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The associations between exposure to tobacco coupons and predictors of smoking behaviours among US youth
  1. Kelvin Choi
  1. Correspondence to Dr Kelvin Choi, Division of Intramural Research, National Institute on Minority Health and Health Disparities, Address: 9000 Rockville Pike, Bethesda, MD 20892, USA; kelvin.choi{at}


Introduction A recent report showed that 13.1% of US middle and high school students were exposed to tobacco coupons in the past 30 days in 2012. The current study reanalysed data from the National Youth Tobacco Survey 2012 to examine the associations between exposure to tobacco coupons in the past 30 days and predictors of smoking among US youth, by smoking status.

Methods 24 658 middle and high school students were asked if and where they had received tobacco coupons in the past 30 days. Demographics, smoking behaviours, smoking-related beliefs, susceptibility to smoking and confidence in quitting smoking were assessed. Analyses were stratified by smoking status (never smokers, experimenters and current smokers). Data were weighted to be representative of the US youth.

Results Exposure to tobacco coupons was associated with lower likelihood of denying the social benefits of cigarette smoking and believing all tobacco products are dangerous; higher likelihood of being susceptible to smoking (among never smokers); lower likelihood to feel confident in quitting cigarettes completely (among current smokers); and higher likelihood to intend to purchase cigarettes in the next 30 days (among experimenters and current smokers; p<0.05).

Conclusions Tobacco coupons may promote smoking and hinder smoking cessation among youth. Regulating tobacco coupons may reduce youth smoking in the USA. Further research is needed to determine the effect of tobacco coupons on youth tobacco use globally.

  • Advertising and Promotion
  • Prevention
  • Tobacco industry

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