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.
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REFERENCES
- 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, GA2016https://e-cigarettes.surgeongeneral.gov/documents/2016_sgr_full_report_non-508.pdf(Published)Date accessed: August 7, 2017
- E-cigarette use among youth in the United States, 2019.JAMA. 2019; 322: 2095-2103https://doi.org/10.1001/jama.2019.18387
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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.
- 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
- 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
- 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
- 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
- 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
Article Info
Publication History
Published online: February 11, 2021
Identification
Copyright
© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
