Dataset Information

Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.

ABSTRACT: OBJECTIVE:We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (current), and smoking ?100 cigarettes in lifetime (established) among adolescents and young adults. METHODS:We surveyed a U.S. telephone sample of 3,342 15- to 23-year-olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N = 2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. RESULTS:Overall, 12% of 15- to 17-year-olds and 26% of 18- to 23-year-olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority nonsmoking respondents were more likely to see tobacco websites than nonsmoking whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio 2.2, 95% confidence interval 1.3-3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (adjusted odds ratio 2.7, 95% confidence interval 1.1-6.6). We observed similar relationships for ever having tried smoking and established smoking. CONCLUSIONS:Direct-to-consumer tobacco marketing reaches adolescent and young adult nonsmokers and is associated with smoking behavior.

SUBMITTER: Soneji S

PROVIDER: S-EPMC4241586 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.

Soneji Samir S Ambrose Bridget K BK Lee Won W Sargent James J Tanski Susanne S

The Journal of adolescent health : official publication of the Society for Adolescent Medicine 20140321 2

<h4>Objective</h4>We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (current), and smoking ≥100 cigarettes in lifetime (established) among adolescents and young adults.<h4>Methods</h4>We surveyed a U.S. telephone sample of 3,342 15- to 23-year-olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N = 2,541 [75%]), we asses ...[more]

PMID: 24661738

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Project description:INTRODUCTION:Engagement with online tobacco marketing among US adolescents increased from nearly 9% (2013-2014) to 21% (2014-2015). Such engagement increases the risk of tobacco use initiation. Despite the increase in the prevalence of and risks associated with engagement, the reasons why adolescents and young adults engage are not known. METHODS:A sample of 2619 adolescents (13-17 years) and 2625 young adults (18-24 years) living in the US participated in an online survey in July-August 2017. Engagement with online tobacco marketing was assessed through five forms of engagement (e.g. watched a video online promoting tobacco products). Reasons for engagement were assessed through an open-ended survey question. Prevalence of reasons for engagement was calculated overall, by tobacco use status, and by age group (adolescents and young adults). Multivariable logistic regression models were fit with engagement as the outcome (overall and specific reasons) and sociodemographics (including age, gender, and race/ethnicity) and tobacco use status (non-susceptible and susceptible never tobacco users; ever, but not past 30-day tobacco users; and past 30-day tobacco users) as covariates. RESULTS:Across all tobacco use statuses, the leading reasons for engagement were curiosity or desire for general knowledge about tobacco products (3.9%); incidental, unintended or forced exposure to tobacco ad (3.8%); and seeking discounts, coupons, incentives, or contests (2.9%). Susceptible never tobacco users were more likely to engage because of curiosity or general knowledge than non-susceptible never tobacco users (adjusted odds ratio, AOR=6.81; p<0.01). Past 30-day tobacco users were more likely to engage because of discounts, coupons, incentives, or contests and product appeal than ever, but not past 30-day tobacco users (AOR=7.10; p<0.01). CONCLUSIONS:Stricter state and federal regulation of tobacco marketing, specifically tobacco ads and coupons, and stronger self-regulation by social networking sites could reduce youth engagement with online tobacco marketing.

Project description:IntroductionYoung adulthood (aged 18-24) is a crucial period in the development of long-term tobacco use patterns. Tobacco advertising and promotion lead to the initiation and continuation of smoking among young adults. We examined whether vulnerability factors moderated the association between tobacco advertisement liking and tobacco use in the United States.MethodsAnalyses were conducted among 9109 US young adults in the nationally representative Population Assessment of Tobacco and Health (PATH) Study wave 1 (2013-14). Participants viewed 20 randomly selected sets of tobacco advertisements (five each for cigarettes, e-cigarettes, cigars, and smokeless tobacco) and indicated whether they liked each ad. The outcome variables were past 30-day cigarette, e-cigarette, cigar, and smokeless tobacco use. Covariates included tobacco advertisement liking, age, sex, race or ethnicity, sexual orientation, education, poverty level, military service, and internalizing and externalizing mental health symptoms.ResultsLiking tobacco advertisements was associated with tobacco use, and this association was particularly strong among those with lower educational attainment (cigarettes, cigars) and living below the poverty level (e-cigarettes, smokeless tobacco).ConclusionsThe association between tobacco advertisement liking and tobacco use was stronger among young adults with lower educational attainment and those living below the poverty level. Policies that restrict advertising exposure and promote counter-marketing messages in this population could reduce their risk.ImplicationsThis study shows that liking tobacco advertisements is associated with current tobacco use among young adults, with stronger associations for vulnerable young adults (ie, lower education levels and living below the poverty level). Findings suggest a need for counter-marketing messages, policies that restrict advertising exposure, and educational interventions such as health and media literacy interventions to address the negative influences of tobacco advertisements, especially among young adults with a high school education or less and those living below the poverty level.

Project description:ImportanceRituximab is among the most frequently used immunotherapies in pediatrics. Few studies have reported long-term adverse events associated with its use for children.ObjectiveTo describe the use of rituximab and to assess whether its use is associated with short- or long-term adverse events, infections, or time to immune reconstitution in a diverse group of young people.Design, setting, and participantsThis retrospective cohort study included 468 patients aged younger than 21 years who received rituximab for diverse indications between October 1, 2010, and December 31, 2017, at Texas Children's Hospital, a large pediatric referral hospital. Patterns of adverse events, infections, and immune recovery are described. Data analyses were conducted from December 2019 to June 2020.ExposureOne or more doses of rituximab.Main outcomes and measuresAdverse drug events (eg, anaphylaxis), incidence of mild and severe infections, and time to recovery of B lymphocyte subset counts and immunoglobulin levels. Survival models and logistic regression analyses and were used to identify associated risk factors of infectious and noninfectious adverse drug events.ResultsWe identified 468 patients receiving at least 1 dose of rituximab. The total follow-up time was 11 713 person-months. Of the 468 patients, 293 (62.6%) were female, the median (interquartile range) age at receipt of dose was 14.3 (9.9-16.8) years, and 209 (44.7%) were self-reported White Hispanic. Adverse events associated with rituximab infusion occurred in 72 patients (15.4%), and anaphylaxis occurred in 17 patients (3.6%). Long-term adverse events, such as prolonged neutropenia and leukoencephalopathy, were absent. Infections occurred in 224 patients (47.9%); 84 patients (17.9%) had severe infections, and 3 patients (0.6%) had lethal infections. Concurrent use of intravenous chemotherapy, treatment of systemic lupus erythematosus, neutropenia, and use of intravenous immunoglobulin were associated with increased risk of infection. Among 135 patients (28.8%) followed up to B cell count recovery, CD19+ or CD20+ cell numbers normalized in a median of 9.0 months (interquartile range, 5.9-14.4 months) following rituximab use; 48 of 95 patients (51%) evaluated beyond a year had low-for-age B cell counts. Recovery of CD27+ memory B cell number occurred in a median of 15.7 months (interquartile range, 6.0-22.7 months). Among patients with normal baseline values, low immunoglobulin G (IgG) levels developed in 67 of 289 patients (23.2%) and low IgM levels in 118 of 255 patients (40.8%); of these patients evaluated beyond 12 months from rituximab, 16 of 117 (13.7%) had persistently low IgG and 37 (33.9%) of 109 had persistently low IgM.Conclusions and relevanceRituximab is well tolerated among young people and is associated with few serious adverse events, but infections are common, corresponding to a prolonged period of B cell count recovery often lasting for longer than a year. Further examination of strategies to prevent infections following rituximab should be pursued.

Dataset Information

Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.

Publications

Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.

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