Differences in Cigarette Use and the Tobacco Environment Among Youth Living in Metropolitan and Nonmetropolitan Areas

Bernat, Debra H.; Choi, Kelvin

doi:10.1111/jrh.12194

Cited by 18 publications

(22 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rural youth reported more cigarette smoking and more exposure to retail tobacco advertising than urban youth 103 . However, sociodemographic factors, cigarette taxes, and tobacco ad exposure did not entirely explain urban/rural disparities 104 .…”

Section: Resultsmentioning

confidence: 95%

Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature

Cruz¹,

Rose²,

Lienemann³

et al. 2019

Tob. Induc. Dis.

View full text Add to dashboard Cite

INTRODUCTIONWe reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups.METHODSFive journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004–2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group.RESULTSThere were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results.CONCLUSIONSWe found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies.

show abstract

Section: Resultsmentioning

confidence: 95%

Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature

Cruz¹,

Rose²,

Lienemann³

et al. 2019

Tob. Induc. Dis.

View full text Add to dashboard Cite

show abstract

“…As a result of successful tobacco control policies that have reduced marketing and advertising of tobacco products, retail outlets are considered the last frontier for the tobacco industry to market its products (Robertson et al, 2015). Compared to their urban counterparts, rural populations have reported greater exposure to tobacco advertising in the retail outlets they visit, including convenience stores, gas stations, grocery stores, and big box stores (Bernat and Choi, 2018).…”

Section: Introductionmentioning

confidence: 99%

Rural-urban disparities in tobacco retail access in the southeastern United States: CVS vs. the dollar stores

Hall

Cho

Maldonado-Molina

et al. 2019

Preventive Medicine Reports

View full text Add to dashboard Cite

Objectives CVS, the largest US pharmacy chain, discontinued selling tobacco products in 2014; meanwhile, Family Dollar and Dollar General, the two largest dollar store chains, began selling tobacco in 2012 and 2013, respectively. The purpose of this study is to evaluate the differential change in tobacco retailer density (TRD) by rurality throughout 12 Southeastern US states. Methods Tobacco retailer density was calculated for CVS and dollar store locations and combined to represent retailer density change before and after policy changes. Bivariate analyses were conducted to compare the corporate-initiated changes in county-level retailer density across rurality categories. Results Findings suggest a statistically significant difference ( p < 0.0001) between TRD effect and rurality. Urban counties together experienced a retailer density increase of 0.4 stores per 10 k adult population, while rural counties reported a TRD increase of 2.6—eight (8) times the increase in urban areas. Conclusions Recent corporate policy changes on tobacco sales have increased access to tobacco retailers in rural counties considerably more than in urban counties, contributing to further disparities. CVS pharmacies discontinuing tobacco sales caused a decrease in retail density in urban areas, and the decision of the dollar stores locations initiating tobacco sales resulted in a greater burden to rural and small-metro counties.

show abstract

“…For example, the prevalence of past-month use was significantly higher among adolescents in rural areas for any tobacco (17.0% rural vs. 13.3% urban), cigarettes (11.0% rural vs. 6.7% urban), and smokeless (7.0% rural vs. 2.9% urban); however, past-month use of cigar products (6.6% vs. 5.8%) and e-cigarettes (3.2% vs. 3.4%) was not significantly different (Pesko & Robarts, 2017). In more recent surveys, past-month cigarette smoking was higher among youth living in rural counties than in metropolitan counties in Florida and in California, the state where the current study was conducted (Bernat & Choi, 2018; Zhu et al, 2019). According to the California Student Tobacco Survey 2017-2018, polyuse of tobacco products in the past 30 days was greater among high school students in rural counties than in nonrural counties (4.6% vs. 3.1%), including cigarettes (3.2% vs. 1.9%), roll-your-own cigarettes (0.8% v. 0.4%), little cigars/cigarillos (3.6% vs. 2.1%), smokeless (2.1% vs 1.7%), and hookah (2.0% vs. 1.7%) but not for e-cigarettes (8.0% vs. 11.2%; Zhu et al, 2019).…”

Section: Introductionmentioning

confidence: 86%

Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices

Henriksen

Schleicher

Johnson

et al. 2020

Health Promotion Practice

View full text Add to dashboard Cite

Objectives. To assess tobacco product availability, advertised discounts, and prices in rural and nonrural stores, comparing results for two definitions of rural. Method. This geospatial study linked data from marketing surveillance in a representative sample of licensed tobacco retailers in California ( n = 1,276) and categorized rural/nonrural stores at the county and tract levels. Data were collected from January to March, 2017, and mixed-models analyses tested for differences by location (rural vs. nonrural). Results. Compared to nonrural stores, rural-county stores were 2.1 (95% confidence interval [CI; 1.2, 3.6]) times more likely to sell chewing tobacco and 2.5 (95% CI [1.4, 4.2]) times more likely to sell roll-your-own. Rural-county stores sold larger packs of cigarillos for less than $1 (coefficient = 0.22, 95% CI [0.05, 0.39]) and charged less for the cheapest cigarette pack regardless of brand (estimated mean difference = $−0.21, 95% CI [−0.39, −0.03]). Contrary to expectation, a popular brand of chewing tobacco cost more in rural-county stores. A tract-level definition of rural reclassified only 1 in 10 stores, and did not substantially alter the results. Overall, 32.9% of stores advertised discounts on chewing tobacco, but this was more common in rural than nonrural census tracts (adjusted odds ratio = 1.81, 95% CI [1.14, 2.88]). Discussion. Evidence that $1 buys more cigarillos in rural-county stores than elsewhere adds to health equity concerns that the prevalence of cheap, flavored tobacco is not limited to neighborhoods characterized by socioeconomic disadvantage, higher proportions of African Americans, and higher proportions of school-age youth. Policies that focus on the retail environment for tobacco are needed to make tobacco less attractive and more costly everywhere, including rural areas.

show abstract

Differences in Cigarette Use and the Tobacco Environment Among Youth Living in Metropolitan and Nonmetropolitan Areas

Abstract: The present results suggest vast differences in smoking behavior among nonmetropolitan and metropolitan adolescents and that targeting social and environmental factors may be beneficial for reducing tobacco disparities among nonmetropolitan adolescents.

Cited by 18 publications

References 20 publications

Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature

Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature

Rural-urban disparities in tobacco retail access in the southeastern United States: CVS vs. the dollar stores

Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices

Contact Info

Product

Resources

About