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

Kelvin Choi, Shyanika W. Rose, Yitong Zhou, Basmah Rahman, Elizabeth Hair

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

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.

Original languageEnglish
Pages (from-to)1036-1040
Number of pages5
JournalNicotine and Tobacco Research
Volume22
Issue number6
DOIs
StatePublished - Jun 1 2020

Bibliographical note

Funding Information:
KC's effort was supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities. All other authors were supported by Truth Initiative. Opinions and comments expressed are the authors' own and do not necessarily reflect those of the US Government, Department of Health and Human Services, National Institutes of Health, and National Institute on Minority Health and Health Disparities.

Publisher Copyright:
© 2019 Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2019.

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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