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Hendlin YH, Small S, Ling PM. 'No-Barriers' tobacco product? Selling smokeless tobacco to women, people of colour and the LGBTQ+ community in the USA. Tob Control 2023; 32:330-337. [PMID: 34599083 PMCID: PMC10171187 DOI: 10.1136/tobaccocontrol-2020-056178] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/28/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In both Sweden and the USA, smokeless tobacco (ST) is legal and used predominantly by men. Starting in the 1970s, US tobacco companies attempted to expand the ST market to women, African Americans, Hispanic Americans and lesbian, gay, bisexual, transgender, queer and other sexual orientation (LGBTQ+) people. DESIGN We analysed industry documents from the Truth Tobacco Industry Documents Library triangulating findings with recent ST advertising and publicly available literature. FINDINGS We found tobacco companies used design innovations such as pouched moist snuff, snus and dissolvable products to expand the market. In addition, diverse advertising campaigns targeted women, people of colour (Hispanic, African American) and LGBTQ+ communities with identity-targeted messages emphasising novelty, convenience, cleanliness and use in smoke-free environments. However, stereotypes of ST users as rural white males endured, perpetuated by continued marketing aimed at this customer base, which created cognitive dissonance and stymied marketer's hopes that pouch products would 'democratize' ST. CONCLUSION These failed campaigns suggest novel products such as nicotine pouch products may provide a 'clean slate' to similarly target women and other low-ST-using groups. Based on this history, the risk of new tobacco and nicotine products to increase health disparities should be closely monitored.
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Affiliation(s)
- Yogi Hale Hendlin
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Dynamics of Inclusive Prosperity Initiative, Erasmus University Rotterdam, Rotterdam, South Holland, Netherlands
| | - Sarah Small
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
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2
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Czaplicki L, Patel M, Rahman B, Yoon S, Schillo B, Rose SW. Oral nicotine marketing claims in direct-mail advertising. Tob Control 2022; 31:663-666. [PMID: 33958422 PMCID: PMC9411885 DOI: 10.1136/tobaccocontrol-2020-056446] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Little is known regarding how oral nicotine products (eg, nicotine pouches, lozenges) are marketed to consumers, including whether potential implicit reduced harm claims are used. In the current study, we explored the marketing claims present in a sample of direct-mail oral nicotine advertisements sent to US consumers (March 2018-August 2020). METHODS Direct-mail ads (n=50) were acquired from Mintel and dual-coded for the following claims: alternative to other tobacco products, ability to use anywhere, spit-free, smoke-free and product does not contain tobacco leaf. We merged the coded data with Mintel's volume estimate (number of mail pieces sent to consumers) and calculated the proportion of oral nicotine advertisements containing claims by category. RESULTS Of the 38 million pieces of oral nicotine direct-mail sent to US consumers, most featured claims that the product could be used anywhere (84%, 31.8 million pieces); was an alternative to other tobacco products (69%, 26.1 million pieces); and did not contain tobacco leaf (eg, 'tobacco leaf-free', 'simple' approach of extracting nicotine from tobacco; 55%, 20.7 million pieces). A slightly smaller proportion contained claims that oral nicotine was 'spit-free' (52%, 19.8 million pieces) or 'smoke-free' (31%, 11.7 million pieces). CONCLUSION Our results provide an early indication of marketing claims used to promote oral nicotine. The strategies documented, particularly the use of language to highlight oral nicotine is tobacco-free, may covey these products as lower-risk to consumers despite the lack of evidence or proper federal authorisation that oral nicotine products are a modified-risk tobacco product. Future research is needed to examine consumer perceptions of such claims.
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Affiliation(s)
- Lauren Czaplicki
- Health, Behavior & Society, Johns Hopkins University, Baltimore, MD, USA
| | - Minal Patel
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Basmah Rahman
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Stephanie Yoon
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Shyanika W Rose
- Behavioral Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
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3
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Blank MD, Ozga JE, Romm KF, Douglas A, Alexander L, Doogan NJ, Wilson M, Dino G. Geographic isolation predicts tobacco product use among youth: A latent class analysis. J Rural Health 2022; 38:373-381. [PMID: 33978979 PMCID: PMC8586053 DOI: 10.1111/jrh.12583] [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] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the current study was to evaluate associations between geographic rurality and tobacco use patterns among adolescents. METHODS High school students (N = 566) from north-central Appalachia reported on their lifetime and/or current use of cigarettes, electronic cigarettes (ECIGs), cigars, and smokeless tobacco. Geographic rurality was measured via the Isolation scale, whereby residential ZIP Codes determined the degree to which respondents have access to health-related resources. Latent class analysis (LCA) was used to identify discrete classes of adolescent tobacco users based on their use of tobacco products. Then, associations between participants' geographic rurality and class membership were evaluated using a series of multinomial logistic regressions. FINDINGS LCA classified participants as Nonusers, Current ECIG Users, Cigarette/ECIG Experimenters, and Polytobacco Users. Individuals with higher Isolation scores were more likely to be Polytobacco Users and Cigarette/ECIG Experimenters than Nonusers, and were more likely to be Polytobacco Users than Current ECIG Users. CONCLUSIONS The continuous Isolation scale used in the present study predicted polytobacco use patterns among adolescents in a manner that is consistent with, while simultaneously expanding upon, prior work. Tobacco control practices and policies should be viewed through a lens that considers the unique needs of geographically isolated areas.
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Affiliation(s)
- Melissa D. Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Jenny E. Ozga
- Department of Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, West Virginia, USA
| | - Katelyn F. Romm
- Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health, Washington, DC, USA
| | - Ashley Douglas
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Linda Alexander
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Nathan J. Doogan
- Government Resources Center, Ohio State University, Columbus, Ohio, USA
| | - Michael Wilson
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
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4
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Ozga JE, Romm KF, Turiano NA, Douglas A, Dino G, Alexander L, Blank MD. Cumulative disadvantage as a framework for understanding rural tobacco use disparities. Exp Clin Psychopharmacol 2021; 29:429-439. [PMID: 34014742 PMCID: PMC9752977 DOI: 10.1037/pha0000476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Traditional tobacco product (cigarettes and smokeless tobacco) and polytobacco use rates are significantly higher among rural adolescents and adults compared to their nonrural counterparts. Such disparities are due to several factors that promote tobacco use initiation and continuation, including individual-level psychopharmacological factors and structural-level factors such as fewer tobacco control efforts (e.g., fewer smoke-free policies and lower tobacco excise taxes), targeted tobacco marketing, less access to health-relevant resources, and more positive cultural norms surrounding tobacco use in rural communities. In this review, we use cumulative disadvantage theory as a framework for understanding how psychopharmacological and structural-level factors serve as drivers of tobacco use in rural areas. We start by describing how structural-level differences between rural-nonrural communities impact psychopharmacological influences and, when available, how these factors influence tobacco use. We conclude by discussing the interplay between factors, providing suggestions for ways to assess our application of cumulative disadvantage theory empirically and making recommendations for research and policy implementation in rural areas. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jenny E. Ozga
- Department of Behavioral Medicine and Psychiatry, West Virginia University
| | - Katelyn F. Romm
- Milken Institute School of Public Health, George Washington University
| | - Nicholas A. Turiano
- Department of Psychology, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
| | | | - Geri Dino
- Department of Social and Behavioral Sciences, Clinical and Translational Sciences Institute, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
| | - Linda Alexander
- Department of Social and Behavioral Sciences, Clinical and Translational Sciences Institute, West Virginia University
| | - Melissa D. Blank
- Department of Psychology, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
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Rhee JU, Abugazia JY, Cruz YMED, Timberlake DS. Use of internal documents to investigate a tobacco company's strategies to market snus in the United States. Tob Prev Cessat 2021; 7:11. [PMID: 33598590 PMCID: PMC7879987 DOI: 10.18332/tpc/131809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Prior studies indicate that cigarette manufacturers have been interested for decades in developing a smokeless tobacco (SLT) product for smokers and non-users of SLT. The current study aims to assess a tobacco company’s use of novel marketing strategies and intent to promote snus in the US as either a replacement or situational substitute for the cigarette. METHODS A Boolean search string was used to search R. J. Reynolds’ (RJR) Records in UCSF’s Truth Tobacco Industry Documents Library. A total of 358 documents, from 2005–2009, met our initial search criteria and were selected for their relevance to the marketing of Camel Snus. A content analysis was subsequently conducted using the Framework Method to identify themes and strategies for promoting Camel Snus. RESULTS Four major themes about Camel Snus emerged from the documents: 1) promotion by third parties including retailers, snus ambassadors and secret shoppers, 2) expansion of the target population of SLT users to include female smokers and dual users of cigarettes and SLT, 3) emphasis on the difference between Camel Snus and other SLT, and 4) a shift from promoting the practical uses of Camel Snus to using emotional messages conveying freedom. CONCLUSIONS The findings align with other studies suggesting that RJR intended to market snus to non-users of SLT. The findings also reveal that RJR employed creative marketing strategies (e.g. snus ambassadors) and may have intended to promote snus as a situational substitute for the cigarette, as evidenced by the company’s recruitment of dual tobacco users.
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Affiliation(s)
- Joshua U Rhee
- Department of Population Health and Disease Prevention, College of Health Sciences, University of California, Irvine, United States
| | - Jamilla Y Abugazia
- Department of Population Health and Disease Prevention, College of Health Sciences, University of California, Irvine, United States
| | - Yan Marco E Dela Cruz
- Department of Population Health and Disease Prevention, College of Health Sciences, University of California, Irvine, United States
| | - David S Timberlake
- Department of Population Health and Disease Prevention, College of Health Sciences, University of California, Irvine, United States
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Czaplicki L, Rahman B, Simpson R, Rose SW, Liu M, Perks SN, Moran MB, Schillo BA. Going Smokeless: Promotional Features and Reach of US Smokeless Tobacco Direct-Mail Advertising (July 2017–August 2018). Nicotine Tob Res 2020; 23:1349-1357. [DOI: 10.1093/ntr/ntaa255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Although cigarette use in the United States has declined over time, smokeless tobacco (SLT) use has remained steady. Direct-mail advertising and coupon redemption have been linked to increased tobacco use, and efforts to promote SLT through direct-mail advertising may contribute to sustained SLT use. We examined reach of SLT direct-mail advertisements by recipient demographics and promotional features, including coupons.
Methods
Direct-mail data (n = 418) were acquired from Comperemedia (Mintel) and coded for product type (traditional [eg, chewing tobacco], pouched [eg, moist snuff, snus], or both [traditional SLT and any pouched SLT products]); promotions (eg, coupons); flavors; and themes (eg, masculinity). Using Mintel’s volume estimates for number of pieces sent, we calculated the proportion of mail volume sent by recipient demographics (age, income, region) and advertising features across product type.
Results
Between July 2017 and August 2018, tobacco companies sent an estimated 249 million pieces of SLT direct-mail to US households; approximately half (49.6%) featured pouched SLT products. Across product types, over 75% of mail volume was sent to 31- to 60-year-old adults and 30–40% was sent to low-income households. The majority (>70%) of pouched SLT product mail contained coupons and flavor promotions. Outdoor and blue-collar-lifestyle themes were prominent in advertisements for all product types, along with less common adventure- and fun-related appeals.
Conclusions
Coupons, flavors, and a combination of blue-collar and fun/adventure message themes were used to promote traditional and pouched SLT products through direct-mail, particularly to low-income households. Results support limits on direct-mail coupon distribution and continued surveillance of marketing appeals.
Implications
There is a long history of research into tobacco advertising practices, largely focusing on cigarettes. This study highlights specific direct-mail marketing tactics used by the tobacco industry, including coupons to promote SLT products across the United States. Given the limited success in reducing SLT use and the association between direct-mail promotions and tobacco use, these study results provide support for policies to restrict use of coupons in direct-to-consumer tobacco marketing and indicate the need for continued surveillance of direct-mail advertisements as the SLT market continues to evolve.
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Affiliation(s)
- Lauren Czaplicki
- Truth Initiative Schroeder Institute, Washington, DC
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Basmah Rahman
- Truth Initiative Schroeder Institute, Washington, DC
| | | | - Shyanika W Rose
- Center for Health Equity Transformation and Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY
| | - Michael Liu
- Truth Initiative Schroeder Institute, Washington, DC
| | | | - Meghan B Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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7
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Nguyen N, Holmes LM, Kim M, Ling PM. Using Peer Crowd Affiliation to Address Dual Use of Cigarettes and E-Cigarettes among San Francisco Bay Area Young Adults: A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7643. [PMID: 33092106 PMCID: PMC7588881 DOI: 10.3390/ijerph17207643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022]
Abstract
Given the emerging tobacco landscape, dual use of cigarettes and e-cigarettes has increased among young adults, but little is known about its associated factors. Peer crowds, defined as macro-level connections between individuals with similar core values (e.g., "Hip Hop" describing a group that prefers hip hop music and values strength, honor, and respect), are a promising way to understand tobacco use patterns. We examined associations between peer crowds and tobacco use patterns by using data from a cross sectional survey of 1340 young adults in the San Francisco Bay Area in 2014. Outcomes were the past 30-day use of: neither cigarettes nor e-cigarettes; cigarettes but not e-cigarettes; e-cigarettes but not cigarettes; and both cigarettes and e-cigarettes. Peer crowds included Hipster, Hip Hop, Country, Partier, Homebody, and Young Professional. Multinomial regression analysis indicated that peer crowds were significantly associated with different tobacco use patterns. Compared to Young Professionals, Hip Hop and Hipster crowds were more likely to dual use; Hipsters were more likely to use e-cigarettes only, and Country participants were more likely to smoke cigarettes only. These findings suggest that tobacco control campaigns and cessation interventions should be tailored to different young adult peer crowds and address poly-tobacco use.
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
| | - Louisa M. Holmes
- Departments of Geography & Demography, and the Social Science Research Institute, Penn State University, University Park, PA 16802, USA;
| | - Minji Kim
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; (M.K.); (P.M.L.)
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McKelvey K, Halpern-Felsher B. From tobacco-endgame strategizing to Red Queen's race: The case of non-combustible tobacco products. Addict Behav 2019; 91:1-4. [PMID: 30642577 PMCID: PMC6541479 DOI: 10.1016/j.addbeh.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
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