Republic of Indonesia Law number 32 of 2002 concerning Broadcasting, article 46 prohibits the promotion of cigarettes by displaying their appearance. To get around this, Sampoerna A-Mild cigarettes broadcast advertisements in the "You'll Understand" version which has meaning and mythology requirements. What mythology is used in branding to show the ideology of building a strong image for A-Mild Cigarettes? Through a postmodern philosophical approach in popular culture, this research wants to dismantle the sole dominance of Modernity. Using Roland Barthes' textual analysis method, it was revealed that the advertisement gave a strong meaning that the Sampoerna A-Mild cigarette advertisement wanted to create a masculine, strong, glamorous image in communal culture, as a form of resistance to the dominance of single modernity.

School-based tobacco prevention and cessation program using psycho-education and counselling: a mixed method

Introduction. In Malaysia, tobacco-related causes of death have claimed an estimated 27,400 lives annually, and that number is anticipated to climb in the coming years. Despite laws in Malaysia banning smoking in public areas, restrictions on tobacco sponsorship, promotion, and advertising in all media, as well as Graphic Warning Labels (GWLs) on cigarette packets and restricting the legal smoking age to 18 years, it is well-known that children and teenagers are involved and youth tobacco usage is rising. As there is a rise in the prevalence of tobacco use so is the call for effective school-based tobacco prevention and cessation program for children and teenagers. The study set out to understand the current level of knowledge, attitude, and behaviour of children and teenagers towards tobacco use and possible change through psycho-education and counselling towards prevention and cessation. Study participants and methods. This study adopted a pre and post Mixed Method Triangulation Design: Convergence Model. There was an independent and concurrent collection of quantitative and qualitative data from school children ages 11 to 18 years and 7 to 10 years respectively. A one-day four-module school-based prevention and cessation program was developed and carried out in five approved schools and data were collected before and after the program. The mean age for the quantitative study was 13 years, 66% were males and 34% were females. For the qualitative study, the mean age was 9 years, 54% were male and 46% were female A grand total of 131 students participated in the study. The data was analyzed using descriptive statistics, paired samples t-test thematic analysis. Results. The quantitative analysis showed a significant difference between knowledge test scores before psychoeducation intervention (M=.803; SD=.1793) and Knowledge test scores after the psycho-education intervention (M=.895; SD=.1193); [t (108) = -4.596, p = .000], attitude and behavior were insignificant Results from the thematic analysis on the qualitative results showed that the psychoeducation and counselling intervention had a significant impact only on knowledge. The children report on attitude and behaviour towards tobacco did not significantly change from before to after the program. The timing between the program and postdata may be a contributing factor but irrespective of the data collection method the outcome was similar for both children and teenagers. Practical Significance. Through psycho-education and counselling towards prevention and cessation the study set out to understand the current level of knowledge, attitude, and behaviour of children and teenagers towards tobacco use and possible change through psycho-education and counselling towards prevention and cessation. Therefore, intervention programme should include psychoeducation and counselling to improve the knowledge of students in school-based interventions.

담배 제품의 간접광고 금지와 WTO 규정과의 일치성 검토

Purpose: This paper examines whether the ban on indirect tobacco advertising is a potential legal issue under the relevant WTO agreements and explores interpretative solutions. Research design, data, and methodology: In a strict sense, prohibiting brand extension and partnership can be judged as a violation of Articles 15.1 and 15.4 of the Intellectual Property Rights Agreement on Trademark Registration Obligations (hereinafter referred to as the TRIPS Agreement). On the other hand, with Article 20 of the TRIPS Agreement and Article III:4 of the GATT, this study reviewed many aspects of consistency with the provisions of the GATS and TBT agreements. Results: Particular attention should be paid to legal issues related to regional trade agreements (Mega-FTA and investment treaties) or the constitutions of individual countries (freedom of expression), including Korea, and additional legal foundations must be established. Conclusions: This paper finds that governments face fewer legal challenges based on WTO-related trade rules than legal challenges based on regional trade agreements or domestic constitutions. A review of the relevant international trade rules of the WTO does not appear to pose the greatest obstacle to member countries adopting a ban on product placement for tobacco products.

Nicotine prevalence among youth of rural Jaipur, Rajasthan.

Children are more sensitive to tobacco advertisements than adults. The World Health Organization (WHO) reported that tobacco use has doubled in the past four decades particularly among the youth. Smoking among teenagers is an issue that affects countries worldwide. This study identified the prevalence of tobacco consumption among youth of rural Jaipur. We also studied, their age of initiation of tobacco and their correlation with the income and occupation of parents. Community based cross-sectional type of study was conducted on youth of 15-24 years of age in 30 clusters in the Vatika, Jaipur. Cluster sampling technique was adopted. A semi-structured pretested and predesigned questionnaire was used for data collection. The inter-personal communication technique was used maintaining full confidentiality. All the results were transferred onto Microsoft excel sheet and evaluated statistically. Out of 420 youths, 79.0% youths consumes nicotine in any form. More male subjects (90.9%) consume nicotine than females (62.8%) highly significantly. 33.1% youths started nicotine consumption <12 years. Youths from more income family(63.6%), illiterate father (76.2%), illiterate mother (74.4%), father having farming as occupation (67.2%), consumes more nicotine. more (88.6%) of youths consume nicotine with their friends. 58.1% parents oppose their children. The prevalence of nicotine intake was higher in boys than girls and majority of them consumes nicotine in any form gutka or beedi-cigarette. The reasons for such high dependence of nicotine according to the youth were lack of knowledge of the ill effects of nicotine intake and peer pressure. However, majority of the youth did not want to quit nicotine consumption.

Tobacco advertising and oral health among never smokers: the mediating role of secondhand smoke exposure.

To determine whether the association between tobacco advertising (TA) exposure and poor self-rated oral health (SROH) is mediated through secondhand smoke (SHS) exposure in Brazilian adults who have never smoked. Secondary cross-sectional analysis of The Brazilian National Health Survey 2019 data. The daily, weekly, or monthly exposure to SHS at home or at work was set as the mediator. Mediation analysis within a counterfactual approach used adjusted binary logistic regressions for both poor SROH and SHS exposure, to estimate the natural direct effect (NDE), natural indirect effect (NIE) through SHS exposure, and marginal total effect (MTE) of TA exposure on poor SROH. To assess the robustness of the results, we calculated the E-value for the MTE. The sample comprised 53,295 never smoker adults. The MTE of TA exposure on poor SROH was 1.09 (1.03, 1.16), with the indirect effect through SHS exposure responsible for only 16.6% of the total (NIE: 1.01 [1.01, 1.02] and NDE: 1.08 [1.02, 1.14]). An effect of 1.42 would be required for an unmeasured confounder to explain away the association between TA and SROH. More individuals exposed to TA have poor SROH than those unexposed, with secondhand smoke exposure explaining only a small portion of this effect. Upstream tobacco policies should consider oral health outcomes.

Youth and Young Adult Awareness of and Perceptions About Tobacco Marketing as a Social Justice Issue.

Systemic racism and tobacco-industry targeting contribute to disparities in communities of color. However, understanding tobacco as a social justice issue and the industry's role in perpetuating inequities remains limited. This study explored youth and young adult awareness of tobacco marketing and perceptions of tobacco marketing as a social justice issue. Focus groups were conducted with youth and young adults in 2020 and 2021, including individuals who used tobacco and e-cigarettes and those who did not use either. Online surveys were conducted in 2021 with youth (n = 1227) and young adults (n = 2643) using AmeriSpeak's nationally representative panel, oversampling for black and Hispanic Americans and people who smoke. Perceptions of flavor bans, social justice, and industry marketing were assessed. Most (>80%) survey respondents agreed that tobacco companies target youth. However, only 20% saw tobacco as a social justice issue. Focus group participants regardless of their tobacco or e-cigarette use, reported higher prevalence of tobacco advertising in their communities relative to survey respondents but did not view it as targeting communities of color. Black non-Hispanic (20.9%) and Hispanic (21.4%) survey respondents perceived tobacco as a social justice issue more than white non-Hispanic (16.1%) respondents. The majority (>60%) of survey respondents supported bans on menthol and flavored tobacco, regardless of race or ethnicity. Respondents broadly supported menthol and flavored tobacco bans and recognized tobacco-industry influence on youth. Low awareness of tobacco as a social justice issue highlights the need to raise awareness of the underlying factors driving tobacco-related disparities. The majority of young people see the tobacco industry as targeting them. Most young people support bans on menthol and flavored tobacco bans, with support across racial and ethnic groups. While few young respondents perceived tobacco as a social justice issue, some perceived tobacco companies as targeting low-income and communities of color. Black non-Hispanic and Hispanic respondents were more likely to perceive tobacco as a social justice issue than white non-Hispanic respondents. Efforts to raise awareness among young people of tobacco as a social justice issue may be key in addressing tobacco disparities and advancing support for flavor tobacco bans.

Changes in Compliance With Bans on Tobacco Product Display and Advertising at Traditional and Modern Point-of-Sale Retailers in Depok, Indonesia, 2019-2021.

Banning Point-of-Sale (POS) advertising and product display is an important tobacco control strategy. Depok, Indonesia enacted some regional tobacco control policies regulating the POS environment in 2021. This study examined changes in compliance before and after the implementation of these policies as of 2021. Data collectors visited 180 modern retailers (hyper/supermarkets/convenience stores) and 147 traditional retailers (warungs) in 2019. The same retailers were revisited in 2021. Data collectors assessed compliance with tobacco product display, and advertising regulations at POS, including if products were displayed in spaces to target minors (near candy or at a child's eye level). Data were analyzed using McNemar and Mann-Whitney U tests. From 2019 to 2021, in modern retailers, tobacco product display (95.6% vs. 52.2%) and product advertising (36.1% vs. 3.9%) were significantly reduced (p < .001). In traditional retailers, tobacco product display (94.6% in 2019, 91.2% in 2021, p > .05) and product advertising (87.1% in 2019, 87.8% in 2021, p > .05) remained common during both data collection periods. Tobacco products were commonly displayed in spaces to target minors in both modern retailers (43.3% in 2019, 34.4% in 2021, p > .05) and traditional retailers (90.5% in 2019, 83.0% in 2021, p > .05). Compliance with bans on tobacco product advertising and display at modern retailers improved significantly from 2019 to 2021; however, most modern retailers continue to display tobacco products in 2021. Traditional retailers remain largely noncompliant. Tobacco products are commonly displayed in areas that target minors. The enforcement of regional regulations should be strengthened, particularly among traditional retailers. In Depok, Indonesia, tobacco advertising and product display bans have been implemented; however, more work is needed to support compliance. Enforcement efforts, such as those carried out by civil police, can focus on tobacco product display bans in traditional and modern retailers, and traditional retailers need additional support to remove tobacco product advertising. Retailers may receive money from the tobacco industry for these advertisements. Creative solutions may include supporting retailers in finding alternative advertising revenue.

Hubungan Iklan Rokok Dengan Perilaku Remaja Laki-Laki Di Kelurahan Desa Limbangan Wetan Kabupaten Brebes

Background: Smoking is common among adults and teenagers, especially men. This lifestyle is one of the biggest problems facing the world of health because it causes almost 6 million deaths every year. More than 5 million people die from smoking, while 600 thousand people die from exposure to cigarette smoke. Method: This research uses a quantitative research type, analytical approach, cross-sectional study design. The population in this study were male teenagers in Limbangan Wetan Village, Brebes Regency. Sampling used simple random sampling with a total sample of 30 male teenagers. This research was conducted using the interview method and data collection tools, namely questionnaires. Results: Research shows that the most common age of smokers is 18-24 years old (50%), the highest level of education is high school graduation (56.7%), the highest number of types of smokers smoked is 11-20 cigarettes per day ( 36.7%), 20 respondents were exposed to cigarette advertising (66.7%) and 26 people smoked (86.7%). Conclusion: there is a significant relationship between cigarette advertising and the behavior of adolescent boys in the Limbangan Wetan Village Village, Brebes Regency.

Socioecological factors associated with multiple nicotine product use among U.S. youth: Findings from the population assessment of tobacco and health (PATH) study 2013–2018

ObjectiveThis study utilized a socioecological approach to prospectively identify intrapersonal, familial, and environmental factors associated with single nicotine product use (NPU) and multiple NPU among U.S. youth. MethodsParticipants were 10,029 youths (ages 12–17 years) who had completed the Population Assessment of Tobacco Health study's Wave 1 (2013–2014) and Wave 4 (2016–2018) assessments and data on past 30-day nicotine product use. Multinomial logistic regression was fit for the 3-level outcome (no use, single NPU, multiple NPU) to estimate adjusted associations between the predictors and the outcome. ResultsThe current study found that intrapersonal (sex, age, race/ethnicity, internalizing symptoms, sensation seeking, harm perceptions, lifetime history of using two or more tobacco products), familial (parental discussion about not using tobacco and living with someone who uses tobacco products) and environmental factors (exposure to tobacco advertising) commonly associated with tobacco use differentiated between individuals who later reported past 30-day NPU (either multiple or single NPU) from those who did not report past 30-day NPU. One familial factor only differentiated between lifetime users who were single NPUs from those who reported no NPU: non-combustible tobacco product use allowed anywhere in the home. Intrapersonal factors differentiated multiple NPU from single NPU: older age, being male, lifetime history of using nicotine product and less harm perceptions. ConclusionsThis study identified factors that may be studied to prevent any NPU, along with factors that may be studied to promote harm reduction by preventing escalation of single NPU to problematic patterns of multiple NPU.