1
|
Kowitt SD, Jetsupphasuk M, Clark SA, Jarman KL, Goldstein AO, Thrasher JF, Jebai R, Ranney LM, Cornacchione Ross J. Knowledge and beliefs about blunts among youth in the United States. Prev Med Rep 2024; 47:102884. [PMID: 39318391 PMCID: PMC11417566 DOI: 10.1016/j.pmedr.2024.102884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 09/03/2024] [Accepted: 09/03/2024] [Indexed: 09/26/2024] Open
Abstract
Background Blunts (i.e., cannabis rolled in cigar paper with or without tobacco) are a popular way of consuming cannabis. Little survey research has examined knowledge and beliefs about blunts, especially among youth who use cigars or are susceptible to cigar use. Methods Participants were a convenience sample of N = 506 youth (ages 15-20) from the United States (US) recruited April-June 2023 who reported ever using little cigars or cigarillos (LCCs), past 30-day use of LCCs, or susceptibility to using LCCs. We used adjusted logistic and ordinal regression models to examine correlates of knowledge that blunts contain nicotine and, separately, relative addiction/harm perceptions for blunts vs. unmodified cigars containing only tobacco. Results One-third of youth (32.1 %) thought that blunts do not contain nicotine. Around half of youth thought that blunts were "much less" or "slightly less" addictive (45.0 %) and "much less" or "slightly less" harmful (51.5 %) than unmodified cigars. Youth who identified as Black/African American (vs. white) had lower odds of knowledge that blunts contain nicotine (aOR = 0.51, 95 % CI: 0.30, 0.87). Youth who frequently used blunts were less likely to report that blunts were more addictive (aOR = 0.39; 95 % CI: 0.24, 0.63) and harmful (aOR = 0.31; 95 % CI: 0.19, 0.50 (vs. unmodified cigars) compared with youth who never used blunts. Conclusions Our study with a sample of US youth-who have used or are susceptible to using LCCs-found that about 1 in 3 participants thought that blunts do not contain nicotine, and many believed blunts were less harmful and addictive than unmodified cigars.
Collapse
Affiliation(s)
- Sarah D. Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Michael Jetsupphasuk
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Sonia A. Clark
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Kristen L. Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Adam O. Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States
| | - Rime Jebai
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, United States
| | - Leah M. Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, United States
| |
Collapse
|
2
|
Guillory J, Curry L, Homsi G, Saunders M, Henes A, MacMonegle A, Nonnemaker J, Sanders EC, Mekos D, Wall Vigorita M, Budenz A. Predictors of Cigar, Cigarillo, and Little Cigar Initiation Among Hip Hop-Identifying Youth. Subst Use Misuse 2024:1-10. [PMID: 39294924 DOI: 10.1080/10826084.2024.2403127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
BACKGROUND We explored predictors of cigar product initiation among Hip Hop-identifying U.S. youth using data from the U.S. Food and Drug Administration's Fresh Empire evaluation. Participants were Hip Hop-identifying youth living in evaluation markets who had not initiated cigar product use at their first survey. OBJECTIVES We modeled cigar product initiation odds using discrete time survival analysis logistic regression models as a function of factors related to one's large social, physical, social/normative, and intrapersonal environment, and other tobacco use. RESULTS In the unique sample, 26.2% initiated cigar product use. Factors associated with higher cigar product initiation odds included: current/former (vs. non-susceptible never) cigarette smoking (odds ratio [OR]=5.35; p=.008); cigarette experimentation (vs. non-susceptible never smoking) (OR=3.26; p<.001); current (vs. never) e-cigarette use (OR=2.06; p<.001) and hookah use (OR=1.83; p=.011); having at least one friend who uses marijuana (OR=1.43; p=.008); high music use (OR=1.32; p=.035); household tobacco use (OR=1.26; p =.042); increased age (OR=1.18; p< .001); and higher sensation seeking (OR=1.16; p=.018). Youth reporting higher perceived smoking risks had lower cigar product initiation odds (OR=0.86; p=.029) as did Hispanic (OR=0.53; p<.001) and non-Hispanic Other youth (OR= 0.68; p=.023) (vs. non-Hispanic Black youth). CONCLUSIONS The finding that high music use predicted cigar product initiation should be considered in light of cigar brand sponsorship of musical artists and events and indicates a potential opportunity for counter messaging. Peer crowd segmentation in this study identified unique and differing factors that influence tobacco use risk among Hip Hop-identifying youth that are not found in the general population.
Collapse
Affiliation(s)
- Jamie Guillory
- Center for Communication & Media Impact, RTI International, Research Triangle Park, North Carolina, USA
| | - Laurel Curry
- Center for Communication & Media Impact, RTI International, Research Triangle Park, North Carolina, USA
| | - Ghada Homsi
- Quality Office, RTI International, Research Triangle Park, North Carolina, USA
| | - McKinley Saunders
- Advanced Methods Development, RTI International, Research Triangle Park, North Carolina, USA
| | - Amy Henes
- Community & Workplace Health, RTI International, Research Triangle Park, North Carolina, USA
| | - Anna MacMonegle
- Center for Communication & Media Impact, RTI International, Research Triangle Park, North Carolina, USA
| | - James Nonnemaker
- Center for Communication & Media Impact, RTI International, Research Triangle Park, North Carolina, USA
| | - Emily C Sanders
- U.S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland, USA
| | - Debra Mekos
- U.S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland, USA
| | - Megan Wall Vigorita
- U.S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland, USA
| | - Alex Budenz
- U.S. Food and Drug Administration, Center for Tobacco Products, Silver Spring, Maryland, USA
| |
Collapse
|
3
|
Audrain-McGovern J, Manikandan D, Koita F, Klapec O, Pickworth WB, Stone MD. Effect of sweet flavouring on the rewarding and reinforcing value of cigarillo use among young adults. Tob Control 2023:tc-2023-058307. [PMID: 38050181 PMCID: PMC11116272 DOI: 10.1136/tc-2023-058307] [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: 07/31/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Cigarillos dominate the US cigar market, and young adults largely drive use. While young adults prefer flavoured to non-flavoured cigarillos, especially those flavoured to taste like fruit or other sweets, the factors that underlie this preference have received little attention. We sought to determine if key indicators of abuse liability, the rewarding and reinforcing effects, are greater for sweet versus non-flavoured cigarillos. METHODS Young adults (18-24 years old) completed three laboratory visits assessing the subjective rewarding value (exposure paradigm), relative reinforcing value (computerised choice task) and absolute reinforcing value (ad libitum cigarillo smoking session) of sweet-flavoured versus non-flavoured cigarillos. General linear regression models were fit with the appropriate family link for each outcome measure. RESULTS Young adults rated sweet-flavoured cigarillos as more rewarding (estimated marginal mean (EMM) =4.52, 95% CI 4.00 to 5.03) than the non-flavoured cigarillo (EMM=3.31, 95% CI 2.80 to 3.83; B=1.20, 95% CI 0.80 to 1.60, p<0.001). The reinforcing value of sweet-flavoured cigarillos, measured by break point, was higher relative to non-flavoured cigarillos (6.34 out of 10), especially among young adults with a preference for flavoured cigarillos (B=1.94, 95% CI 0.71 to 3.18, p=0.003). Young adults took 1.9 times the number of puffs (35.75 vs 19.95) from sweet-flavoured cigarillos compared with non-flavoured cigarillos (Rate Ratio =1.94, 95% CI 1.30 to 2.90, p<0.001). CONCLUSIONS Sweet flavouring increases the abuse liability of cigarillos among young adults as reflected in greater liking, motivation to use and actual use. Banning sweet flavouring in cigarillos may diminish their use in young adults.Trial registration number CT.gov (NCT05092919).
Collapse
Affiliation(s)
| | - Divya Manikandan
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Fodie Koita
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Olivia Klapec
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Matthew D Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
4
|
Ozga JE, Smiley SL, Hart JL, Popova L, Stanton CA. Premium Cigar Festivals: A Potential Target for Marketing Restrictions. Nicotine Tob Res 2023; 25:S81-S83. [PMID: 37506236 PMCID: PMC10380184 DOI: 10.1093/ntr/ntac286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/16/2022] [Accepted: 12/13/2022] [Indexed: 07/30/2023]
Affiliation(s)
- Jenny E Ozga
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Joy L Hart
- Department of Communication and Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
| | - Lucy Popova
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | | |
Collapse
|
5
|
Venrick SJ, Kelley DE, O'Brien E, Margolis KA, Navarro MA, Alexander JP, O'Donnell AN. U.S. digital tobacco marketing and youth: A narrative review. Prev Med Rep 2023; 31:102094. [PMID: 36820374 PMCID: PMC9938337 DOI: 10.1016/j.pmedr.2022.102094] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
We describe findings from peer-reviewed articles on digital tobacco marketing (DTM) using U.S. data related to youth, including research that examines use of age restrictions, DTM exposure and engagement, and associated tobacco use. We searched PubMed, EMBASE, Web of Science, and EBSCOhost in May 2019 and May 2020 for published English language peer-reviewed articles examining DTM that were published from January 2016 to May 2020. Inclusion coding occurred in three stages. The first search identified 519 articles; 167 were coded for inclusion. The second search identified 189 articles; 67 were coded for inclusion. Two coders then assessed whether the included articles mentioned youth (age 18 and younger) or age restrictions in the method and results sections of the full text. Ultimately, 47 articles were included in this review. A codebook was developed and tested through training. Each article was coded for age restrictions, youth exposure to DTM, youth engagement with DTM, and youth tobacco use associated with DTM exposure or engagement. The studies reviewed indicate that DTM on social media was infrequently age-restricted and the stringency of age restriction varied by tobacco product, site owner, and channel. Youth reported being exposed to DTM frequently via the Internet. While youth reported less frequently engaging with DTM compared to being exposed, engagement increased over time. DTM exposure and engagement were associated with tobacco product use. The studies reviewed document an association between DTM exposure and engagement and future tobacco use; thus, DTM may be contributing to the youth tobacco epidemic.
Collapse
Affiliation(s)
- Samantha J. Venrick
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Dannielle E. Kelley
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Erin O'Brien
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
| | - Katherine A. Margolis
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Mario A. Navarro
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
| | - Jennifer P. Alexander
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Allison N. O'Donnell
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
| |
Collapse
|
6
|
Ganz O, Wackowski OA, Gratale S, Chen-Sankey J, Safi Z, Delnevo CD. The Landscape of Cigar Marketing in Print Magazines from 2018-2021: Content, Expenditures, Volume, Placement and Reach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16172. [PMID: 36498246 PMCID: PMC9739552 DOI: 10.3390/ijerph192316172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Cigar consumption has increased in the U.S. over the past decade, yet gaps remain in research on cigar promotion in print magazines. This study examines ad placement, volume, ad characteristics, and associated expenditures for cigars from 2018-2021, and readership data for magazines containing cigar ads. We merged content analysis data with Kantar Media data on magazine placement and expenditures and used magazine readership data from MRI-Simmons. The only brand in print magazines was Black & Mild (B & M), a top cigar brand in the U.S. There were 30 unique B & M magazine ads and 284 occurrences (i.e., appearances in magazines), translating to $46,504,578 in expenditures. All ads featured the word "enjoy/enjoyment" and a warning label. Filtered cigars were the most featured cigar type (75%) and sweets was the most featured flavor (78%). Nearly half of the publications in which B & M were advertised in have substantial Black/African American readership and were featured in publications with disproportionate young adult and Hispanic/Latino readership. This study identified tactics used in print advertising for a top cigar brand. Future research should examine how these tactics impact consumer perceptions. Findings of cigar ads reaching vulnerable populations may inform the FDA's efforts to reduce health disparities through regulations and public education.
Collapse
Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Olivia A. Wackowski
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Stefanie Gratale
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Julia Chen-Sankey
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Zeinab Safi
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| |
Collapse
|
7
|
The Impact of Influencers on Cigar Promotions: A Content Analysis of Large Cigar and Swisher Sweets Videos on TikTok. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127064. [PMID: 35742315 PMCID: PMC9222503 DOI: 10.3390/ijerph19127064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Little is known about the content, promotions, and individuals in cigar-related videos on TikTok. TikTok videos with large cigar and Swisher Sweets-related hashtags between July 2016 and September 2020 were analyzed. Follower count was used to identify influencers. We compared content characteristics and demographics of featured individuals between cigar types, and by influencer status. We also examined the association between content characteristics and video engagement. Compared to large cigar videos, Swisher Sweets videos were more likely to feature arts and crafts with cigar packages, cannabis use, and flavored products. In addition, Swisher Sweets videos were also more likely to feature females, Black individuals, and younger individuals. Both Swisher Sweets and large cigar influencers posted more videos of cigar purchasing behaviors than non-influencers, which was associated with more video views. None of the videos disclosed sponsorship with #ad or #sponsored. Videos containing the use of cigar packages for arts and crafts, and flavored products highlight the importance of colorful packaging and flavors in the appeal of Swisher Sweets cigars, lending support for plain packaging requirements and the prohibition of flavors in cigar products to decrease the appeal of cigars. The presence and broad reach of cigar promotions on TikTok requires stricter enforcement of anti-tobacco promotion policies.
Collapse
|
8
|
Ganz O, Jeong M, Schroth KRJ, Hrywna M. The importance of cigarillo product characteristics among young adult cigarillo users: Differences by demographics, cigarillo use and other tobacco/substance use behaviors. PLoS One 2022; 17:e0265470. [PMID: 35395013 PMCID: PMC8993004 DOI: 10.1371/journal.pone.0265470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/02/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Cigar products, including cigarillos, have increased in popularity in the U.S. and are disproportionately used by young adults. Cigarillo product characteristics can influence consumer perceptions and the appeal of these characteristics can vary by subgroup. The goal of this study was to examine a) product characteristics important to young adult cigarillo users and b) differences based on demographics and cigarillo and other tobacco/substance use behaviors. METHODS In 2016, a convenience sample of 628 past-year cigarillo users rated the importance of the following cigarillo product characteristics when choosing a cigarillo to smoke tobacco: brand, tobacco filler quality, tobacco wrap quality, flavors, price, package graphic design, and number of cigars in the pack. Differences in mean importance by demographic, cigarillo use and other tobacco/substance use characteristics were analyzed using t-tests and ANOVA tests. RESULTS The most important cigarillo product characteristics were price, quality of tobacco wrap, and flavors. The least important was graphic design of packaging. There were differences in importance by demographics and/or cigar and other tobacco/substance use behaviors for all product characteristics. In particular, pack size was rated as more important among current cigarillo users, users of foil pouches (2-3 cigarillos) or cardboard/paper boxes or other packaging styles, and current users of cigarettes, blunts and marijuana. Price was rated as more important among Hispanic/Latino and lower income smokers, and current cigarette and blunt smokers. CONCLUSIONS Findings suggest cigarillo users prioritize different product characteristics depending on their demographics or smoking behavior. Further research is needed to examine whether various cigar-related policies, such as those that ban flavors or set minimum pack sizes, could impact sub-populations of cigarillo users differently.
Collapse
Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Michelle Jeong
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Kevin R. J. Schroth
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Mary Hrywna
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| |
Collapse
|
9
|
Broun A, Phan L, Duarte DA, Ajith A, Jewett B, Mead-Morse EL, Choi K, Chen-Sankey J. Physical and Sociocultural Community-Level Influences on Cigar Smoking among Black Young Adults: An In-Depth Interview Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4430. [PMID: 35457307 PMCID: PMC9025611 DOI: 10.3390/ijerph19084430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/22/2023]
Abstract
Black young adults experience disparately high rates of cigar use and its health consequences. Little research has explored community-level influences on cigar smoking in this population, especially concerning product-specific influences and cigar smokers' perceptions. We conducted in-depth interviews with 40 Black young adult (ages 21-29) cigar smokers in the Washington, D.C. area and analyzed themes regarding physical and sociocultural community-level factors perceived to influence cigar use. Themes were further analyzed based on participants' predominant cigar products (cigarillos, large cigars, blunts). Participants reported easy access to affordable cigarillos, widespread cigarillo sales and targeted marketing, norms of cigar and blunt smoking for stress relief, socialization, and cultural participation, and ubiquitous cigar and blunt smoking cues, all of which promoted cigar use in their communities. Future research should further explore how community-level influences contribute to disproportionate cigar use among Black young adults. Our findings suggest that programs and policies addressing physical and sociocultural community-level pro-smoking influences may help mitigate cigar smoking disparities.
Collapse
Affiliation(s)
- Aaron Broun
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (A.B.); (D.A.D.)
| | - Lilianna Phan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20814, USA; (L.P.); (B.J.); (K.C.)
| | - Danielle A. Duarte
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (A.B.); (D.A.D.)
| | - Aniruddh Ajith
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15201, USA;
| | - Bambi Jewett
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20814, USA; (L.P.); (B.J.); (K.C.)
| | - Erin L. Mead-Morse
- School of Medicine, University of Connecticut, Farmington, CT 06032, USA;
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20814, USA; (L.P.); (B.J.); (K.C.)
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| |
Collapse
|
10
|
Ebrahimi Kalan M, Jebai R, Bursac Z, Popova L, Gautam P, Li W, Alqahtani MM, Taskin T, Atwell LL, Richards J, Ward KD, Behaleh R, Ben Taleb Z. Trends and Factors Related to Blunt Use in Middle and High School Students, 2010-2020. Pediatrics 2021; 148:peds.2020-028159. [PMID: 34127552 DOI: 10.1542/peds.2020-028159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Blunt use is a popular mode of marijuana consumption among adolescents in the United States, but little is known about how its prevalence has changed over time or factors associated with its use. With this study, we assessed trends and correlates of past (ever used but not in the past 30 days) and current (used in past 30 days) blunt use among adolescents in Florida. METHODS We analyzed data from 2010-2020 cross-sectional, statewide representative Florida Youth Tobacco Surveys that comprised 461 706 middle and high schoolers using Joinpoint to calculate annual percentage change (APC) in the weighted prevalence of past and current blunt use. A weighted multivariable regression model was developed by using 2019-2020 Florida Youth Tobacco Survey data to examine the factors associated with past and current blunt use. RESULTS Whereas the prevalence of past (APC = -5.32%) and current (APC = -5.28%) blunt use significantly decreased from 2010 to 2015, an increasing trend in current use prevalence (APC = 14.91%) was observed from 2015 to 2018 and has been approximately constant ever since. Similar increasing trends were observed in current blunt use among female students (APC = 14.92%), middle schoolers (19.57%), and non-Hispanic (NH) white students (APC = 11.12%) from 2016 to 2020. Several factors were consistently associated with greater odds of both past and current blunt use for both middle and high schoolers, including older age, being NH Black (versus NH white), past and current use of cigarettes, electronic cigarettes, hookah, cigars, and ever vaping marijuana. CONCLUSIONS Although blunt use among Florida youth decreased from 2010 to 2015, substantial increases were observed since 2015, suggesting that existing tobacco control programs should incorporate marijuana (and blunt) modules into existing tobacco and nicotine prevention programs.
Collapse
Affiliation(s)
| | | | - Zoran Bursac
- Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Lucy Popova
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | | | - Wei Li
- Departments of Epidemiology
| | - Mohammed M Alqahtani
- Rehabilitation Science Program, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | | | - Kenneth D Ward
- School of Public Health, The University of Memphis, Memphis, Tennessee
| | - Raed Behaleh
- Department of Public Health and Prevention Sciences, College of Education and Health Sciences, Baldwin Wallace University, Berea, Ohio
| | - Ziyad Ben Taleb
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas
| |
Collapse
|
11
|
Navarro MA, O'Brien EK, Ganz O, Hoffman L. Influencer prevalence and role on cigar brand Instagram pages. Tob Control 2020; 30:e33-e36. [PMID: 33046583 DOI: 10.1136/tobaccocontrol-2020-055994] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Influencers market products for tobacco companies on social media. This is the first study to systematically examine leading cigar brands' use of influencers on their brand Instagram pages. METHODS We identified 24 leading cigar brands, using July 2017-June 2018 US retail data. We identified cigar brands that had official appearing Instagram pages, with at least one influencer in the past 20 posts. We coded characteristics of the past three posts from each of five brand pages that contained influencers, such as setting and what the influencer was doing. Finally, we described influencer characteristics. RESULTS Approximately one-third of the 24 brands had official Instagram accounts with at least one influencer in the past 20 posts. We identified 28 influencers, typically people of colour from the hip-hop music industry, some with millions of followers. Influencers included Bella Thorne (@bellathorne), Shaquille O'Neal (@shaq) and T.I. (@troubleman31). Brands' posts that contained influencers showed the influencer using/holding a product, wearing branded merchandise or appearing in photos with a brand watermark. Three brands' pages posted sponsored event photos (ie, concerts and events using branded backgrounds). DISCUSSION Cigar brands commonly use influencers to market their products on brand Instagram pages. Results are consistent with previous findings that cigar companies' marketing may target younger African Americans and highlight the potential utility of education campaigns that similarly engage influencers.
Collapse
Affiliation(s)
- Mario Antonio Navarro
- Office of Health Communication and Education, Center for Tobacco Products, Silver Spring, Maryland, USA
| | - Erin Keely O'Brien
- Office of Science, Center for Tobacco Products, Silver Spring, Maryland, USA
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Leah Hoffman
- Communication Research, Strategy & Outreach, Fors Marsh Group, Arlington, Virginia, USA
| |
Collapse
|
12
|
Choi K, Rose SW, Zhou Y, Rahman B, Hair E. Exposure to Multimedia Tobacco Marketing and Product Use Among Youth: A Longitudinal Analysis. Nicotine Tob Res 2020; 22:1036-1040. [PMID: 31198962 PMCID: PMC7395665 DOI: 10.1093/ntr/ntz096] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 06/13/2019] [Indexed: 11/12/2022]
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.
Collapse
Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | | | - Yitong Zhou
- Truth Initiative Schroeder Institute, Washington, DC
| | - Basmah Rahman
- Truth Initiative Schroeder Institute, Washington, DC
| | - Elizabeth Hair
- Truth Initiative Schroeder Institute, Washington, DC
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
13
|
Guo M, Ganz O, Cruse B, Navarro M, Wagner D, Tate B, Delahanty J, Benoza G. Keeping It Fresh With Hip-Hop Teens: Promising Targeting Strategies for Delivering Public Health Messages to Hard-to-Reach Audiences. Health Promot Pract 2020; 21:61S-71S. [PMID: 31908198 DOI: 10.1177/1524839919884545] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Despite overall declines in youth cigarette use, tobacco use inequities exist by race/ethnicity. Health communication campaigns can be effective in changing tobacco-related attitudes, intentions, and behaviors and can be used to address tobacco use inequities by targeting young people who are at high risk for tobacco use. In 2015, the U.S. Food and Drug Administration launched Fresh Empire, the first tobacco public education campaign designed to reach primarily African American, Hispanic, and/or Asian American/Pacific Islander youth ages 12 to 17 years who identify with the Hip-Hop peer crowd. This article presents an overview of two targeting strategies-(a) influencers on social media and (b) paid digital and social media advertisements-that Fresh Empire uses to reach its audience and increase message credibility that can inform future campaigns targeting hard-to-reach populations. These strategies help the campaign expand its reach, be authentic, and increase engagement with the target audience. Microinfluencers are selected for their alignment with Hip-Hop values and high engagement rates; local influencers are teens recruited to promote the campaign in their communities; and digital and social ads are purchased with a minimum number of in-target guaranteed impressions. Across both strategies, metrics have met or exceeded expectations, including a sentiment analysis that revealed 87.3% of comments on microinfluencer posts were positive. Initial findings suggest that the tobacco prevention messages have reached the target population and resonated positively, which may help to increase message credibility and improve receptivity to tobacco prevention messages.
Collapse
Affiliation(s)
- Merrybelle Guo
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | - Ollie Ganz
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | | | - Mario Navarro
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | | | | | - Janine Delahanty
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| | - Gem Benoza
- U.S. Food and Drug Administration's Center for Tobacco Products, Silver Spring, MD, USA
| |
Collapse
|
14
|
Moran MB, Villanti AC, Johnson A, Rath J. Patterns of Alcohol, Tobacco, and Substance Use Among Young Adult Peer Crowds. Am J Prev Med 2019; 56:e185-e193. [PMID: 31104724 PMCID: PMC6538284 DOI: 10.1016/j.amepre.2019.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The association between peer crowd identification and substance use is well documented among adolescents, but less is known about substance use among young adult peer crowds. METHODS This study leverages data from the Truth Initiative Young Adult Cohort Study (Wave 8, June-July 2015), a nationally representative cohort sample of young adults aged 18-34 years. The current cross-sectional analyses (conducted in 2018) focused on 1,341 individuals aged 18-24 years in this sample. Participants reported their peer crowd identification and current use of alcohol, marijuana, other drugs, and tobacco (cigarettes, little cigars/cigarillos, e-cigarettes, hookah, smokeless tobacco). Adjusted logistic regression models assessed associations between peer crowd identification and substance use. RESULTS In general, young adults who identified as homebody, young professional, or religious had lower odds of substance use than their counterparts. Young adults who identified as social/partier were more likely to be current users of alcohol, marijuana, any tobacco, cigarettes, and e-cigarettes than those who did not identify as social/partier. Those who identified as alternative were more likely to be current users of marijuana and other drugs than those not identified as alternative. Those who identified as country were more likely than those not identified as country to be current users of cigarettes and smokeless tobacco. Those who identified as hip hop were more likely to be current users of marijuana and e-cigarettes. CONCLUSIONS Peer crowd identification is associated with substance use among young adults. These findings can help identify target populations for prevention and cessation interventions and inform intervention design and delivery.
Collapse
Affiliation(s)
- Meghan Bridgid Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Andrea C Villanti
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington, Vermont; Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Amanda Johnson
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| | - Jessica Rath
- Schroeder Institute at Truth Initiative, Washington, District of Columbia
| |
Collapse
|
15
|
Lee YO, Curry LE, Fiacco L, Henes A, Farrelly MC, Nonnemaker JM, Hoffman L, Walker MW. Peer crowd segmentation for targeting public education campaigns: Hip hop youth and tobacco use. Prev Med Rep 2019; 14:100843. [PMID: 30997323 PMCID: PMC6453823 DOI: 10.1016/j.pmedr.2019.100843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/11/2019] [Accepted: 03/14/2019] [Indexed: 11/30/2022] Open
Abstract
This study examines the potential association between strength of Hip Hop peer crowd identification and tobacco use in one of the first large samples of Hip Hop youth in the United States. Data are from a geographically-targeted, address-based convenience sample of 2194 youths aged 12–17 who identify with the Hip Hop peer crowd collected via in-person and web interviews in 30 U.S. media markets in 2015. We examined strength of Hip Hop peer crowd identification, perceived peer tobacco use, and tobacco use outcomes. Overall, 18.3% of Hip Hop youth reported current blunt (cigar with added marijuana) use, followed by electronic cigarettes (e-cigarettes) (11.6%), cigar (without added marijuana) (8.8%), hookah (6.5%), and cigarette (5.6%) use. Stronger Hip Hop peer crowd identification was associated with increased odds of using cigarettes (OR = 2.25, p < 0.05), cigars (OR = 2.14, p < 0.05), and blunts (OR = 1.61, p < 0.05), controlling for demographic characteristics and perceived peer tobacco use. Results suggest that a Hip Hop peer crowd–targeted public education prevention campaign for youth can be promising for a variety of tobacco products.
Collapse
Affiliation(s)
- Youn Ok Lee
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Laurel E Curry
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Leah Fiacco
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Amy Henes
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Matthew C Farrelly
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - James M Nonnemaker
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States of America
| | - Leah Hoffman
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States of America
| | - Matthew W Walker
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States of America
| |
Collapse
|