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Hamilton-Moseley KR, McNeel TS, Choi K. Cumulative cigarette discount coupon exposure and trajectories of cigarette smoking: a longitudinal analysis in US adults. Tob Control 2024; 33:565-569. [PMID: 37015744 DOI: 10.1136/tc-2022-057801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/10/2023] [Indexed: 04/06/2023]
Abstract
INTRODUCTION Exposure to cigarette discount coupons is associated with short-term increase in cigarette smoking; however, long-term impact is unclear. This study examined associations of cumulative exposure to cigarette coupons with trajectories of cigarette smoking in US adults. METHODS Data were from the US Population Assessment of Tobacco and Health Study Adult Surveys (n=19 824; waves 2-5). We examined the number of waves participants received cigarette discount coupons/promotions during waves 2-4 and smoking behaviours at wave 5. Weighted logistic multivariable regression models were used, adjusting for wave 2 demographics and stratified by wave 2 smoking status. RESULTS Among wave 2 adults who never smoked, each increment wave of exposure to cigarette discount coupons was associated with greater odds of wave 5 current smoking (adjusted OR (aOR)=2.09, 95% CI 1.24-3.52). Among wave 2 adults who smoked daily, each wave of coupon exposure was associated with lower odds of quitting smoking at wave 5 (aOR=0.67, 95% CI 0.62-0.73). Among wave 2 adults who had quit smoking, each increment wave of exposure was associated with greater odds of wave 5 current smoking (aOR=1.61, 95% CI 1.41-1.85). Additionally, women (vs men) and adults with lower socioeconomic status (SES) (vs higher SES) were more frequently exposed to cigarette coupons for a higher number of waves (p<0.05). DISCUSSION Exposure to cigarette coupons exhibited a dose-response relationship with changes in cigarette smoking behaviours over time, promoting smoking progression and hindering smoking cessation especially among women and people with lower SES. Prohibiting these coupons can be an important tobacco control strategy.
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Affiliation(s)
- Kristen R Hamilton-Moseley
- Division of Intramural Research, Social and Behavioral Sciences Branch, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | | | - Kelvin Choi
- Division of Intramural Research, Social and Behavioral Sciences Branch, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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Pravosud V, Holmes LM, Lempert LK, Ling PM. Impacts of Tax and Flavor Tobacco Policies on San Francisco Bay Area Tobacco Prices. EVALUATION REVIEW 2023; 47:763-785. [PMID: 36943027 PMCID: PMC10542911 DOI: 10.1177/0193841x231164908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
California Proposition 56 increased the state tobacco tax by $2 per cigarette pack effective April 1, 2017. Between 2015-2020 San Francisco (SF) and some cities in Alameda County enacted local flavored tobacco sales restrictions. SF also increased its Cigarette Litter Abatement Fee, from $0.20/pack in 2015 to $1.00 in 2020. Compare the change in tobacco prices before (2015) and after (2019/20) the implementation of a $2 increase in tobacco excise tax and local flavored tobacco policies in SF and Alameda Counties. Descriptive study of the pre-to-post policy analysis design. We drew a proportional random sample of retailers (N=463) in SF and Alameda Counties, by city. Using multivariable, single- and multiple-level linear regressions, we compared inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and by flavor policy, accounting for socio-demographics. Change in inflation-adjusted average tobacco prices in 2015 vs. 2019/20 by county and flavor policy, accounting for socio-demographics. Between 2015-2019/20, the increase in cigarette prices was higher than the $2 tax increase, and higher in SF than Alameda County (+$4.6 vs +$2.5). SF retailers stopped selling Newport menthol cigarettes and Blu brand menthol e-cigarettes in 2019/20. Adjusted average cigarette prices increased significantly more in SF and Alameda County cities with comprehensive or partial flavor policies versus cities without flavor policies (by $3.23 and $2.11). Local flavor policies affected menthol product availability and may have had positive spillover effects and indirectly increased pack prices.
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Affiliation(s)
- Vira Pravosud
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Louisa M. Holmes
- The Pennsylvania State University, Departments of Geography and Demography, University Park, PA, USA
| | - Lauren K. Lempert
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA
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Levy DT, Liber AC, Cadham C, Sanchez-Romero LM, Hyland A, Cummings M, Douglas C, Meza R, Henriksen L. Follow the money: a closer look at US tobacco industry marketing expenditures. Tob Control 2023; 32:575-582. [PMID: 35074930 PMCID: PMC9346571 DOI: 10.1136/tobaccocontrol-2021-056971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/12/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION While much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases. METHODS We examine annual US marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies as reported to the Federal Trade Commission. We consider three categories: direct advertising, promotional allowances and price discounting. In addition to considering trends in these expenditures, we examine how price discounting expenditures relate to changes in product prices and excise taxes. RESULTS US direct advertising expenditures for cigarettes fell from 80% of total industry marketing expenditures in 1975 to less than 3% in 2019, while falling from 39% in 1985 to 6% in 2019 for smokeless tobacco. Price discounting expenditures for cigarettes became prominent after the Master Settlement Agreement and related tax increases in 2002. By 2019, 87% of cigarette marketing expenditures were for price discounts and 7% for promotional allowances. Smokeless marketing expenditures were similar: 72% for price promotions and 13% for promotional allowances. Price discounting increased with prices and taxes until reaching their currently high levels. CONCLUSIONS Between 1975 and 2019, direct advertising dramatically fell while price discounting and promotional expenditures increased. Local, state and federal policies are needed that apply non-tax mechanisms to increase tobacco prices and restrict industry contracts to offset industry marketing strategies. Further study is needed to better understand industry decisions about marketing expenditures.
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Affiliation(s)
- David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Alex C Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Christopher Cadham
- Department of Health Management and Policy, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Andrew Hyland
- Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cliff Douglas
- Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rafael Meza
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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Zarei K, Hamilton-Moseley KR, Chen-Sankey J, Phan L, Ajith A, Hacker K, Jewett B, Choi K. Financial hardship during the COVID-19 pandemic and increased receipt of commercial tobacco discount coupons among US adults who use commercial tobacco. Tob Control 2023:tc-2022-057814. [PMID: 37339815 PMCID: PMC10730766 DOI: 10.1136/tc-2022-057814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Many individuals experienced financial hardship during the COVID-19 pandemic; yet commercial tobacco (CT) sales increased in the USA. We examined how experiencing financial hardships relates to increased CT discount coupon reception during the pandemic. METHODS A nationally representative sample of 1700 US adults who used CT during the 12 months prior to the survey were surveyed online during January to February 2021. Participants reported if they had received more discount coupons for various CT products during (compared with before) the pandemic. They also reported whether they experienced six different types of financial hardships since the pandemic, and the total number of hardships experienced was counted. Weighted multivariable logistic regressions were used to examine the associations between financial hardships and increased coupon reception, adjusting for demographics and CT product use. RESULTS During the first 10-11 months of the pandemic, 21.3% of US adults who used CT during the 12 months prior to the survey reported receiving more CT discount coupons. Experiencing financial hardship during the pandemic was associated with higher odds of receiving more coupons for all types of CT products: every additional count of financial hardship was associated with higher odds of increased reception of discount coupons for all CT products (adjusted odds ratios ranging from 1.13 to 1.23 across products). CONCLUSIONS Over one-fifth of US adults who used CT received more discount coupons during the pandemic. Those facing financial hardships had higher discount coupon reception, suggesting potential targeted marketing to financially vulnerable individuals by the tobacco industry.
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Affiliation(s)
- Kasra Zarei
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Kristen R Hamilton-Moseley
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Julia Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
- School of Public Health, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey, USA
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Lilianna Phan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kiana Hacker
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Bambi Jewett
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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Liber AC, Sánchez-Romero LM, Cadham CJ, Yuan Z, Li Y, Oh H, Cook S, Warner KE, Henriksen L, Mistry R, Meza R, Fleischer NL, Levy DT. Tobacco Couponing: A Systematic Review of Exposures and Effects on Tobacco Initiation and Cessation. Nicotine Tob Res 2022; 24:1523-1533. [PMID: 35143678 PMCID: PMC9575981 DOI: 10.1093/ntr/ntac037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Tobacco couponing continues to be part of contemporary tobacco marketing in the United States. We performed a systematic review of the evidence of tobacco product coupon receipt and redemption to inform regulation. AIMS AND METHODS We searched EMBASE OVID and Medline databases for observational (cross-sectional and longitudinal) studies that examined the prevalence of tobacco coupon receipt and coupon redemption across different subpopulations, as well as studies of the association between coupon receipt and redemption with tobacco initiation and cessation at follow-up. We extracted unadjusted and adjusted odds ratios for the associations between coupon exposure (receipt, redemption) and tobacco use outcomes (initiation, cessation) and assessed each studies' potential risk of bias. RESULTS Twenty-seven studies met the criteria for inclusion. Of 60 observations extracted, 37 measured coupon receipt, nine measured coupon redemption, eight assessed tobacco use initiation, and six assessed cessation. Tobacco product coupon receipt and redemption tended to be more prevalent among younger adults, women, lower education individuals, members of sexual and gender minorities, and more frequent tobacco users. Coupon receipt at baseline was associated with greater initiation. Coupon receipt and redemption at baseline were associated with lower cessation at follow-up among tobacco users. Results in high-quality studies did not generally differ from all studies. CONCLUSIONS Tobacco product coupon receipt and redemption are often more prevalent among price-sensitive subpopulations. Most concerning, our results suggest coupon receipt may be associated with higher tobacco initiation and lower tobacco cessation. Couponing thereby increases the toll of tobacco use and could prove to be a viable public health policy intervention point. IMPLICATIONS A systematic review was conducted of the scientific literature about the receipt, redemption, and effects on tobacco initiation and cessation of tobacco product couponing. This review found that tobacco coupons are more often received by price-sensitive persons and these coupons serve to increase tobacco initiation and decrease tobacco cessation. Policy efforts to address these consequences may help curb tobacco's harms and address health inequities.
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Affiliation(s)
- Alex C Liber
- Department of Oncology, Georgetown University-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Luz María Sánchez-Romero
- Department of Oncology, Georgetown University-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Christopher J Cadham
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Zhe Yuan
- Department of Oncology, Georgetown University-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Yameng Li
- Department of Oncology, Georgetown University-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Hayoung Oh
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Steven Cook
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Kenneth E Warner
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lisa Henriksen
- Department of Oncology, Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David T Levy
- Department of Oncology, Georgetown University-Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
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Price Promotions of E-Liquid Products Sold in Online Stores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148870. [PMID: 35886722 PMCID: PMC9323160 DOI: 10.3390/ijerph19148870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023]
Abstract
Background: Retailer price promotions are an important marketing strategy to attract consumers. However, there is scarce evidence on how retail price promotions are being implemented by e-cigarette online stores, particularly for e-liquid products that are not often found in brick-and-mortar stores and sold in lower prices compared to other types of e-cigarettes. Objectives: We collect data on e-liquid price-promotion activities from online stores using web scraping. From February to May 2021, we scraped the price promotion data of over 14,000 e-liquid products, from five popular online vape shops that sell nationwide in the US. We present descriptive analyses of price promotion on those products, assess price promotion practices in online stores, and discuss components of the final purchase price paid by online customers. Findings: Of the 14,000 e-liquid products and over, 13,326 (92.36%) were on sale, and each online store on average offered discounts from 9.20% to 47.53% for these products. The distribution of the after-discount price was largely similar across the five stores, and there is evidence that each store had adopted different price-promotion strategies. Conclusion: Despite low prices, price promotions are common for e-liquid products, which may undermine the effect of e-cigarette pricing policies such as excise tax that are designed to raise e-cigarette prices.
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Silver N, Rahman B, Folger S, Bertrand A, Khatib B, Gbenro M, Schillo B. A content analysis of promotional features in US direct-mail from ads across tobacco products from 2018-2020. Nicotine Tob Res 2022; 24:1627-1634. [PMID: 35417549 PMCID: PMC9759106 DOI: 10.1093/ntr/ntac095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/22/2022] [Accepted: 04/11/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Direct-mail advertising is a crucial channel through which tobacco companies deliver price incentives that lower the barrier to tobacco use while promoting tobacco products via thematic appeals not legally permitted on other marketing channels. We examine the prevalence of price incentives and ad characteristics used in tobacco product ads mailed directly to US consumers. METHODS We analyzed the content of direct-mail tobacco advertisements (N= 1047) in circulation between January 2018 and December 2020 as captured by Mintel Comperemedia Direct. These ads were coded for product type, manufacturer/brand type, model characteristics, price incentives, and themes known to appeal to vulnerable subgroups. RESULTS Ads across all tobacco products included price incentives (96%) and contained themes that appealed to rural white (40%) and black audiences (15%). Themes known to appeal to youth and young adults were present in 40% of ads across all products, including 78% of ads promoting electronic nicotine delivery systems (ENDS). Moreover, among the ENDS ads featuring youth appealing themes (51%), also featured young models. DISCUSSION Expanding on previous research which focused on combustible and smokeless tobacco products, this analysis examines direct-mail ads across the full range of tobacco products. Our findings highlight the need for regulations to address 1) the high prevalence of price incentives which undermine the effectiveness of excise taxes on tobacco use, and 2) ad themes and characteristics that appeal to groups vulnerable to tobacco use, both of which have the potential to further exacerbate tobacco related health disparities. IMPLICATIONS This study reinforces the importance of examining direct-mail as the dominant medium for tobacco advertising, particularly by including coupons and discount codes that reduce product price and thus circumventing the effect of tobacco-related tax legislation.Direct-mail encourages continued product loyalty and use and engages new consumers using price incentives and advertising strategies likely to appeal to price-sensitive consumers and other vulnerable populations.Substantial use of youth-appealing elements in ENDS ads contradict the tobacco industry's mandate to not appeal to youth, warranting highlighting the gaps in current regulations that allows them to continue appealing to this population.
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Affiliation(s)
- Nathan Silver
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | - Basmah Rahman
- Evidence Synthesis Program, U.S. Department of Veteran Affairs, Washington, DC USA
| | - Shanell Folger
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Bushraa Khatib
- Truth Initiative Schroeder Institute, Washington, DC, USA
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Parks MJ, Patrick ME, Levy DT, Thrasher JF, Elliott MR, Fleischer NL. Cigarette Pack Price and Its Within-Person Association With Smoking Initiation, Smoking Progression, and Disparities among Young Adults. Nicotine Tob Res 2022; 24:519-528. [PMID: 34633457 PMCID: PMC8887579 DOI: 10.1093/ntr/ntab210] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/08/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is a dearth of research on within-person relationships between tobacco price and cigarette smoking initiation and progression in young adulthood. This project examines the within-person association between cigarette pack price and smoking initiation and progression between age 18 and 21/22, focusing on differences across subgroups. METHODS Data came from the longitudinal Monitoring the Future (MTF) project. MTF examines drug use behaviors with nationally representative samples of 12th graders annually. Subsamples of 12th graders are annually selected and followed longitudinally. Among 12th graders from baseline years 2000-2014, we examined past 30-day cigarette smoking initiation among baseline never smokers (N = 15 280) and progression to daily smoking among youth who were not daily smokers at baseline (N = 26 998). We used hierarchical logistic regression and interaction terms to assess differences across sex, race/ethnicity, and parental education. RESULTS The within-person relationship between pack price and smoking indicated that a one-dollar increase in pack price corresponded with a 72% decrease in the odds of initiation (AOR = 0.28, 95% CI = 0.18, 0.44) and 70% decrease in the odds of progression to daily smoking (AOR = 0.30, 95% CI = 0.21, 0.44). There was a linear age trend for both smoking initiation and progression. There were no statistically significant interactions between price and demographics, making it difficult to disentangle differences across subgroups. CONCLUSIONS Exposure to increased cigarette prices during young adulthood was associated with lower odds of cigarette smoking initiation and progression. Additional policies and programs beyond cigarettes prices could help reduce tobacco-related disparities in smoking initiation and progression among young adults. IMPLICATIONS There is a strong, within-person relationship between cigarette prices and smoking initiation and progression during the transition to young adulthood: higher prices are associated with decreased odds of both initiation and progression. Cigarette taxation can help to prevent smoking initiation and progression among youth, but it is less clear how taxes are associated with disparities in smoking experienced by certain subgroups. We could not draw definitive conclusions about the impact of cigarette prices on tobacco-related disparities. Tobacco taxes should be increased on a regular basis to ensure young adults experience within-person increases in prices, and complementary programs geared toward reducing tobacco-related disparities among young adults should be promoted.
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Affiliation(s)
- Michael J Parks
- Institute for Translational Research in Children’s Mental Health, University of Minnesota, Minneapolis, MN, USA
| | - Megan E Patrick
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Michael R Elliott
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Keller-Hamilton B, Stevens EM, Wedel AV, LaPolt DT, Miranda A, Wagener TL, Patterson JG. Associations of race and ethnicity with tobacco messaging exposures and tobacco use among bisexual and pansexual women. Prev Med Rep 2022; 25:101657. [PMID: 34976704 PMCID: PMC8683774 DOI: 10.1016/j.pmedr.2021.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023] Open
Abstract
Within the lesbian and bisexual community, bisexual women have the highest prevalence of tobacco use, and Black and Latina women are much more likely to use tobacco than their heterosexual peers. Research on tobacco use among bisexual women is limited to descriptions of prevalence in this population. We evaluated associations between race/ethnicity, exposure to pro- and anti-tobacco messages, and tobacco use outcomes among bisexual and pansexual women. We recruited a sample of N = 382 bisexual and pansexual women in the United States using the online survey platform, Prolific. Participants reported sociodemographics, exposure to pro- and anti-tobacco messaging, receipt of coupons, and ever and current use of cigarettes, e-cigarettes, and other tobacco products. We modeled associations between race/ethnicity, pro- and anti-tobacco messaging exposures, and tobacco use outcomes. Unadjusted results indicated differences in prevalence of tobacco use by race/ethnicity, with White women having the highest prevalence of ever using each product, but Black women having the highest prevalence of current cigar smoking and any tobacco use. Associations between race and tobacco use were attenuated in adjusted analyses. Receiving coupons was strongly associated with current use of cigarettes (aOR = 8.02; 95% CI [3.55, 18.1]), e-cigarettes (aOR = 7.26; 95% CI [3.55, 14.9]), and any tobacco (aOR = 5.04; 95% CI [2.44, 10.4]). In conclusion, unadjusted differences in prevalence of tobacco use across race/ethnic groups were attenuated after controlling for pro- and anti-tobacco messaging exposures. Receiving tobacco coupons was consistently associated with current tobacco use among bisexual and pansexual women. Restrictions on coupons could promote health equity.
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Affiliation(s)
- Brittney Keller-Hamilton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Amelia V. Wedel
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Devin T. LaPolt
- College of Public Health, The Ohio State University, Columbus, OH, USA
- College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH, USA
| | - Alexis Miranda
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Theodore L. Wagener
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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Giovenco DP, Spillane TE, Lewis MJ. Blowing the lid off: an analysis of interior cigarette pack features and marketing strategies. Tob Control 2021; 30:599-600. [PMID: 32675249 PMCID: PMC8207258 DOI: 10.1136/tobaccocontrol-2020-055701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/21/2020] [Accepted: 06/02/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Daniel P Giovenco
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Torra E Spillane
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - M Jane Lewis
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
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Acosta-Deprez V, Jou J, London M, Ai M, Chu C, Cermak N, Kozlovich S. Tobacco Control as an LGBTQ+ Issue: Knowledge, Attitudes, and Recommendations from LGBTQ+ Community Leaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5546. [PMID: 34067341 PMCID: PMC8196887 DOI: 10.3390/ijerph18115546] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022]
Abstract
Tobacco companies use price discounts, including coupons and rebates, to market their products. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities are targeted by these marketing strategies, contributing to inequitably high tobacco use. Some localities have adopted policies restricting tobacco price discounts; for successful implementation, community buy-in is crucial. From July-October 2018, Equality California staff conducted semi-structured interviews with seven participants in Los Angeles, CA. Themes included familiarity with tobacco price discounts, their perceived impact on tobacco use in LGBTQ+ communities, and attitudes toward potential policy restrictions. Interview notes were analyzed using a deductive approach to qualitative analysis. Awareness of tobacco price discounts varied; some interviewees were familiar, while others expressed surprise at their ubiquity. Price discounts were seen to disproportionately impact LGBTQ+ individuals, especially those who additionally identify with other vulnerable groups, including young people and communities of color. Support for policy restrictions was unanimous; however, interviewees expressed concern over political opposition and emphasized a need for culturally competent outreach to LGBTQ+ communities. Community organizations are essential in mobilizing support for policy reform. Understanding the perceptions and recommendations of community leaders provides tools for policy action, likely improving outcomes to reduce LGBTQ+ tobacco use through restricting tobacco price discounts.
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Affiliation(s)
- Veronica Acosta-Deprez
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Judy Jou
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Marisa London
- OUT Against Big Tobacco Program, Equality California, Los Angeles, CA 90010, USA; (M.L.); (M.A.)
| | - Mike Ai
- OUT Against Big Tobacco Program, Equality California, Los Angeles, CA 90010, USA; (M.L.); (M.A.)
| | - Carolyn Chu
- Urban and Regional Planning Masters Program, University of California, Los Angeles, CA 90095, USA;
| | - Nhi Cermak
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Shannon Kozlovich
- Programs Department, Equality California, Los Angeles, CA 90010, USA
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