A Longitudinal Study of Exposure to Retail Cigarette Advertising and Smoking Initiation

Abstract

OBJECTIVES: Accumulating evidence suggests that widespread advertising for cigarettes at the point of sale encourages adolescents to smoke; however, no longitudinal study of exposure to retail tobacco advertising and smoking behavior has been reported. METHODS: A school-based survey included 1681 adolescents (aged 11–14 years) who had never smoked. One measure of exposure assessed the frequency of visiting types of stores that contain the most cigarette advertising. A more detailed measure combined data about visiting stores near school with observations of cigarette advertisements and pack displays in those stores. Follow-up surveys 12 and 30 months after baseline (retention rate: 81%) documented the transition from never to ever smoking, even just a puff. RESULTS: After 12 months, 18% of adolescents initiated smoking, but the incidence was 29% among students who visited convenience, liquor, or small grocery stores at least twice per week and 9% among those who reported the lowest visit frequency (less than twice per month). Adjusting for multiple risk factors, the odds of initiation remained significantly higher (odds ratio: 1.64 [95% confidence interval: 1.06–2.55]) for adolescents who reported moderate visit frequency (0.5–1.9 visits per week), and the odds of initiation more than doubled for those who visited ≥2 times per week (odds ratio: 2.58 [95% confidence interval: 1.68–3.97]). Similar associations were observed for the more detailed exposure measure and persisted at 30 months. CONCLUSIONS: Exposure to retail cigarette advertising is a risk factor for smoking initiation. Policies and parenting practices that limit adolescents' exposure to retail cigarette advertising could improve smoking prevention efforts.

Exposure to Tobacco Retail Outlets and Smoking Initiation among New York City Adolescents

“…9,15 This measure is based on the definition of initiation used in the National Survey on Drug Use and Health and similar to the definition used in Henriksen et al 9 It includes those who tried cigarettes once (i.e., experimenters), as well as those who continued to smoke regularly. Students who never smoked or who tried smoking more than 12 months ago were classified as non-initiators.…”

“…6 Weekly or more frequent visits to tobacco retailers have been associated with a 50 % increase in the odds of ever smoking, 7,8 and incidence of smoking initiation has been observed to be significantly higher among teens visiting retail outlets at least twice per week. 9 Teen smokers are more likely to prefer the brands that are marketed in stores near their schools, 7 and exposure to brand promotion in retail outlets has been associated with teens overestimating the prevalence of peer smoking and the social acceptability of smoking. 4,7 Furthermore, high tobacco retailer outlet density has been associated with an elevated smoking prevalence at nearby schools, 10 higher odds of smoking initiation 11 and more positive perceptions of smoking.…”

Youth activity spaces and daily exposure to tobacco outlets

“…In particular, such exposure may increase access to tobacco, exposure to tobacco advertising and promotion, and exposure to others who use tobacco. All of these factors are related to youth tobacco use (Botello-Harbaum et al, 2009;Carpenter & Cook, 2008;DiFranza, Savageau, & Fletcher, 2009;Ding, 2003;Henriksen, Feighery, Wang, & Fortmann, 2004;Henriksen, Schleicher, Feighery, & Fortmann, 2010;Lipperman-Kreda, Grube, & Friend, 2012;Wakefield & Chaloupka, 2000). Controls over the number of tobacco outlets and their distance from residential areas or schools are frequently advocated approaches to reduce youth exposure and access to tobacco products and thus their tobacco use.…”

Targeted Advertising, Promotion, and Price For Menthol Cigarettes in California High School Neighborhoods

“…It examines the availability of promotions as well as the price for menthol and nonmenthol cigarettes as a function of neighborhood demographics for Blacks and youth. It also focuses on school neighborhoods where adolescents' exposure to retail cigarette marketing has been shown to promote smoking uptake (Henriksen, Schleicher, Feighery, & Fortmann, 2010;Slater, Chaloupka, Wakefield, Johnston, & O'Malley, 2007).…”