Advertisement

Associations Between Exposure to The Real Cost Campaign, Pro-Tobacco Advertisements, and Tobacco Use Among Youth in the U.S.

Published:February 11, 2021DOI:https://doi.org/10.1016/j.amepre.2020.11.006

      Introduction

      E-cigarette use is rising among youth. Advertising and anti-tobacco campaigns may be associated with the use of E-cigarettes and other tobacco products. This study examines the associations between tobacco use and exposure to The Real Cost's first campaign focusing on E-cigarettes.

      Methods

      Using the 2019 National Youth Tobacco Survey, a national survey of middle and high school students, the associations between exposure to The Real Cost anti-tobacco campaign, exposure to pro-tobacco advertising, and the use of tobacco products in the past 30 days (exclusive E-cigarettes, exclusive other tobacco use, and dual/poly use of E-cigarettes and other tobacco products) was examined. Other tobacco included anything but E-cigarettes.

      Results

      Participants (N=13,165) were aged 11–17 years. Exposure to The Real Cost campaign was associated with decreased odds of using other tobacco products (AOR=0.60, 95% CI=0.43, 0.84) and dual/poly use (AOR=0.77, 95% CI=0.63, 0.94) but not E-cigarette use. Greater E-cigarette advertising exposure was associated with increased odds of being an exclusive E-cigarette user (AOR=1.90, 95% CI=1.52, 2.30) or dual/poly user (AOR=1.69, 95% CI=1.31, 2.18). Greater exposure to other tobacco advertising was associated with increased odds of being a dual/poly user (AOR=1.32, 95% CI=1.01, 1.71) but lower odds of exclusive E-cigarette use (AOR=0.76, 95% CI=0.60, 0.97).

      Conclusions

      Exposure to The Real Cost campaign was associated with decreased odds of using other tobacco products and dual/poly products. Exposure to pro-tobacco advertising was also associated with use. Future studies should assess the long-term effectiveness of anti-tobacco messaging.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • HHS
        E-cigarette use among youth and young adults: a report of the Surgeon General.
        HHS, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA2016 (Published)
        • Cullen KA
        • Gentzke AS
        • Sawdey MD
        • et al.
        E-cigarette use among youth in the United States, 2019.
        JAMA. 2019; 322: 2095-2103https://doi.org/10.1001/jama.2019.18387
        • Mantey DS
        • Cooper MR
        • Clendennen SL
        • Pasch KE
        • Perry CL.
        E-cigarette marketing exposure is associated with e-cigarette use among U.S. youth.
        J Adolesc Health. 2016; 58: 686-690https://doi.org/10.1016/j.jadohealth.2016.03.003
        • Padon AA
        • Lochbuehler K
        • Maloney EK
        • Cappella JN.
        A randomized trial of the effect of youth appealing e-cigarette advertising on susceptibility to use e-cigarettes among youth.
        Nicotine Tob Res. 2018; 20: 954-961https://doi.org/10.1093/ntr/ntx155
        • Villanti AC
        • Rath JM
        • Williams VF
        • et al.
        Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in U.S. young adults: a randomized controlled trial.
        Nicotine Tob Res. 2016; 18: 1331-1339https://doi.org/10.1093/ntr/ntv235
        • Zeller M.
        Evolving “The Real Cost” campaign to address the rising epidemic of youth e-cigarette use.
        Am J Prev Med. 2019; 56: S76-S78https://doi.org/10.1016/j.amepre.2018.09.005
        • Farrelly MC
        • Duke JC
        • Nonnemaker J
        • et al.
        Association between The Real Cost media campaign and smoking initiation among youths - United States, 2014-2016.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 47-50https://doi.org/10.15585/mmwr.mm6602a2
        • Duke JC
        • Farrelly MC
        • Alexander TN
        • et al.
        Effect of a National Tobacco Public Education campaign on youth's risk perceptions and beliefs about smoking.
        Am J Health Promot. 2018; 32: 1248-1256https://doi.org/10.1177/0890117117720745
        • Huang LL
        • Lazard AJ
        • Pepper JK
        • Noar SM
        • Ranney LM
        • Goldstein AO.
        Impact of The Real Cost campaign on adolescents’ recall, attitudes, and risk perceptions about tobacco use: a national study.
        Int J Environ Res Public Health. 2017; 14: 42https://doi.org/10.3390/ijerph14010042
        • Grucza RA
        • Agrawal A
        • Krauss MJ
        • Cavazos-Rehg PA
        • Bierut LJ.
        Recent trends in the prevalence of marijuana use and associated disorders in the United States.
        JAMA Psychiatry. 2016; 73: 300-301https://doi.org/10.1001/jamapsychiatry.2015.3111
        • Kranzler EC
        • Gibson LA
        • Hornik RC.
        Recall of “The Real Cost” anti-smoking campaign is specifically associated with endorsement of campaign-targeted beliefs.
        J Health Commun. 2017; 22: 818-828https://doi.org/10.1080/10810730.2017.1364311
      1. Historical NYTS data and documentation. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/surveys/nyts/data/index.html. Updated December 21, 2020. Accessed September 2, 2020.

        • Delahanty J
        • Ganz O
        • Bernat JK
        • et al.
        Awareness of “The Real Cost” campaign among U.S. middle and high school students: National Youth Tobacco Survey, 2017.
        Public Health Rep. 2020; 135: 82-89https://doi.org/10.1177/0033354919889992
        • Duke JC
        • MacMonegle AJ
        • Nonnemaker JM
        • et al.
        Impact of The Real Cost media campaign on youth smoking initiation.
        Am J Prev Med. 2019; 57: 645-651https://doi.org/10.1016/j.amepre.2019.06.011
        • Jamal A
        • Gentzke A
        • Hu SS
        • et al.
        Tobacco use among middle and high school students - United States, 2011-2016 [published correction appears in MMWR Morb Mortal Wkly Rep. 2017;66(28):765].
        MMWR Morb Mortal Wkly Rep. 2017; 66: 597-603https://doi.org/10.15585/mmwr.mm6623a1
        • Niederdeppe J.
        Conceptual, empirical, and practical issues in developing valid measures of public communication campaign exposure.
        Commun Methods Meas. 2014; 8: 138-161https://doi.org/10.1080/19312458.2014.903391
        • Hébert ET
        • Vandewater EA
        • Businelle MS
        • Harrell MB
        • Kelder SH
        • Perry CL.
        Feasibility and reliability of a mobile tool to evaluate exposure to tobacco product marketing and messages using ecological momentary assessment.
        Addict Behav. 2017; 73: 105-110https://doi.org/10.1016/j.addbeh.2017.05.004