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Original research
Objective and perceived measures of tobacco marketing are uniquely associated with cigar use
  1. Sarah D Kowitt1,
  2. Laura J Finan2,
  3. Sharon Lipperman-Kreda3
  1. 1 Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2 Department of Psychology, Illinois State University, Normal, Illinois, USA
  3. 3 Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
  1. Correspondence to Dr Sarah D Kowitt, Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; kowitt{at}email.unc.edu

Abstract

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
  • environment
  • non-cigarette tobacco products

Data availability statement

Data are available on reasonable request to Dr Lipperman-Kreda at skreda@prev.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 skreda@prev.org. 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.

https://doi.org/10.1136/tobaccocontrol-2021-056601

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    Data availability statement

    Data are available on reasonable request to Dr Lipperman-Kreda at skreda@prev.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 skreda@prev.org. 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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    Footnotes

    • Contributors SDK drafted the initial manuscript, analysed the data and revised the manuscript. SL-K supervised the study and acquired funding. LJF and SL-K collected the data. All authors interpreted the data, revised the manuscript for important intellectual content and approved the final manuscript.

    • Funding This research and analysis were supported by grant 25IR-0029 from the California Tobacco-Related Disease Research Program (TRDRP) and grant P60-AA006282 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH).

    • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of TRDRP, NIAAA or NIH.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.