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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.
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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
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Lee J, Ouellette RR, Morean ME, Kong G. Adolescents and Young Adults Use of Social Media and Following of e-Cigarette Influencers. Subst Use Misuse 2024; 59:1424-1430. [PMID: 38755112 DOI: 10.1080/10826084.2024.2352620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND With high rates of both e-cigarette and social media use among adolescents and young adults (AYAs), social media influencers who promote e-cigarettes are particularly concerning but are understudied. We examined the association between AYAs' use of 11 different social media platforms (e.g. Facebook, Twitter, Instagram, TikTok, and YouTube) and exposure to social media e-cigarette influencers. OBJECTIVES From November 2022 to February 2023, we conducted an online, US national survey of AYAs (14-29 years) who endorsed past-30-day e-cigarette use. We used binomial logistic regression to examine associations between the frequency of use of each social media platform and following e-cigarette influencers, controlling for age, sex, race, ethnicity, e-cigarette use frequency, and other tobacco and substance use (i.e., alcohol and cannabis). The model was stratified by adolescents (14-17 years; n = 293) and young adults (18-29 years; n = 654). RESULTS The most frequently used social media platforms were Snapchat, TikTok and Instagram among adolescents, and YouTube, Instagram and TikTok among young adults. In adjusted models, following e-cigarette influencers was associated with more frequent use of TikTok (adjusted odds ratio [95% CI]; 1.33 [1.05, 1.68]) and Pinterest (1.18 [1.02, 1.38]) among adolescents, and more frequent use of Twitter (1.17 [1.06, 1.29]) among young adults. CONCLUSIONS The use of different platforms was associated with exposure to e-cigarette influencers: TikTok and Pinterest among adolescents and Twitter among young adults. These findings can inform tobacco regulatory policy and social media platform restrictions of e-cigarette influencers on the platforms that are popular among AYAs.
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Affiliation(s)
- Juhan Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rachel R Ouellette
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Meghan E Morean
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Grace Kong
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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Vogel EA, Flentje A, Lunn MR, Obedin-Maliver J, Capriotti MR, Ramo DE, Prochaska JJ. Active Social Media Use and Health Indicators Among Sexual and Gender Minority Adults. LGBT Health 2024; 11:292-300. [PMID: 38153392 DOI: 10.1089/lgbt.2023.0170] [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] [Indexed: 12/29/2023] Open
Abstract
Purpose: Sexual and gender minority (SGM) individuals may receive social support through active use of social media (i.e., posting and interacting). This study examined associations between active social media use, social support, and health indicators in a large sample of SGM adults in the United States. Methods: Data were derived from the 2017 wave of The PRIDE Study, a national cohort study of SGM health. SGM-identified adults reporting social media use (N = 5995) completed measures of active social media use, social support, depressive symptoms, cigarette smoking, hazardous drinking, sleep, and physical activity. Regression models examined main and interactive effects of active social media use and social support on health indicators. Results: The sample reported a moderate level of active social media use (mean [M] = 3.2 [1.0], scale = 1-5) and relatively high social support (M = 16.7 [3.3], scale = 4-20); 31.8% reported moderate-to-severe depressive symptoms. Participants with greater active social media use were more likely to experience depressive symptoms (adjusted odds ratio [AOR] = 1.18, 95% confidence interval [CI] = 1.10-1.26), cigarette smoking (AOR = 1.11, 95% CI = 1.01-1.22), insufficient sleep (AOR = 1.13, 95% CI = 1.06-1.21), and physical inactivity (AOR = 1.09, 95% CI = 1.02-1.15) than those with less active social media use. Active social media use did not significantly interact with social support to predict any health indicators (p values >0.159). Conclusions: Among SGM adults, active social media use was associated with several negative health indicators. Active social media use may increase health risks, or SGM adults with poor health may actively use social media to maintain social connections. Moderate active social media use may be compatible with health.
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Affiliation(s)
- Erin A Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Annesa Flentje
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
- Alliance Health Project, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew R Capriotti
- Department of Psychology, San Jose State University, San Jose, California, USA
| | | | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
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Kong G, Laestadius L, Vassey J, Majmundar A, Stroup AM, Meissner HI, Ben Taleb Z, Cruz TB, Emery SL, Romer D. Tobacco promotion restriction policies on social media. Tob Control 2024; 33:398-403. [PMID: 36328589 PMCID: PMC10154427 DOI: 10.1136/tc-2022-057348] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
Tobacco promotion is prolific on social media, with each platform setting their own restrictions on tobacco promotion and sales. We evaluated the policies related to tobacco product promotion and sales on 11 sites that are popular with youth in May 2021: Discord, Facebook, Instagram, Pinterest, Reddit, Snapchat, TikTok, Tumblr, Twitch, Twitter and YouTube. Nine of the 11 sites prohibited paid advertising for tobacco products. However, only three of them clearly prohibited sponsored content (ie, social influencers) that promotes tobacco. Six platforms restricted content that sells tobacco products and three tried to prohibit underage access to content that promotes or sells tobacco products. Although most platform policies prohibited paid tobacco advertising, few addressed more novel strategies, such as sponsored/influencer content and few had age-gating to prevent youth access. There is a pressing need to regulate tobacco promotion on social media platforms.
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Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Linnea Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Anuja Majmundar
- Tobacco Control Research, American Cancer Society, Inc, Atlanta, Georgia, USA
| | | | - Helen I Meissner
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Tess Boley Cruz
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Sherry L Emery
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Dan Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Vogel EA, Barrington-Trimis JL, Vassey J, Soto D, Unger JB. Young Adults' Exposure to and Engagement With Tobacco-Related Social Media Content and Subsequent Tobacco Use. Nicotine Tob Res 2024; 26:S3-S12. [PMID: 38366337 PMCID: PMC10873498 DOI: 10.1093/ntr/ntad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/18/2023] [Accepted: 06/28/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Nicotine/tobacco social media content may increase young people's risk for use. This study examined prospective associations between exposure to and engagement with nicotine/tobacco-related social media content and nicotine/tobacco use among young adults. AIMS AND METHODS Young adults (N = 2080) originally recruited from Southern California high schools for a prospective cohort study reported frequency of viewing and posting nicotine/tobacco content on four social media platforms (Facebook, Instagram, Twitter, and YouTube). Participants also reported frequency of seeing nicotine/tobacco posts from friends, seeing nicotine/tobacco posts from influencers or celebrities, and liking nicotine/tobacco posts. Within subsamples of nicotine/tobacco never users (n = 794), past users (n = 897) and current users (n = 389), analyses examined associations of baseline (May-October 2020) social media content exposure and engagement with follow-up (January-June 2021) tobacco use initiation (among never users), resumption (among past users), and continuation (among current users), adjusting for sociodemographic and socioenvironmental characteristics. RESULTS Never users who saw nicotine/tobacco posts from friends (Adjusted Odds Ratio [AOR] = 2.91 [95% Confidence Interval [CI]: 1.46, 5.82], p = .002) or from celebrities or influencers (AOR = 2.77 [1.32, 5.84], p = .007) were significantly more likely to initiate nicotine/tobacco use than their peers. Among past users, posting nicotine/tobacco content at baseline was associated with use resumption (AOR = 1.77 [1.12, 2.80], p = .014). Content exposure and engagement were not associated with nicotine/tobacco use continuation among current users (p-values > .05). CONCLUSIONS Seeing nicotine/tobacco posts from friends, influencers, or celebrities was associated with greater odds of tobacco use initiation, but not resumption or continuation, 6 months later. Young adults with past nicotine/tobacco use who post about nicotine/tobacco may be at elevated risk for resuming use. IMPLICATIONS Young adults with exposure to nicotine/tobacco social media content were more likely than their peers to initiate nicotine/tobacco use 6 months later. Past nicotine/tobacco users who reported posting about nicotine/tobacco on social media at baseline were more likely than their peers to resume nicotine/tobacco use. Among young adults with current nicotine/tobacco use at baseline, social media activity did not predict odds of nicotine/tobacco use continuation at follow-up. Nicotine/tobacco content on social media should be restricted to reduce young people's chances of nicotine/tobacco use initiation or resumption.
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Affiliation(s)
- Erin A Vogel
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, San Francisco, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, San Francisco, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, San Francisco, Los Angeles, CA, USA
| | - Daniel Soto
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, San Francisco, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, San Francisco, Los Angeles, CA, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
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6
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Rhee JU, Huang Y, Soroosh AJ, Alsudais S, Ni S, Kumar A, Paredes J, Li C, Timberlake DS. The Marketing and Perceptions of Non-Tobacco Blunt Wraps on Twitter. Subst Use Misuse 2024; 59:469-477. [PMID: 37982451 DOI: 10.1080/10826084.2023.2280572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Non-tobacco blunt wraps (N-TBWs), which entered the marketplace in 2017, are being promoted as an alternative to traditional TBWs (e.g., cigarillos) for blunt smoking. The lack of studies on these novel products warrants an investigation. This study was the first to explore blunt smokers' perceptions about N-TBWs and the extent of product marketing on Twitter. METHODS A corpus of tweets from Twitter, posted between January 2017 and November 2021, were identified by a Boolean search string (N = 149,343), where 48,695 tweets were classified as relevant by a machine learning algorithm. These relevant tweets were further screened and labeled as promotional or organic based on product URLs, usernames, keywords, or hashtags. Topic modeling using Dirichlet Allocation was then employed for identifying latent patterns of words among relevant tweets. The Social Networking Potential (SNP) score was employed for identifying influential accounts. RESULTS Most relevant tweets (89%) were organic, non-promotional expressions about N-TBWs. Account users who only posted non-promotional tweets had a significantly higher SNP than those who only posted promotional tweets. Yet, neither of the two groups of account users consisted of known celebrities. Topic modeling revealed three broad groups of topics (7 in total) denoting the attributes of hemp N-TBWs, interest in non-hemp N-TBWs, and product marketing. CONCLUSIONS The large proportion of organic tweets is indicative of the nascency of N-TBWs, which will need to be marketed more extensively if they are to replace cigar products used by blunt smokers.
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Affiliation(s)
- Joshua U Rhee
- Department of Population Health and Disease Prevention, Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
| | - Yicong Huang
- Department of Computer Science, University of California, Irvine, CA, USA
| | | | - Sadeem Alsudais
- Department of Computer Science, University of California, Irvine, CA, USA
| | - Shengquan Ni
- Department of Computer Science, University of California, Irvine, CA, USA
| | - Avinash Kumar
- Department of Computer Science, University of California, Irvine, CA, USA
| | - Jacob Paredes
- Department of Population Health and Disease Prevention, Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
| | - Chen Li
- Department of Computer Science, University of California, Irvine, CA, USA
| | - David S Timberlake
- Department of Population Health and Disease Prevention, Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
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Vogel EA, Unger JB, Vassey J, Barrington-Trimis JL. Effects of a nicotine warning label and vaping cessation resources on young adults' perceptions of pro-vaping instagram influencer posts. Addict Behav 2024; 149:107888. [PMID: 37857044 PMCID: PMC10841614 DOI: 10.1016/j.addbeh.2023.107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Exposure to social media content promoting e-cigarette use ("vaping") is associated with subsequent tobacco use among young adults. Adding features to pro-vaping Instagram influencer posts, such as a nicotine warning label and vaping cessation resources, could help counteract posts' negative influence. METHODS Young adults (N = 2,179; Mage = 22.6 [SD = 0.4]; 53.0 % cisgender women, 45.1 % Hispanic) completed an online experiment in 2021-2022 through an ongoing prospective cohort study. Participants viewed three simulated pro-vaping Instagram influencer posts in a four-group, between-subjects design. Post features differed by experimental condition: "label-only" (nicotine warning label on post), "link-only" (link to vaping cessation resources under post), "L&L" (label and link), or "control" (neither). Participants rated each influencer's traits (honest, trustworthy, informed, smart, attractive, popular; 0-100 %). After viewing all three posts, participants reported use intentions, susceptibility, positive and negative expectancies, and harm perceptions around the fictitious advertised vaping product. Past-month vapers additionally reported their desire and self-efficacy for quitting. RESULTS L&L (versus control and link-only) participants viewed influencers as more honest, trustworthy, and informed. L&L (versus control) participants had lower odds of susceptibility to using the advertised product, lower positive expectancies, and greater negative expectancies. The label and link did not significantly affect participants' intentions to use the product, perceived harm of the product, or desire or self-efficacy for quitting vaping. CONCLUSIONS Providing a nicotine warning label and link to vaping cessation resources on influencers' Instagram posts may have the unintended effect of increasing positive perceptions of the influencer. However, they may reduce susceptibility to product use.
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Affiliation(s)
- Erin A Vogel
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA.
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA 90033, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto St., Los Angeles, CA 90089, USA; Institute for Addiction Sciences, University of Southern California, 1845 N. Soto St., Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA 90033, USA
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8
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Duan Z, Romm KF, Wang Y, Huang J, Berg CJ. Exposure to E-Cigarette Advertisements or Reviews and E-Cigarette Use Progression: A Longitudinal Examination of Short-Term and Long-Term Associations among US Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:123. [PMID: 38397614 PMCID: PMC10887947 DOI: 10.3390/ijerph21020123] [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] [Received: 11/15/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
Limited research has investigated the impact of e-cigarette advertising and reviews on the progression of e-cigarette use among young adults in the US. This study utilized five-wave longitudinal data (2018-2020) with 3006 young adults aged 18-34, reporting exposure to e-cigarette advertisements or reviews at Wave 1 (W1) and W3. Generalized estimating equations (GEE) were used to examine the prospective associations between frequent exposure to e-cigarette advertisements or reviews and e-cigarette use progression in four groups: never users (n = 1271 at W1), former users (previously used but quit ≥ 6 months ago, n = 422 at W1), recent former users (used in the past 6 months but not in the past month, n = 186 at W1), and current users (used in the past month, n = 1127 at W1). Among baseline former users, frequent exposure to e-cigarette reviews was associated with current use at 6-month follow-up (aOR = 4.40, 95%CI = 1.46-13.29). Among baseline current users, frequent exposure to e-cigarette reviews was associated with increased days of use at 6-month follow-up (IRR = 1.20, 95%CI = 1.07-1.34) and 12-month follow-up (IRR = 1.18, 95%CI = 1.03-1.35). E-cigarette reviews may contribute to relapse among recent former users and increased usage frequency among current users, highlighting the need for enhanced e-cigarette promotional activity regulation.
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Affiliation(s)
- Zongshuan Duan
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Katelyn F. Romm
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA;
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (Y.W.); (C.J.B.)
| | - Jidong Huang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30302, USA;
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; (Y.W.); (C.J.B.)
- George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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9
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Vassey J, Valente T, Barker J, Stanton C, Li D, Laestadius L, Cruz TB, Unger JB. E-cigarette brands and social media influencers on Instagram: a social network analysis. Tob Control 2023; 32:e184-e191. [PMID: 35131947 PMCID: PMC9473311 DOI: 10.1136/tobaccocontrol-2021-057053] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/22/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Exposure to visual posts featuring e-cigarette products on social media is associated with increased e-cigarette use among US adolescents. Instagram is the largest source of e-cigarette social media marketing, where influencers-for example, bloggers, brand ambassadors-post promotional materials. This study analysed the network of e-cigarette brands and influencers on Instagram, characterising the most central players in e-cigarette social media marketing. METHODS We tracked influencers with public profiles on Instagram who posted promotional e-cigarette content in 2020, had over 1000 followers and high user engagement rate (ratio of likes and comments to followers) of 1%-25% per post. By conducting a social network analysis, we identified the most central (highly involved in promotional activities) influencers and e-cigarette brands. The number of the influencers' followers aged 13-17 years old and the age verification practices restricting youth access were also assessed. RESULTS There is a highly interconnected network of engaging e-cigarette influencers (n=55) worldwide who collaborated with over 600 e-cigarette brands in 2020. The Asian and US influencers had five to six times more teenage followers compared with the European influencers. 75% of the influencers did not restrict youth access to their promotional content on Instagram. The brands Voopotech, Innokin, Geekvape, Lost Vape, Smok and Vaporesso collaborated with the largest number of influencers (mean n=20). CONCLUSIONS It is important to understand associations among influencers and e-cigarette use behaviours, especially youth, to inform effective public health communication and potential policies that could regulate social media marketing sponsored by e-cigarette companies.
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Affiliation(s)
- Julia Vassey
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Tom Valente
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Joshua Barker
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester, Rochester, New York, USA
| | - Linnea Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tess Boley Cruz
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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10
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Kong G, Lee J, Celentano M, Tang C, Geller A, Mead A, Landrum Sterling K. The Promotion of Premium Cigars on Social Media. Nicotine Tob Res 2023; 25:59-64. [PMID: 37506234 PMCID: PMC10380185 DOI: 10.1093/ntr/ntad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/21/2022] [Accepted: 05/10/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION The health effect of premium cigar smoking is determined by patterns of use and perceptions, which are shaped by marketing messages. The tobacco industry uses brand-owned media promotion on social media to market its product. However, premium cigar brands' promotion of their products on social media is unknown. AIMS AND METHODS Forty-seven premium cigar brands were reviewed. For each brand, we identified the social media accounts and examined the content of the 10 most recent posts of each social media platform to identify the marketing themes in July 2022. We also assessed the presence of age-gating and the dates of the posts. RESULTS Of the 47 brands, 65% (n = 31) had Facebook and Instagram, 56% (n = 27) had Twitter, 21% (n = 10) had YouTube, and 17% (n = 8) had "other" (e.g. LinkedIn and Pinterest) accounts. Age-gating across these platforms ranged from 0% to 49%. Marketing themes identified from 981 social media posts included product features, alcohol, holidays, events and festivals, discounts and sweepstakes, taste, family, quality, lounges and clubs, culture, innovation, masculinity, and "other" (e.g. fundraising for charity and celebrity endorsement). CONCLUSIONS Premium cigar brands are using brand-owned social media to promote their products using similar strategies (e.g. discounts and sweepstakes) used by other tobacco industries but also using novel themes (e.g. fundraising for charity, events and festivals) to enhance engagement. Ongoing comprehensive surveillance of premium cigars' marketing is needed on social media to inform marketing restrictions to protect public health, including priority populations such as youth. IMPLICATIONS This study is the first to identify that premium cigar brands are promoting their brands and products on brand-owned social media, using diverse themes and strategies to engage and appeal to the public. Age gating of the promotional content on social media was low. Findings suggest that marketing restrictions to reduce the appeal of premium cigars among youth is needed to reduce tobacco-related harm.
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Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Juhan Lee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mia Celentano
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Charis Tang
- Department of Psychiatry, School of Public-Dallas Campus, University of Texas Health Sciences Center, Dallas, TX, USA
| | - Amy Geller
- Department of Psychiatry, National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA
| | - Aimee Mead
- Department of Psychiatry, National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA
| | - Kymberle Landrum Sterling
- Department of Psychiatry, School of Public-Dallas Campus, University of Texas Health Sciences Center, Dallas, TX, USA
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Vassey J, Unger JB. Should Tobacco-Related Marketing on Social Media Have Stronger Restrictions? Commentary. Subst Use Misuse 2023; 58:1615-1619. [PMID: 37442760 PMCID: PMC11335318 DOI: 10.1080/10826084.2023.2223287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
Background: Tobacco-related promotional content on social media often features young-looking influencers, models, or brand ambassadors who are appealing to youth; their posts often have inconsistent disclosures of partnerships with tobacco brands and lack age-restrictions prohibiting access to users under 18 or 21 years of age. These examples demonstrate violations of the U.S. Federal Food and Drug Administration (FDA) marketing restrictions. Methods: Marketing granted orders issued by the FDA to RJ Reynolds, Logic Technology, NJOY and Phillip Morris as part of the Premarket Tobacco Product Applications (PMTA) review process were qualitatively analyzed. Marketing practices that the tobacco companies intended to adhere to (e.g., refrain from using young-looking influencers in marketing materials) were documented. Perceived age of 55 micro-influencers who promote e-cigarette products on Instagram were assessed by 15 undergraduate student raters. Results: Despite the existing regulations of tobacco-related online marketing, the use of models or influencers and overall social media marketing is not prohibited, which leaves room for potential use of loopholes. The tobacco companies that were issued marketing granted orders set different age limits for the models to be considered young-looking and not to be used in marketing materials. The perceived age of the 55 influencers assessed by the raters was between 21-30, which is below the age limit proposed in several PMTA applications. Conclusion: Tobacco product online marketing, especially on social media, is underregulated. Strengthening tobacco marketing regulations, along with partnering of policymakers with social media platforms on establishing and maintaining effective tobacco-restriction policies, could help reduce proliferation of youth-appealing marketing of tobacco products.
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Affiliation(s)
- Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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Berg CJ, LoParco CR, Cui Y, Pannell A, Kong G, Griffith L, Romm KF, Yang YT, Wang Y, Cavazos-Rehg PA. A review of social media platform policies that address cannabis promotion, marketing and sales. Subst Abuse Treat Prev Policy 2023; 18:35. [PMID: 37337216 PMCID: PMC10278361 DOI: 10.1186/s13011-023-00546-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Cannabis marketing exposure via social media may impact use in youth and young adults. Most states with recreational cannabis lack policies regarding social media-based marketing. Thus, we examined such policies among prominent platforms, particularly those popular among youth and young adults. METHODS In September-October 2022, 3 research team members extracted policies applying to the general community, advertising, and any specific content regarding drug-related content for 11 social media sites: Discord, Facebook, Instagram, Pinterest, Reddit, Snapchat, TikTok, Tumblr, Twitch, Twitter, and YouTube. Using inductive thematic analysis, they then dual-coded restrictions on cannabis-related content (e.g., paid advertising, unpaid promotion, sales). Descriptive analyses were conducted. RESULTS Ten (all except TikTok) referenced cannabis/marijuana, 7 (all except Discord, Instagram, TikTok, and YouTube) distinguished different cannabis-derived products, and 5 (Reddit, Snapchat, TikTok, Tumblr, Twitter) noted jurisdictional differences in cannabis regulations/legality. All prohibited sales, 9 (all except Snapchat and Tumblr) prohibited paid advertising, and 4 (Discord, Reddit, Snapchat, TikTok) prohibited unpaid promotion (e.g., user-generated content). All restricted underage access to cannabis-related content. However, policies varied and were ambiguous regarding how "promotion" was defined, whether/how jurisdictional differences in legality were addressed, how businesses may interact on social media, barriers implemented to inhibit the facilitation of sales, and enforcement protocols. CONCLUSIONS Social media policies regarding cannabis marketing are ambiguous and may facilitate cannabis marketing, promotion, sales, and underage exposure, thus compounding concerns regarding insufficient governmental regulations. Greater specificity in social media cannabis-related policies and enforcement is needed.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA.
- George Washington Cancer Center, George Washington University, 2121 I St NW, Washington, DC, 20052, USA.
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
| | - Alexandria Pannell
- Department of Global Health, Milken Institute School of Public Health, George Washington University, 2121 I St NW, Washington, DC, 20052, USA
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, 06519, USA
| | - Lynniah Griffith
- Wellesley College, 106 Central Street, Wellesley, MA, 02481, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Y Tony Yang
- George Washington Cancer Center, George Washington University, 2121 I St NW, Washington, DC, 20052, USA
- Center for Health Policy and Media Engagement, School of Nursing, George Washington University, 1919 Pennsylvania Ave NW #500, Washington, DC, 20006, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000C, Washington, DC, 20052, USA
- George Washington Cancer Center, George Washington University, 2121 I St NW, Washington, DC, 20052, USA
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
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Hébert ET, Vandewater EA, Businelle MS, Harrell MB, Kelder SH, Perry CL. Tobacco advertising exposure and product use among young adults: An ecological momentary assessment approach. Addict Behav 2023; 139:107601. [PMID: 36592525 PMCID: PMC9872832 DOI: 10.1016/j.addbeh.2022.107601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Tobacco-related content is prevalent on social media, yet many methods of measuring exposure are inadequate due to the personalized nature of online marketing. The purpose of this paper is to examine the association between exposure to pro-tobacco messages (both industry-sponsored and user-generated) and the use of tobacco products, as reported via ecological momentary assessment (EMA). METHODS Young adults (n = 175) were instructed to record all sightings of marketing (both in-person and online) related to tobacco for 28 days. Tobacco product use and recall of message encounters were assessed daily using app-initiated EMA. RESULTS Participants who reported exposure to tobacco messages were significantly more likely to report using tobacco, adjusting for gender, age, race/ethnicity, baseline use of any tobacco product, and having friends who use tobacco and e-cigarettes (p <.001). For each industry-sponsored message viewed, the odds of using tobacco or e-cigarettes in a given day increased by a factor of 1.77 (95 % CI = 1.41, 2.23). For each user-generated message viewed, the odds of using tobacco or e-cigarettes in a given day increased by a factor of 1.52 (95 % CI = 1.27, 1.83). DISCUSSION To our knowledge, this is the first study to specifically examine the association between exposure to user-generated messages and daily tobacco use. The findings suggests that there is a unique element to user-generated messages that distinguishes them from both traditional marketing and from simple peer influence.
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Affiliation(s)
- Emily T Hébert
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States.
| | | | - Michael S Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Steven H Kelder
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
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Wu J, Origgi JM, Ranker LR, Bhatnagar A, Robertson RM, Xuan Z, Wijaya D, Hong T, Fetterman JL. Compliance With the US Food and Drug Administration's Guidelines for Health Warning Labels and Engagement in Little Cigar and Cigarillo Content: Computer Vision Analysis of Instagram Posts. JMIR INFODEMIOLOGY 2023; 3:e41969. [PMID: 37113379 PMCID: PMC10132024 DOI: 10.2196/41969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023]
Abstract
Background Health warnings in tobacco advertisements provide health information while also increasing the perceived risks of tobacco use. However, existing federal laws requiring warnings on advertisements for tobacco products do not specify whether the rules apply to social media promotions. Objective This study aims to examine the current state of influencer promotions of little cigars and cigarillos (LCCs) on Instagram and the use of health warnings in influencer promotions. Methods Instagram influencers were identified as those who were tagged by any of the 3 leading LCC brand Instagram pages between 2018 and 2021. Posts from identified influencers, which mentioned one of the three brands were considered LCC influencer promotions. A novel Warning Label Multi-Layer Image Identification computer vision algorithm was developed to measure the presence and properties of health warnings in a sample of 889 influencer posts. Negative binomial regressions were performed to examine the associations of health warning properties with post engagement (number of likes and comments). Results The Warning Label Multi-Layer Image Identification algorithm was 99.3% accurate in detecting the presence of health warnings. Only 8.2% (n=73) of LCC influencer posts included a health warning. Influencer posts that contained health warnings received fewer likes (incidence rate ratio 0.59, P<.001, 95% CI 0.48-0.71) and fewer comments (incidence rate ratio 0.46, P<.001, 95% CI 0.31-0.67). Conclusions Health warnings are rarely used by influencers tagged by LCC brands' Instagram accounts. Very few influencer posts met the US Food and Drug Administration's health warning requirement of size and placement for tobacco advertising. The presence of a health warning was associated with lower social media engagement. Our study provides support for the implementation of comparable health warning requirements to social media tobacco promotions. Using an innovative computer vision approach to detect health warning labels in influencer promotions on social media is a novel strategy for monitoring health warning compliance in social media tobacco promotions.
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Affiliation(s)
- Jiaxi Wu
- College of Communication Boston University Boston, MA United States
| | - Juan Manuel Origgi
- Department of Computer Science Boston University Boston, MA United States
| | - Lynsie R Ranker
- Department of Community Health Sciences School of Public Health Boston University Boston, MA United States
| | - Aruni Bhatnagar
- Department of Medicine University of Louisville Louisville, KY United States
- American Heart Association Tobacco Regulation and Addiction Center Dallas, TX United States
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center Dallas, TX United States
- Department of Medicine School of Medicine, Vanderbilt University Nashville, TN United States
| | - Ziming Xuan
- Department of Community Health Sciences School of Public Health Boston University Boston, MA United States
| | - Derry Wijaya
- Department of Computer Science Boston University Boston, MA United States
| | - Traci Hong
- College of Communication Boston University Boston, MA United States
| | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute Boston University Chobanian & Avedisian School of Medicine Boston, MA United States
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Lee J, Suttiratana SC, Sen I, Kong G. E-Cigarette Marketing on Social Media: A Scoping Review. CURRENT ADDICTION REPORTS 2023. [DOI: 10.1007/s40429-022-00463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Guillory J, Curry L, Farrelly M, Henes A, Homsi G, Saunders M, MacMonegle A, Fiacco L, Alexander T, Delahanty J, Mekos D, Hoffman L, Ganz O. Reach, Receptivity, And Beliefs Associated With the Fresh Empire Campaign to Prevent and Reduce Cigarette Use Among Youth in the United States. Am J Health Promot 2022; 36:789-800. [PMID: 35081751 PMCID: PMC9258634 DOI: 10.1177/08901171211069991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the association between exposure to FDA's Fresh Empire tobacco public education campaign and tobacco-related beliefs. DESIGN Repeated cross-sectional data collection design with embedded longitudinal cohort over six data collection waves. SETTING 30 US evaluation markets. SAMPLE Hip Hop peer crowd-identified US youth aged 12-18 (N = 5,378). MEASURES Self-reported brand and video ad awareness (saw any ad at least sometimes) and perceived effectiveness (1-5 scale) to describe campaign awareness and receptivity. Exogenous exposure was measured using population-adjusted broadcast and digital video impressions. Tobacco-related beliefs included beliefs about smoking risks, attitudes towards tobacco-free people and lifestyles, and normative beliefs about smoking. ANALYSIS Descriptive analyses of awareness, receptivity, and agreement with tobacco-related beliefs. Logistic regression models to determine the relationship between broadcast and digital video impressions and beliefs. INTERVENTION Fresh Empire campaign. RESULTS The campaign generated a high level of reach (71% brand and 66% video ad awareness at final wave) and messages were well-received (across waves 3.5-4.1 mean perceived effectiveness scores). Higher broadcast television exposure was associated with increased agreement with five beliefs related to addiction/control, being a bad influence on family/friends, and cosmetic effects of smoking (breath and attractiveness) (ORs = 1.16-1.27, (Ps < .05)). CONCLUSION Fresh Empire successfully reached and resonated with Hip Hop-identified youth. The campaign was associated with a limited number of targeted beliefs.
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Affiliation(s)
| | | | | | - Amy Henes
- RTI International, Research Triangle Park, NC, USA
| | - Ghada Homsi
- RTI International, Research Triangle Park, NC, USA
| | | | | | - Leah Fiacco
- RTI International, Research Triangle Park, NC, USA
| | - Tesfa Alexander
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Janine Delahanty
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | - Debra Mekos
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MA, USA
| | | | - Ollie Ganz
- Rutgers University, New Brunswick, NJ, USA
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Pourkarim M, Nayebzadeh S, Alavian SM, Hataminasab SH. Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis. Pathogens 2022; 11:626. [PMID: 35745480 PMCID: PMC9228079 DOI: 10.3390/pathogens11060626] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022] Open
Abstract
New technologies are supported by the global implementation of the internet. These improvements have deeply affected various disciplines of sciences and consequently changed services such as daily business, particularly health sectors. Innovative digital marketing strategies utilize the channels of social media and retrieved user data to analyze and improve relevant services. These multidisciplinary innovations can assist specialists, physicians and researchers in diagnostic, prophylaxis and treatment issues in the health sector. Accordingly, compared to recent decades, health decision makers are more accurate and trustful in defining new strategies. Interestingly, using social media and mobile health apps in current pandemics of SARS-CoV-2 could be an important instance of the key role of these platforms at the local and global level of health policies. These digital technologies provide platforms to connect public health sectors and health politicians for communicating and spreading relevant information. Adding influencers and campaigns to this toolbox strengthens the implementation of public health programs. In 2016, the WHO adopted a global program to eliminate viral hepatitis by 2030. Recent constructive measures that have been used in the battle against COVID-19 could be adopted for the elimination of viral hepatitis program. The presented evidence in our narrative review demonstrates that the application of digital marketing tools to create campaigns on social media, armed with professional influencers, can efficiently consolidate this program. The application of different strategies in using these popular tools will raise the public awareness about viral hepatitis. Subsequently, the availability of an effective vaccine for HBV and antiviral medication for HCV can motivate the audience to take steps towards prophylaxis and screening methods against these infectious illnesses. The encouragement of health policy makers to apply digital communication technologies and comprehensive roadmaps to implement this global program will certainly decrease the burden of viral hepatitis worldwide.
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Affiliation(s)
- Mohammadreza Pourkarim
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
| | - Shahnaz Nayebzadeh
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
| | | | - Seyyed Hassan Hataminasab
- Department of Management, Yazd Branch, Islamic Azad University, Yazd P.O. Box 89195/155, Iran; (M.P.); (S.H.H.)
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