Background Few studies have examined associations between perceived and objective exposure to tobacco marketing and cigar use, which is the second most commonly used tobacco product by youth.
Methods We used Geographic Ecological Momentary Assessment data over 14 days from youth aged 16–20 years (n=83 participants, n=948 observations; 34% past month users of any tobacco product) in eight city areas in California. Tobacco outlets in study cities were visited by trained observers to record outlet Global Positioning System (GPS) point locations and outdoor tobacco marketing. We assessed daily perceived exposure to tobacco marketing within participants’ activity spaces; daily objective exposure to tobacco outlets with outdoor marketing within 50 m of activity space polylines (number of outlets and time spent near outlets) and daily cigar use excluding and including blunts.
Results Controlling for demographics and baseline tobacco use, results from mixed logistic regression models showed that greater perceived exposure to tobacco marketing was positively associated with higher odds of cigar use each day, excluding blunts (adjusted odds ratios (aOR): 2.00; 95% CI 1.03 to 3.87) and including blunts (aOR: 1.87; 95% CI 1.26 to 2.77). Also, exposure to a greater number of tobacco outlets with outdoor marketing was associated with higher odds of cigar use each day, excluding blunts (aOR: 1.34; 95% CI 1.01 to 1.78), but not including blunts.
Conclusions Tobacco control efforts should consider both perceived and objective exposure to tobacco marketing and unique associations with blunt use to prevent cigar use.
- advertising and promotion
- non-cigarette tobacco products
Data availability statement
Data are available on reasonable request to Dr Lipperman-Kreda at firstname.lastname@example.org. Only deidentified data can be shared. It is the policy of the IRB overseeing this project to not share data that are personally identifiable or could lead to disclosure of the identities of individual subjects or could cause significant social or legal harm to research participants. Data are available upon reasonable request to Dr. Lipperman-Kreda at email@example.com. Only de-identified data can be shared. It is the policy of the IRB overseeing this project to not share data that are personally identifiable or could lead to disclosure of the identities of individual subjects or could cause significant social or legal harm to research participants.
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