The perceived influence of cigarette advertisements and smoking susceptibility among seventh graders

A perceptual bias, the third person effect, has been observed where individuals believe themselves to differ from others regarding the perceived influence of media messages. Given the frequency with which youth encounter prosmoking messages and the reported negative effects of these messages, it is of value to study whether youth perceive cigarette advertisements to influence themselves and their friends and peers. This study examined the associations between exposure to social and information prosmoking environments, the perceived influence of cigarette advertisements on self, best friends, and other youth, and smoking susceptibility. A sample of 571 seventh graders completed surveys on tobacco advertisements and promotions. Using Student's-t, chi-square, ANOVA tests and proportional odds models, we found significant associations between perceived influence of cigarette advertisements and exposure to social and information prosmoking environments as well as smoking susceptibility. These data suggest that youth be taught that everyone is vulnerable to the tobacco industry's strategies and be given skills to resist prosmoking advertising.     

Laws prohibiting the sale of tobacco to minors: impact and adverse consequences

This paper discusses the consequences of laws that prohibit the sale of tobacco to minors. When enforced, such laws may decrease tobacco sales to minors, but local authorities are often reluctant to enforce these laws. However, the prohibition of tobacco sales to minors is often followed by an increase in the use of tobacco obtained from social sources, mainly family and friends. Importantly, these laws do not decrease smoking prevalence among minors. Several local laws prohibit youths from purchasing, using, and possessing tobacco. However, these laws shift responsibility from retailers to youth, criminalizing young smokers. Those who advocate this type of approach have not documented the adverse consequences of laws that prohibit minors from purchasing, using, or possessing tobacco. In conclusion, youth access laws are ineffective and are not based on sound science.     

A study of young adults who provide tobacco products to minors

Teens acquire tobacco from social sources. This study examined factors related to young adults providing tobacco products to minors. Variables such as demographics, rate and method of provision, attitudes toward provision, and youth access restriction laws were measured. A sample of 250 college students completed the survey. About 33.2% of those young adults were asked to provide tobacco to minors, and 30.8% of these students provided it. Students in health-related majors were as likely to be approached and to provide tobacco as were nonhealth majors. Males were more likely to be approached and to provide tobacco to minors than were females. Convenience stores and gas stations were the most popular locations. Young adults favored laws that restrict minors from purchasing tobacco, and their intention to give tobacco in the future was the best predictor of providing tobacco to minors.     

Evaluating the effects of enforcements and fines on youth smoking

Restricting access to retail sources of tobacco and fining minors for possession of tobacco products were evaluated as possible strategies to reduce the rising rates of teenage smoking. Four towns were assigned to enforce both tobacco minimum-age-of sales laws and tobacco possession laws (P). The remaining four towns were assigned to enforce only tobacco minimum-age-of sales laws (NP). Tobacco use among sixth-, seventh- and eighth-grade students was assessed. White youth who lived in communities with strict enforcement of tobacco sales and possession laws had significantly fewer increases in tobacco use than those living in communities with only moderate enforcement of tobacco sales laws. Public health interventions that involve police fining minors along with very high merchant compliance rates might decrease rates of tobacco use of white youth during a developmental time when they are susceptible to experimentation and use of tobacco products.     

A Content Analysis of Smoking Fetish Videos on YouTube: Regulatory Implications for Tobacco Control

This study examined the prevalence, accessibility, and characteristics of eroticized smoking portrayal, also referred to as smoking fetish, on YouTube. The analysis of 200 smoking fetish videos revealed that the smoking fetish videos are prevalent and accessible to adolescents on the website. They featured explicit smoking behavior by sexy, young, and healthy females, with the content corresponding to PG-13 and R movie ratings. We discuss a potential impact of the prosmoking image on youth according to social cognitive theory, and implications for tobacco control.     

Exposure to Pro-tobacco Messages and Smoking Status Among Mexican Origin Youth

Though several studies have found a positive relationship between exposure to tobacco advertising and/or promotional marketing and smoking status among youth, few have examined these relationships specifically for youth of Mexican origin. The current analysis examines the relationship between perceived exposure to pro-tobacco messages and progression through the smoking continuum from trying to repeated use in a cohort of Mexican origin youth ages 14–19. Data were collected via personal in-home interviews at two time points—in 2008–2009 and 2010–2011 (N = 942). Smoking status, exposure to pro-tobacco messages from five major media sources, demographic variables and established risk factors for adolescent smoking were measured at both waves. Data were analyzed using Pearson’s Chi square tests, ANOVA, and multinomial logistic regression. Adolescent perception of the number of pro-tobacco messages seen in 2008–2009 was unrelated to smoking less than one cigarette assessed in 2010–2011. However, having seen a higher number of pro-tobacco messages was significantly associated with being more likely to have smoked more than one cigarette (OR = 1.21; 95 % CI 1.03–1.42) controlling for demographic factors and known psychosocial risk factors of smoking behavior. Results suggest that the more pro-tobacco messages Mexican origin youth are able to recall, the further their progression through the smoking trajectory a year later. These youth are clearly susceptible to pro-tobacco messaging, and our results underscore the need to restrict all forms of messaging that promote tobacco use.     

Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies

BackgroundReducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.MethodsWe reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.FindingsThirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths’ home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.ConclusionsThe existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths’ home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.     

A randomized trial evaluating tobacco possession-use-purchase laws in the USA

Tobacco Purchase-Use-Possession laws (PUP) are being implemented throughout the US, but it is still unclear whether they are effective in reducing smoking prevalence among the youth targeted by these public health policies. In the present study, 24 towns in Northern Illinois were randomly assigned to one of two conditions. One condition involved reducing commercial sources of youth access to tobacco (Control), whereas the second involved both reducing commercial sources of youth access to tobacco as well as fining minors for possessing or using tobacco (Experimental). Students in 24 towns in Northern Illinois in the United States completed a 74 item self-report survey in 2002, 2003, 2004 and 2005. At the start of the study, students were in grades 7-10. During each time period, students were classified as current smokers or nonsmokers (i.e., completely abstinent for the 30 consecutive days prior to assessment). The analyses included 25,404 different students and 50,725 assessments over the four time periods. A hierarchical linear modeling analytical approach was selected due to the multilevel data (i.e., town-level variables and individual-level variables), and nested design of sampling of youth within towns. Findings indicated that the rates of current smoking were not significantly different between the two conditions at baseline, but over time, rates increased significantly less quickly for adolescents in Experimental than those in Control towns. The implications of these findings are discussed.     

Youth Tobacco Access: Adult Attitudes, Awareness, and Perceived Self-Efficacy in Two Arizona Counties

While a variety of steps have been taken to restrict youth access to tobacco, little has been done to explore adult attitudes, beliefs, and behaviors concerning this issue. To ameliorate this knowledge gap, 828 adults from Arizona's Maricopa and Pima counties were surveyed. Overall, adults perceived that the prevention of youth tobacco access was: an important issue, an issue they are willing to spend money on, and a responsibility shared by all adults. Further, when asked who was most responsible for keeping tobacco away from minors, 65.4% of adults surveyed perceived parents of the youth purchasing tobacco as most responsible. Responding to items soliciting opinions regarding appropriate penalties for minors purchasing tobacco and for those selling tobacco to minors, respondents recommended stiffer punishment for the sellers of tobacco. Almost 10% recommended a night in jail for vendors caught selling tobacco products to minors. Interestingly, respondents exhibited low perceived self-efficacy regarding the prevention of youth tobacco access. The majority of adults agreed that it is easy for minors to gain access to tobacco and that there is nothing they or the community can do to stop minors who wish to purchase tobacco. Future research efforts should investigate how adult self-efficacy can be increased and the impact that such a change would have on efforts to prevent youth tobacco access.     

Cigars, youth, and the Internet link

OBJECTIVES: This study examined the accessibility and appeal to youth of cigar marketing sites on the Internet. METHODS: Sites marketing cigars (n = 141) were examined for age restrictions, prices, health warnings, and other elements. RESULTS: Although it is illegal for minors to purchase tobacco, only 36 sites (25.5%) prohibited purchases by minors. Sites offered low prices, and 32% accepted money orders, cashier's checks, or cash-on-delivery (COD) orders. Almost 30% of the sites included elements with potential youth appeal; only 3.5% displayed health warnings. CONCLUSIONS: The unregulated promotion of cigars on the Internet has the potential to attract youth, and there are few barriers to Internet tobacco purchases by minors.     

Usual sources of cigarettes for middle and high school students--Texas, 1998-1999

Persons often begin smoking when they are minors (aged <18 years), and easy access to cigarettes might contribute to this behavior. Laws and regulations were in place in Texas during 1998-1999 to reduce minors' access to cigarettes by 1) prohibiting the sale and distribution of tobacco products to minors; 2) imposing fines against retailers caught selling cigarettes to minors; 3) prohibiting minors from purchasing, possessing, or using tobacco products; 4) limiting vending machines to adult-only locations; and 5) requiring tobacco retailers to ask for proof of identification from anyone attempting to purchase tobacco who appeared to be aged <27 years. To measure progress in reducing access to cigarettes among middle and high school students in Texas, CDC analyzed self-reported data from the 1998 and 1999 Texas Youth Tobacco Survey (TYTS). This report summarizes the results of that survey, which indicate that during 1998-1999, reported access to cigarettes from stores and vending machines (commercial sources) decreased among middle school students from 13.2% to 5.3% and from 7.6% to 1.7%, respectively, but access from noncommercial and other sources (e.g., stealing cigarettes and "getting them some other way") increased from 8.3% to 12.3% and from 16.6% to 23.3%, respectively. Among high school students, most sources did not change. Educating retailers and actively enforcing laws governing youth access to tobacco as part of a comprehensive tobacco-control approach are required to reduce youth access to cigarettes.     

Empowering youth for tobacco control

PURPOSE: To investigate common youth group activities and how they relate to young people's attitudes of empowerment around tobacco control. DESIGN: A mailed survey was administered to 940 Minnesota youth involved in locally organized tobacco prevention groups. By multivariate linear regression, participation in eight tobacco-related activities and selected personal characteristics were examined in relation to youths'perceived influence on youth smoking. RESULTS: Two activities--developing materials with antismoking messages and taking action to change school smoking policies--were associated with significantly higher perceived influence scores for the youth involved (p < .05). Youth in groups who had worked to raise awareness of how the tobacco industry targets teens also had significantly higher influence scores (p < .001). Associated personal factors included high involvement in extracurricular activities (p < .001), having never experimented with smoking (p < .01), leadership experience (p < .001), and being white (p < .01). DISCUSSION: Some youth group activities and strategies may be particularly effective at instilling attitudes of empowerment for tobacco control among youth.     

Tobacco: knowledge,reasoning and opinion of high school students in Doubs. Reflections on prevention

The prevalence of smoking has increased among young people aged 14 to 18 between 1993 and 1999, and most notably among girls within the same period. These observations illustrate the necessity for significant changes in mass media campaigns and education programmes related to the prevention of smoking among youth. The objective of this survey, initiated by the city of Besan?on and the French National Mutual Insurance of Doubs, was to describe and analyse the knowledge and rationale of high school students on tobacco and their opinions in terms of prevention. Twelve public and private high schools in Besan?on and Morteau (Doubs-France) participated in the survey; the group also represented a mix of general and professional schools. The questionnaire was filled out by 970 students selected at random. 96% of the students indicated cancer as being the main illness linked to tobacco and 94% stated that second-hand smoke constitutes a health risk. 61% admitted to seeking out the psychoactive effects of smoking. The students responses confirm that the types of messages relayed in a smoking prevention campaign which have an impact on them are: evoking fear of death (74%) and the use of humor (16%). One-third of high school students find that it is unacceptable to forbid smoking on school premises. The knowledge of the dangers related to smoking is not sufficient to keep young people from smoking and confirms that an educational approach based solely on knowledge and facts will not be sufficient to decrease their tobacco consumption. It is important to take into account the image that young people have of tobacco as a means to combat stress in future prevention strategies and campaigns.     

Anti-tobacco messages from different sources make a difference with secondary school students.

Mass media campaigns are often effective in reducing tobacco use, but research has typically focused on these campaigns without considering other sources of anti-tobacco information. The present study examined whether the number of sources of anti-tobacco information (family, sports, and other community events, advertisements, and the Internet), made a difference in use and attitudes of high school students. A representative sample of 1,151 students in grades 6 to 12 in one southeastern state were interviewed at school on cell phones provided by researchers. They reported on average 2.49 of the 4 sources of anti-tobacco information. Students who heard anti-tobacco messages from a variety of sources of information were less likely to use tobacco than students who heard anti-tobacco messages from few sources. Never-users, nonsmokers, and relatively younger youth reported more sources than ever-users, smokers, and relatively older youth. Surprisingly, those who reported more sources labeled smokers as attractive more than those who reported fewer sources. Although having a variety of sources of anti-tobacco messages is associated with less tobacco use, an implication of present results is that anti-tobacco information needs to convey the point that using tobacco is ugly.     

Fatal deception: the tobacco industry's "new" world standards for tobacco marketing]

Being increasingly threatened by the worldwide antismoking struggle, the major tobacco companies are eager to improve their public image. This leads the companies to adopt inconsequential "measures" such as the tobacco industry's "new" standards for tobacco marketing that were "voluntarily" issued in September 2001 by the British American Tobacco company. These measures are clearly attempts to reduce the disapproval generated by the companies' promotion and advertising campaigns, which indirectly target young people. With these standards the tobacco companies supposedly commit themselves, among other things, to not using advertising directed at youth and to not selling or distributing tobacco products in places frequented by young people. This document explains why these measures are completely ineffective, are not anything new, and are a subtle effort to feign a conscientious, responsible attitude, which is far from genuine. As long as there are marketing activities directed at adults, young people will be exposed to the influence of those activities. Many countries have completely prohibited the marketing of tobacco products, given that the "new" marketing standards do not represent progress in any way whatsoever.     

Consumerism: its impact on the health of adolescents

Marketplace practices are integral to the larger economic and social context of adolescent health risk behaviors. To corporations and marketers, adolescents represent a gold mine of current and future profits. Adolescent incomes increased by almost a third in the 1990s. The annual spending of the U.S. adolescent population is estimated now to have reached 155 billion US dollars. The sheer size of the adolescent population and its spending power are of keen interest to corporations and marketers. This chapter presents a brief history of youth-targeted marketing and examines the major avenues in the media and inside schools that marketers and corporations use today to reach adolescents with their messages and products. It outlines the impact of consumerism and marketing on adolescent health using five case examples: tobacco, alcohol, cosmetic surgery, laxatives, and diet pills. It then concludes with a discussion of resistance efforts, led by health advocates, policy makers, parents, and youth themselves to restrict sales of harmful products to youth and curtail advertisers' access to adolescents in schools. A critical role for adolescent health researchers and advocates is to contribute a public health perspective into ongoing debates over regulating business practices that negatively affect the health of young people.     

Social influences, and attitudes and beliefs associated with smoking among border Latino youth

BACKGROUND: Adolescent smoking rates have declined among all ethnic groups since the late 1990s. However, despite the recent declines and intervention efforts, today smoking remains a serious problem among youth, with a quarter of adolescents being current smokers by the time they complete 12th grade. This problem is particularly prevalent among Latino youth, who have among the highest rates of lifetime and past-30-day use. The purpose of this study was to examine the association between psychosocial factors and the smoking behavior of Latino youth living along the Mexico-US border. METHODS: A convenient sample of 2471 middle and high school Latino students was surveyed in fall 2000. Logistic regression analysis was used to examine the association between study risk factors and youth smoking behavior. RESULTS: The strongest predictor of lifetime and past-30-day smoking was peer influence; however, the strength of the association was greater with recent use. There were also differences in the influence of family and attitudes and beliefs between the 2 groups. CONCLUSIONS: These differences need to be taken into consideration to guide development of tailored prevention and control interventions aimed at this specific group. These efforts should address social influences to smoke, particularly those from peers; promote changes in attitudes and beliefs toward smoking; increase understanding of the addictive nature of nicotine; and provide development of skills young people need to resist social and environmental pressures to smoke. Strict control and enforcement measures are needed to completely eliminate the sale of cigarettes to minors.     

Antitobacco Media Awareness of Rural Youth Compared to Suburban and Urban Youth in Indiana

PURPOSE: This study examined the awareness and impact of antitobacco media messages among rural, suburban, and urban youth. METHOD: Self-administered questionnaires were received from 1,622, 1,059, and 1,177 middle school (sixth, seventh, and eighth grade) students in rural, suburban, and urban locations, respectively. Logistic regression compared media awareness and impact among the groups, controlling for grade, gender, race, and smoking behavior. RESULTS: Compared to rural youth, suburban youth were more likely to recall media messages about the dangerous health effects of tobacco use (odds ratio [OR] = 1.94) and have their personal choice to use tobacco affected by the messages (OR = 1.85). Suburban and urban youth more often recalled antitobacco messages (OR = 2.00 and 2.15), reported that the messages made them think about the dangers of tobacco use (OR = 2.02 and 1.47), believed that these ads prevent youth from initiating tobacco use (OR = 3.21 and 1.46) and stop youth from using tobacco (OR = 2.25 and 1.47), and recalled seeing specific campaign television ads (OR = 3.72 and 3.57). Urban youth were more likely to recall specific campaign messages on the radio (OR = 1.58). Neither suburban nor urban youth differed from the rural youth on whether the campaign-specific radio and television ads made them think about not using tobacco. CONCLUSIONS: The results support the need for targeting antitobacco media announcements to youth, based on their residence.