Exposure to Multimedia Tobacco Marketing and Product Use Among Youth: A Longitudinal Analysis

Author:

Choi Kelvin1,Rose Shyanika W2,Zhou Yitong2,Rahman Basmah2,Hair Elizabeth23

Affiliation:

1. Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD

2. Truth Initiative Schroeder Institute, Washington, DC

3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Abstract

Abstract Introduction Tobacco companies continue to reach youth through direct-to-consumer marketing, which has been associated with overall tobacco use. We examine how exposure to these marketing activities influences product-specific use behaviors. Methods We analyzed data from 10 081 youth (aged 12–18 years) who participated in Waves 1 and 2 (2013–2015) of the Population Assessment of Tobacco and Health (PATH) Study. Participants reported past 6-month tobacco coupon receipt and online tobacco marketing engagement, and susceptibility to ever and current use of cigarette, e-cigarettes, cigars, smokeless tobacco, and hookah. Weighted multivariable logistic regression examined Wave 1 predictors of coupon receipt at Wave 2, and associations between coupon receipt, online engagement, and past 30-day use of different tobacco products. Results Youth received tobacco coupons at one (9.7%) or both waves (1.2%) and 11.1% engaged with online tobacco marketing. Coupon receipt and online marketing engagement at Wave 1 predicted Wave 2 coupon receipt among susceptible-never, ever-but-not-current, and current tobacco users (p < .05). Coupon receipt and online engagement at Wave 1 was positively associated with past 30-day use of cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookah at Wave 2 (p < .05). The relationships were stronger for those who received coupons at both waves or engaged with more sources of online marketing. Conclusions Tobacco direct-to-consumer marketing is reaching youth. Repeated exposure to these marketing activities within and across media is associated with use of different tobacco products. New policies and strong enforcement of existing regulations prohibiting these illegal marketing tactics are critical to protect youth from future tobacco use. Implications Tobacco companies utilize coupons and online engagement activities to increase brand awareness, knowledge, and sales of their products. These kinds of marketing activities can be influential among youth at a time when they may develop tobacco use behaviors. Our findings suggest that tobacco companies may be targeting at-risk youth through cross-media marketing activities. The findings also indicate that exposure to these marketing activities predicts subsequent use of different tobacco products, with suggestive dose–response relationships. Increased regulations are needed to protect youth from these marketing activities.

Funder

National Institute on Minority Health and Health Disparities

Truth Initiative

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

Reference22 articles.

1. Tobacco use among middle and high school students—United States, 2011–2017;Wang;MMWR Morb Mortal Wkly Rep,2018

2. Notes from the field: use of electronic cigarettes and any tobacco product among middle and high school students—United States, 2011-2018;Cullen;MMWR Morb Mortal Wkly Rep.,2018

3. —;National Cancer Institute,2008

4. United States Congress. Family Smoking Prevention and Tobacco Control Act.,

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