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November 21st, 2015:

Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels


In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as “smokers” (11%); (4) nondaily, light smokers who self-identify as “social or occasional smokers” (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily “smokers,” LCC and hookah users (RRR=2.35) and nonusers closed to smoking (RRR=2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function.

Exposure to e-cigarette ads may boost usage among young adults

Exposure to e-cigarette advertisements may enhance curiosity and usage among young adults, according to a study published this week in the journal Nicotine & Tobacco Research.

Researchers at the Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative assessed more than 4,200 young adults (ages 18-34) and the impact of random assignment to exposure to e-cigarette advertisements on perceptions, intentions, and subsequent use. Approximately 6% of young adults who had never before tried an e-cigarette had done so at six month follow-up; ad exposure was associated with a greater likelihood of e-cigarette trial at follow-up (3.6% exposed vs. 1.2% unexposed) in never users of cigarettes and e-cigarettes. Ad exposure was also associated with greater curiosity to try an e-cigarette (18.3% vs. 11.3%) in the full sample.

Promotional expenditures for e-cigarettes across all media channels have rapidly increased since 2010. Since e-cigarettes are not subject to the same regulations as cigarette and smokeless tobacco products, e-cigarette manufacturers have been able to advertise their products via television, radio, and sponsorship of sporting and entertainment events. This increased and far-reaching advertising has occurred concurrently with increased availability of e-cigarettes in venues ranging from tobacco shops to pharmacies.

“Our study is the first randomized controlled study to show that forced exposure to e-cigarette advertising has an impact on longer-term e-cigarette trial in a small number of never users,” said Andrea Villanti, lead author of the study. “These findings highlight the potential impact of unrestricted e-cigarette advertising to enhance curiosity and trial of e-cigarettes in young adults.”