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The Influence of Tobacco Marketing and Counter-advertising on Smoking Initiation among Youth

Principal Investigator: Michael Siegel, M.D., M.P.H.
Publications Type: Journal Article
Author(s): Albers A.B., Biener L.
Article Title: The role of smoking and rebelliousness in the development of depressive symptoms among a cohort of Massachusetts adolescents
Journal: Preventive Medicine
Volume/Issue/Pages: 34, : 625-631
Year: 2002
Abstract:
BACKGROUND: Recent studies have shown that smoking leads to depressive symptoms among adolescents, but the mechanisms underlying the relationship remain unclear. In this study, we focused on one possible mechanism, namely, the effect of rebelliousness. We examined the extent to which rebelliousness accounts for the relation between smoking and depression among adolescents in Massachusetts. METHODS: Data were from a follow-up telephone survey of youth in Massachusetts. A subset of adolescents who were classified as not highly depressed at baseline in 1993 was used for the analyses (n = 522). Logistic regression analyses were used to predict whether cigarette smoking increased the odds of developing high depressive symptoms 4 years later, while controlling for rebelliousness and other factors. RESULTS: Ever smoking a cigarette at baseline had a statistically significant impact on high depressive symptoms at follow-up. Once rebelliousness was considered, the relationship between ever smoking and follow-up depressive symptoms became nonsignificant. CONCLUSIONS: The findings indicate that rebelliousness accounted for the relation between adolescent smoking and the emergence of depressive symptoms. Rebelliousness may provide a modifiable variable to be targeted to interrupt the linkage between adolescent smoking and depression. Copyright 2002 Elsevier Science (USA).
Publications Type: Journal Article
Author(s): Biener L., Siegel M.
Article Title: Tobacco marketing and adolescent smoking: More evidence for casual inference
Journal: American Journal of Public Health
Volume/Issue/Pages: 90, : 407-411
Year: 2000
Abstract:
OBJECTIVES: This prospective study examined the effect of tobacco marketing on progression to established smoking. METHODS: Massachusetts adolescents (n = 529) who at baseline had smoked no more than 1 cigarette were reinterviewed by telephone in 1997. Analyses examined the effect of receptivity to tobacco marketing at baseline on progression to established smoking, controlling for significant covariates. RESULTS: Adolescents who, at baseline, owned a tobacco promotional item and named a brand whose advertisements attracted their attention were more than twice as likely to become established smokers (odds ratio = 2.70) than adolescents who did neither. CONCLUSIONS: Participation in tobacco marketing often precedes, and is likely to facilitate, progression to established smoking. Hence, restrictions on tobacco marketing and promotion could reduce addiction to tobacco.
Publications Type: Journal Article
Author(s): Siegel M., Biener L.
Article Title: The impact of anti-smoking media campaigns on progression to established smoking: Results of a longitudinal youth study in Massachusetts
Journal: American Journal of Public Health
Volume/Issue/Pages: 90, : 380-386
Year: 2000
Abstract:
OBJECTIVES: We examined the impact of a statewide antismoking media campaign on progression to established smoking among Massachusetts adolescents. METHODS: We conducted a 4-year longitudinal survey of 592 Massachusetts youths, aged 12 to 15 years at baseline in 1993. We examined the effect of baseline exposure to television, radio, and outdoor antismoking advertisements on progression to established smoking (defined as having smoked 100 or more cigarettes), using multiple logistic regression and controlling for age; sex; race; baseline smoking status; smoking by parents, friends, and siblings; television viewing; and exposure to antismoking messages not related to the media campaign. RESULTS: Among younger adolescents (aged 12 to 13 years at baseline), those reporting baseline exposure to television antismoking advertisements were significantly less likely to progress to established smoking (odds ratio = 0.49, 95% confidence interval = 0.26, 0.93). Exposure to television antismoking advertisements had no effect on progression to established smoking among older adolescents (aged 14 to 15 years at baseline), and there were no effects of exposure to radio or outdoor advertisements. CONCLUSIONS: These results suggest that the television component of the Massachusetts antismoking media campaign may have reduced the rate of progression to established smoking among young adolescents.
Publications Type: Journal Article
Author(s): Siegel M., Biener L., Rigotti N.
Article Title: The effect of local tobacco sales laws on adolescent smoking initiation
Journal: Preventive Medicine
Volume/Issue/Pages: 29, 5: 334-342
Year: 1999
Abstract:
BACKGROUND: More than 700 communities have en acted laws prohibiting the sale of tobacco to minors, but little is known about the impact of such laws on youth smoking behavior. The objective of this study was to determine whether local tobacco sales laws de crease the rate of progression to established smoking among adolescents. METHODS: We conducted a prospective cohort study of 592 Massachusetts youths who did not smoke and were ages 12-15 years at the time of a baseline, random-digit-dial, telephone survey in 1993 and who were reinterviewed in 1997. RESULTS: Youths living in towns with a local tobacco sales ordinance at baseline were significantly less likely to progress to established smoking (defined as having smoked at least 100 cigarettes in one's life) than youths living in a town without an ordinance (odds ratio = 0.60; 95% confidence interval 0. 37, 0.97). The magnitude of this effect was unchanged after control ling for potential confounding variables. However, there was no relationship between living in a town with an ordinance and youths' perceived access to tobacco. CONCLUSIONS: Local tobacco sales laws are associated with reduced rates of adolescent smoking initiation, but in this setting, this effect did not appear to be mediated through reduced access to cigarettes.
Publications Type: Journal Article
Author(s): Albers A., Biener L.
Article Title: Adolescent participation in tobacco promotions: The role of psychosocial factors
Journal: Pediatrics
Volume/Issue/Pages: 111, 2: 402-406
Year: 2003
Abstract:
OBJECTIVES: To identify psychosocial factors that place adolescents at risk for participation in tobacco promotions, and to further investigate the hypothesis that psychosocial vulnerabilities have an indirect effect on smoking initiation among youth by way of involvement with tobacco promotions. METHODS: Data were from a follow-up telephone survey of youth in Massachusetts. A subset of adolescents who were not established smokers, had not smoked cigarettes in the past 30 days, and did not own a promotional item at baseline in 1993 was used for the analyses (n = 468). Bivariate analyses were used to evaluate the association between psychosocial vulnerabilities and subsequent acquisition of cigarette promotional items. Logistic regression was conducted to identify the set of factors that best predict attainment of tobacco promotional items, and to examine the mediating influence of item acquisition on the relation of between psychosocial vulnerabilities and smoking initiation. RESULTS: Adolescents who were academically disengaged at baseline were more likely to acquire a tobacco promotional item at follow-up. Academic disengagement was significantly associated with item acquisition, above and beyond the other psychosocial vulnerabilities. The direct effect of academic disengagement changed from marginally significant to nonsignificant when item acquisition was introduced. CONCLUSIONS: This study provides evidence that receptivity to tobacco promotional items is greatest among youth who are disengaged from school.
Publications Type: Journal Article
Author(s): Biener L., Ji M., Gilpin E., Albers A.
Article Title: The impact of emotional tone, message and broadcast parameters in youth antismoking advertisements
Journal: Journal of Health Communications
Volume/Issue/Pages: 9, 3:
Year: 2004
Abstract:
Objectives. In the context of controversy regarding the optimal characteristics of anti-smoking advertisements for youth, this study examines the impact on recall and perceived effectiveness of variations in the message, emotional tone, reach and frequency of broadcast, remoteness of broadcast, and characteristics of the adolescent audience such as changes in smoking behavior, ownership of cigarette promotional items, and demographic variables. Method. A two-wave longitudinal survey of a population-based sample of 618 Massachusetts youth 12 to 15 years old was carried out in 1993 and 1997. A Generalized Estimating Equation (GEE) approach was used to model the recall and perceived effectiveness of eight advertisements as a function of viewer and ad characteristics. Results. Advertisements featuring messages about serious health consequences which had been independently rated as high in negative emotion were more likely to be recalled and were perceived as more effective by youth survey respondents than ads featuring messages about normative behavior for teens or ads relying on humor. Advertising intensity, while contributing to recall, was negatively related to perceived effectiveness.Conclusions. This study supports mounting evidence that negative emotion in anti-smoking advertisements is effective with youth audiences.
Publications Type: Journal Article
Author(s): Pucci L.G., Siegel M.
Article Title: Exposure to brand-specific cigarette advertising in magazines and its impact on youth smoking
Journal: Preventive Medicine
Volume/Issue/Pages: 29, 5: 313-320
Year: 1999
Abstract:
BACKGROUND: Despite the potential influence of cigarette advertising on youth smoking, few studies have characterized brand-specific magazine advertising exposure among youths or examined its impact on youth smoking behavior. METHODS: A longitudinal youth survey was conducted to assess baseline exposure to brand-specific cigarette advertising in magazines and to measure subsequent smoking behavior. The sample comprised 1,069 Massachusetts youths, ages 12-15 years at baseline in 1993, and 627 of these youths who were interviewed after 4 years. RESULTS: Five brands accounted for 81.8% of the gross impressions for magazine advertising among Massachusetts youths. These same brands accounted for 88.4% of the brand market share among 12- to 15-year-old smokers nationally in 1993. The levels of brand-specific advertising exposure in the sample were highly correlated with these national brand market shares (r = 0.96, P = 0. 0002). Among the cohort, baseline brand-specific exposure to cigarette advertising in magazines was highly correlated with brand of initiation among new smokers (r = 0.93, P = 0.0001), brand smoked by current smokers (r = 0.86, P = 0.0004), and brand whose advertisements attracted attention the most (r = 0.87, P = 0.0002). CONCLUSION: By documenting a relationship between brand-specific magazine advertising exposure and brand of smoking initiation among new smokers, this study provides strong new evidence that cigarette advertising influences youth smoking.
Publications Type: Journal Article
Author(s): Honjo K., Siegel M.
Article Title: Perceived importance of being thin and smoking initiation among young girls
Journal: Tobacco Control
Volume/Issue/Pages: 12, 3: 289-295
Year: 2003
Abstract:
BACKGROUND: Smoking among adolescents remains unacceptably high and the difference in potential risk factors for smoking initiation between male and female adolescents has been explored. Although the association between smoking initiation and dieting behaviour has been observed among girls, the mechanism of the association is unknown. OBJECTIVE: To examine prospectively the association between perceived importance of being thin at baseline and smoking initiation among girls. DESIGN: A four year prospective cohort survey including perceived importance of being thin at baseline and smoking behaviour, conducted in 1993 and 1996. SETTING AND PARTICIPANTS: 273 Massachusetts female adolescents aged 12-15 years at baseline who reported having smoked no more than one cigarette by the time of the baseline survey, drawn from households sampled by random digit dialling. MAIN OUTCOME MEASURE: Progression to established smoking, defined as having smoked 100 or more cigarettes in their lifetime. RESULTS: After adjusting for age, smoking status at baseline, and race/ethnicity, girls who valued thinness most strongly and somewhat strongly were both more likely to have become established smokers, compared to the girls who valued thinness least strongly. The odds ratios are 4.5 (95% confidence interval (CI), 1.4 to 16.7) and 3.4 (95% CI 1.04 to 10.9), respectively. CONCLUSIONS: The level of perceived importance of being thin among young female adolescents predicts future smoking initiation. Smoking prevention programmes designed for female adolescents may therefore benefit from the inclusion of content related to importance of being thin.

 
   
 
 
     
   
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