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Parvanta C, Hammond RW, He W, Zemen R, Boddupalli S, Walker K, Chen H, Harner RN. Face Value: Remote facial expression analysis adds predictive power to perceived effectiveness for selecting anti-tobacco PSAs. JOURNAL OF HEALTH COMMUNICATION 2022; 27:281-291. [PMID: 35838201 DOI: 10.1080/10810730.2022.2100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Perceived effectiveness (PE) is a validated tool for predicting the potential impact of anti-tobacco public service announcements (PSAs). We set out to evaluate the added predictive value of facial expression analysis when combined with PE in a remote (online) survey. Each of 302 tobacco users watched 3 PSAs and allowed transmission of webcam videos from which metrics for "attention" (head position) and "facial action units" (FAU) were computed. The participants completed scales for their subjective emotions, willingness to share on social media, and intention to quit smoking using the Tobacco Free Florida website. Based on PE, both ready to quit (RTQ) and not ready (NR) respondents favored the same PSAs but RTQs assigned higher PE scores. Negative PSAs ("sad" or "frightening") were more compelling overall but RTQs also favored surprising ads and were more willing to share them on social media. Logistic regression showed that the combination of Attention + FAU+ PE (AUC = .816, p < .0001) outperformed single factors or factor combinations in distinguishing RTQ from NR. This study demonstrates that on-line assessment of facial expressions enhances the predictive value of PE and can be deployed on large remote samples.
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Affiliation(s)
- Claudia Parvanta
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - R W Hammond
- Muma College of Business, Center for Marketing and Sales Innovation, University of South Florida, Tampa, Florida, USA
| | - W He
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - R Zemen
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - S Boddupalli
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - K Walker
- Zimmerman School of Mass Communication and Advertising, University of South Florida, Tampa, Florida, USA
| | - H Chen
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - R N Harner
- Muma College of Business, Center for Marketing and Sales Innovation, University of South Florida, Tampa, Florida, USA
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Karras E, Stokes CM, Warfield SC, Bossarte RM. Designing mental health promotion campaigns: segmenting U.S. Veteran audiences to address public stigma. J Ment Health 2022:1-7. [PMID: 35502828 DOI: 10.1080/09638237.2022.2069712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Public stigma is a significant deterrent to mental health service use for U.S. veterans. Media campaigns are often used to dispel stigmatizing beliefs and actions. Segmentation is an evidence-based practice for their effective use; however, little data has been published on veteran segments to target with anti-stigma messages. AIMS This article aims to identify and describe initial typologies of stigmatizing attitudes within a group of U.S. military veterans. METHODS Telephone-based cross-sectional surveys were conducted with a national random sample of veterans from 2014 to 2016 (N = 2142). Stigma outcomes were measured using a brief, validated instrument used in population-based surveys of public perceptions toward people with mental illness. Cluster analysis was conducted to identify specific groupings along multiple dimensions. RESULTS A final four-cluster solution was identified among veterans with distinct patterns of attitudes toward mental illness and include: 1) the undecided, 2) the influencer, 3) the ambivalent, and 4) the potential ally. Several strategies were also identified for designing anti-stigma messaging toward these segments. CONCLUSIONS This research demonstrates veterans can be segmented by attitudes to target with anti-stigma campaign messages.
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Affiliation(s)
- Elizabeth Karras
- Department of Veterans Affairs, Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, NY, USA
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Cara M Stokes
- Department of Veterans Affairs, Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, NY, USA
| | - Sara C Warfield
- Department of Veterans Affairs, Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, NY, USA
- College of Medicine, University of Illinois, Peoria, IL, USA
| | - Robert M Bossarte
- Department of Veterans Affairs, Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, NY, USA
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, USA
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Mantey DS, Clendennen SL, Ruiz FA, Perry CL. Language Gap in Reach of "The Real Cost": Examination of a Federal Mass Media Campaign From 2017 to 2019. Nicotine Tob Res 2021; 23:1602-1606. [PMID: 33782698 DOI: 10.1093/ntr/ntab054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/22/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Approximately 25% of youth in the United States speak a language other than English at home. These youth may have less exposure to English-speaking media, including public smoking prevention initiatives such as the FDA's "The Real Cost" campaign. Research is needed to explore potential gaps in the reach of "The Real Cost" campaign among bilingual youth. AIMS AND METHODS Data were pooled from the 2017-2019 National Youth Tobacco Surveys. Participants were n = 12 803 middle and high school students who were either: (1) susceptible never smokers; or (2) ever smokers that had smoked less than 100 cigarettes; these criteria reflect the FDA's definition of "target population" for "The Real Cost" campaign. Multiple, logistic regression analyses examined the relationship between speaking a language other than English at home (ie, bilingual) and self-reported exposure to "The Real Cost" campaign among both samples. Analyses controlled for sex, race/ethnicity, grade level, tobacco marketing exposure, and current tobacco use. RESULTS The majority (61.7%) of youth who met "target population" criteria self-reported exposure to "The Real Cost" from 2017 to 2019. Regression analyses found that youth who reported speaking a language other than English at home were significantly less likely to self-report exposure to "The Real Cost" campaign (adjusted odds ratio: 0.85; p < .001), adjusting for covariates. CONCLUSIONS Bilingual youth were significantly less likely to report exposure to "The Real Cost" campaign. Findings suggest the need to develop methods of increasing reach among bilingual youth, given the high smoking prevalence among these youth. IMPLICATIONS This study highlights a social and cultural gap in the reach of the FDA's "The Real Cost" campaign. Agencies such as FDA should consider enhancing existing mass media campaigns to reach diverse communities, including the nearly 25% of youth who speak a language other than English.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Stephanie L Clendennen
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Felisa A Ruiz
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Cheryl L Perry
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
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Pérez A, N’hpang RS, Callahan E, Bluestein M, Kuk AE, Chen B, Perry CL, Harrell MB. Age at Initiation of Cigarette Use in a Nationally Representative Sample of US Youth, 2013-2017. JAMA Netw Open 2021; 4:e210218. [PMID: 33635326 PMCID: PMC7910812 DOI: 10.1001/jamanetworkopen.2021.0218] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Cigarettes are still a commonly used tobacco product among youth despite recent declines in cigarette use. OBJECTIVE The aim of this study was to prospectively estimate the age of cigarette use initiation among youth (aged 12-17 years) overall, by sex, and by race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from waves 1 through 4 of the nationally representative Population Assessment of Tobacco and Health (PATH) study, conducted from September 12, 2013, to January 3, 2018. Two subpopulations of youth were assessed: (1) those nonsusceptible to cigarette use and (2) never users of cigarettes at their first wave of PATH participation. Weighted interval-censoring survival analyses were used to prospectively estimate the age of initiation of cigarette use outcomes. Weighted interval-censoring Cox proportional hazard models were used to estimate differences in the age of initiation by sex and by race/ethnicity. Statistical analyses were performed from October 7, 2019, to May 1, 2020. EXPOSURES Differences in the age of initiation by sex and race/ethnicity. MAIN OUTCOMES AND MEASURES Age of initiation of susceptibility to cigarette use, ever use, past 30-day use, and fairly regular cigarette use overall, by sex, and by race/ethnicity. RESULTS A total of 15 776 youth never users and, among them, 11 022 youth who were nonsusceptible to cigarette use, were included in this study (weighted mean [SE] age, 13.5 [0.01] years; 58.6% [SE, 0.46%] non-Hispanic White; and 51.0% [SE, 0.32%] boys) and 15 776 were never users of cigarettes at their first wave of PATH participation (weighted mean [SE] age, 13.7 [0.01] years; 55.0% [SE, 0.29%] non-Hispanic White; and 51.0% [SE, 0.15%] boys). By age 18 years, among those who were nonsusceptible, 46.2% (95% CI, 44.3%-48.2%) became susceptible to cigarette use. Among never users, 24.4% (95% CI, 22.9%-25.9%) initiated ever cigarette use, 16.4% (95% CI, 15.2%-17.6%) initiated past 30-day cigarette use, and 4.3% (95% CI, 3.9%-4.8%) initiated fairly regular cigarette use. Boys had a higher risk of initiating ever (hazard ratio [HR], 1.21; 95% CI, 1.08-1.36) and past 30-day cigarette use (HR, 1.27; 95% CI, 1.10-1.47) at earlier ages compared with girls. Non-Hispanic White youth had a higher risk of an earlier age of initiation of susceptibility to cigarette use (HR, 0.77; 95% CI, 0.68-0.88), ever use (HR, 0.59; 95% CI, 0.49-0.71), past 30-day use (HR, 0.64; 95% CI, 0.52-0.77), and fairly regular cigarette use (HR, 0.25; 95% CI, 0.14-0.43) compared with non-Hispanic Black youth. CONCLUSIONS AND RELEVANCE The results of this cohort study suggest that, despite current interventions and existing laws, a large number of youth initiated cigarette use before the legal age to purchase tobacco products.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Roi San N’hpang
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Elizabeth Callahan
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Meagan Bluestein
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Arnold E. Kuk
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Baojiang Chen
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Cheryl L. Perry
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin
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Barrington-Trimis JL, Braymiller JL, Unger JB, McConnell R, Stokes A, Leventhal AM, Sargent JD, Samet JM, Goodwin RD. Trends in the Age of Cigarette Smoking Initiation Among Young Adults in the US From 2002 to 2018. JAMA Netw Open 2020; 3:e2019022. [PMID: 33021650 PMCID: PMC7539122 DOI: 10.1001/jamanetworkopen.2020.19022] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Success in reducing the prevalence of adolescent smoking could reflect complete prevention of smoking initiation or a shift in the age of cigarette smoking initiation from adolescence into early adulthood. OBJECTIVE To assess trends in early adult (ages 18-23 years) vs adolescent (age <18 years) cigarette smoking initiation and transition to daily cigarette smoking from 2002 to 2018. DESIGN, SETTING, AND PARTICIPANTS Ages at initiation of smoking and the transition to daily smoking were ascertained from the National Survey on Drug Use and Health (2002-2018), an annual, population-based, repeated cross-sectional study representative of the US population. This cross-sectional analysis was restricted to young adults who completed the survey at ages 22 to 23 years during survey years 2002 to 2018 to limit potential age-related recall bias. Retrospectively collected age of cigarette smoking initiation was assessed among ever cigarette smokers; age of transition to daily smoking was assessed among ever daily cigarette smokers. Data analysis was performed from June 2019 to July 2020. EXPOSURES Calendar year of survey (2002 to 2018). MAIN OUTCOMES AND MEASURES The main outcomes were population-weighted cigarette smoking prevalence and cigarette smoking initiation and transition to daily smoking in adolescence (age <18 years) vs early adulthood (ages 18-23 years). RESULTS Among 71 756 young adults aged 22 to 23 years (38 226 women [50.5%]), ever cigarette smoking prevalence decreased from a population-weighted estimate of 74.6% (95% CI, 73.1%-75.9%) in 2002 to 51.4% (95% CI, 49.3%-53.5%) in 2018 (P < .001). Daily smoking prevalence rates similarly decreased from 41.1% (95% CI, 39.1%-43.1%) in 2002 to 20.2% (95% CI, 18.6%-21.8%) in 2018 (P < .001). However, among 48 015 ever smokers, the proportion initiating smoking in early adulthood (ages 18-23 years) increased over this time, from 20.6% (95% CI, 18.5%-22.8%) in 2002 to 42.6% (95% CI, 39.6%-45.7%) in 2018 (P < .001). Similarly, among 24 490 daily cigarette smokers, the proportion who transitioned to daily smoking in early adulthood increased from 38.7% (95% CI, 35.9%-41.6%) in 2002 to 55.9% (95% CI, 52.0%-59.8%) in 2018 (P < .001). CONCLUSIONS AND RELEVANCE A substantial proportion of beginning smokers and most new daily smokers are now young adults, reflecting a shift from adolescence to early adulthood, a population segment once considered beyond the critical risk period for cigarette smoking onset. Expanding the long-standing emphasis on adolescent surveillance and prevention in adolescence to include the young adult population is warranted.
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Affiliation(s)
- Jessica L. Barrington-Trimis
- Department of Preventive Medicine, University of Southern California, Los Angeles
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles
| | | | - Jennifer B. Unger
- Department of Preventive Medicine, University of Southern California, Los Angeles
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles
| | - Rob McConnell
- Department of Preventive Medicine, University of Southern California, Los Angeles
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles
| | - Andrew Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles
- Department of Psychology, University of Southern California, Los Angeles
| | - James D. Sargent
- Department of Pediatrics, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| | | | - Renee D. Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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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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Santiago S, Mahoney C, Murray MP, Benoza G. "The Real Cost": Reaching At-Risk Youth in a Fragmented Media Environment. Am J Prev Med 2019; 56:S49-S56. [PMID: 30661525 DOI: 10.1016/j.amepre.2018.07.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/24/2018] [Accepted: 07/25/2018] [Indexed: 11/18/2022]
Abstract
In 2014, the U.S. Food and Drug Administration launched its first youth smoking prevention media campaign, "The Real Cost," with the goal of preventing cigarette smoking among at-risk youth aged 12-17 years in the U.S. This paper examines how the paid media strategy was developed, implemented, and refined between 2013 and 2016. Specifically, this paper discusses how research and best practices informed the media targeting strategy used to implement a multifaceted national campaign that successfully reached and influenced thousands of teens at risk for cigarette smoking. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Fifth Anniversary Retrospective of "The Real Cost," the Food and Drug Administration's Historic Youth Smoking Prevention Media Campaign, which is sponsored by the U.S. Food and Drug Administration.
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Affiliation(s)
| | | | - Michael P Murray
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Gem Benoza
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
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Crosby K, Santiago S, Talbert EC, Roditis ML, Resch G. Bringing "The Real Cost" to Life Through Breakthrough, Evidence-Based Advertising. Am J Prev Med 2019; 56:S16-S23. [PMID: 30661521 DOI: 10.1016/j.amepre.2018.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 10/27/2022]
Abstract
Building on the success "The Real Cost" campaign has already achieved requires the constant development of new audience insights, novel ideas, and unconventional ways of bringing the campaign to life. This article provides a high-level overview of the campaign's approach to developing and testing breakthrough advertising that has proven effective in preventing smoking initiation among a skeptical, hard-to-reach, at-risk youth audience. This approach is informed by evidence-based communication best practices for youth behavior change campaigns; insights from published literature and subject matter experts with decades of experience in youth health marketing and tobacco prevention; and findings from formative research studies conducted as part of the campaign development process. The paper also explores two campaign advertisements to showcase the research-based creative development process in action. This article is a collaboration between federal government officials, campaign managers, ad agency creatives, and researchers, and thus provides a unique, multidisciplinary examination into the research and creative processes that go into creating a national health communication effort. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Fifth Anniversary Retrospective of "The Real Cost," the Food and Drug Administration's Historic Youth Smoking Prevention Media Campaign, which is sponsored by the U.S. Food and Drug Administration.
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Affiliation(s)
- Kathleen Crosby
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | | | - Emily C Talbert
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
| | - Maria L Roditis
- Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
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Crosby K. How the Food and Drug Administration Convinced Teens to Rethink Their Relationship With Cigarettes. Am J Prev Med 2019; 56:S1-S4. [PMID: 30661520 DOI: 10.1016/j.amepre.2018.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Kathleen Crosby
- Office of Health Communication and Education,Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
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