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Reasons for engagement with online tobacco marketing among US adolescents and young adults.

ABSTRACT: 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.

SUBMITTER: Soneji S

PROVIDER: S-EPMC6751987 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveTo assess changes in engagement with online tobacco and electronic cigarette (e-cigarette) marketing (online tobacco marketing) among adolescents in the United States between 2013 and 2015.MethodsWe assessed the prevalence of six forms of engagement with online tobacco marketing, both overall and by brand, among adolescents sampled in Wave 1 (2013-2014; n = 13651) and Wave 2 (2014-2015; n = 12172) of the nationally representative Population Assessment for Tobacco and Health Study. Engagement was analyzed by tobacco use status: non-susceptible never tobacco users; susceptible never tobacco users; ever tobacco users, but not within the past year; and past-year tobacco users.ResultsAmong all adolescents, the estimated prevalence of engagement with at least one form of online tobacco marketing increased from 8.7% in 2013-2014 to 20.9% in 2014-2015. The estimated prevalence of engagement also increased over time across all tobacco use statuses (eg, from 10.5% to 26.6% among susceptible adolescents). Brand-specific engagement increased over time for cigarette, cigar, and e-cigarette brands.ConclusionEngagement with online tobacco marketing, both for tobacco and e-cigarettes, increased almost twofold over time. This increase emphasizes the dynamic nature of online tobacco marketing and its ability to reach youth. The Food and Drug Administration, in cooperation with social networking sites, should consider new approaches to regulate this novel form of marketing.ImplicationsThis is the first study to estimate the national prevalence of engagement with online tobacco marketing among adolescents over time. The estimated prevalence of this engagement approximately doubled between 2013-2014 and 2014-2015 among all adolescents and, notably, among adolescents at relatively low risk to initiate tobacco use. This increase in engagement could represent public health harm if it results in increased initiation and use of tobacco products. Stronger federal regulation of online tobacco marketing and tighter control of access to tobacco-related content by social media sites could reduce adolescents' exposure to and engagement with online tobacco marketing.

Project description:ObjectiveTo develop tobacco control strategies by analyzing online tobacco marketing information in China.MethodsUsing web-crawler software, this study acquired 106,485 pieces of online tobacco marketing information published on 11 different Internet platforms including Weibo, WeChat, Baidu, etc., from January-June 2018. The data were used to investigate the characteristics and social networks of online tobacco marketing via content and social network analysis.ResultsThe total volume of online tobacco marketing during the study period was high, showing a positive trend. Of all the marketing subjects, those involving "flavor capsule", "Marlboro", and "Esse" were the most popular. The Weibo platform had the highest volume of online tobacco marketing information as well as the largest proportion of explicit marketing information. This was followed by other social media platforms such as Baidu Search, Baidu Tieba, and Xiaohongshu, where implicit marketing information predominated. The overall network structure of tobacco websites exhibited a significant centralization feature, where traditional and novel tobacco websites formed two clusters with almost no intersections. The China Tobacco Science and Education Website (http://www.tobaccoinfo.com.cn/) and E-Cigarette Home (http://ecigm.com/) were the two nodes of the highest degree centrality within the respective "circle", while the China Tobacco Monopoly Bureau Website (http://www.tobacco.gov.cn/) was the node with the highest closeness centrality. By contrast, Baidu Tieba's overall network structure was more decentralized, and the degree of correlation between different nodes was relatively low.ConclusionOnline tobacco marketing demonstrated high volumes and wide coverage, and an intertwined network, thereby creating major obstacles for tobacco control. To address this issue, the government should strengthen network supervision of tobacco marketing and revise its current regulations. Meanwhile, Internet platforms should improve self-regulation by comprehensively removing and blocking tobacco-related information. Lastly, the media and public should advocate associated policies and support Internet platform supervision.

Project description:ObjectiveThe relation between respiratory symptoms and the range of tobacco product use among US adolescents/young adults is not yet clear. This cross-sectional analysis examines tobacco product use and respiratory symptoms in a nationally representative sample of 21,057 adolescents/young adults aged 12-24 years from Wave 4 (2016-17) of the Population Assessment of Tobacco and Health Study.MethodsPresence of functionally important respiratory symptoms was defined by questions regarding wheezing and nighttime cough at a cutoff score associated with poorer functional health status. Past-30-day tobacco use was analyzed 2 ways: never-tobacco users (reference) versus combustible users, noncombustible-only users, and former users; or frequency of use of cigarettes and/or e-cigarettes. Weighted Poisson regression adjusted for past-30-day marijuana use, secondhand smoke exposure, and asthma.ResultsFunctionally important respiratory symptoms were present in 10.0% overall: 13.8% of combustible users, 9.0% of noncombustible users, 8.2% of noncurrent users and 9.7% of never users. Functionally important respiratory symptoms were associated with combustible tobacco use (relative risk [RR] = 1.52[95% CI 1.29, 1.80]), marijuana use (RR = 1.54[1.34, 1.77]) and secondhand smoke exposure (RR = 1.04[1.03, 1.05]). Higher cigarette smoking frequency was also associated with functionally important respiratory symptoms for frequency categories >14 days/month (eg, RR = 1.93[1.50, 2.49] for 15-29 days/month). Frequency of e-cigarette use was not associated with functionally important respiratory symptoms.ConclusionsDuring 2016-17, smoking cigarettes, marijuana use, and secondhand smoke exposure were cross-sectionally associated with functionally important respiratory symptoms in adolescents/young adults. Risk increased with increased frequency of cigarette use but not e-cigarette use. Given changes to contemporary e-cigarettes and use, findings may not generalize to newer products.

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Reasons for engagement with online tobacco marketing among US adolescents and young adults.

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