||7R21CA208206-03 Interpret this number
||University Of Kentucky
||Exposure to Flavored Tobacco Advertising and Associations with Future Use in Young Adults: Implications for Health Equity
A potential ban on flavored tobacco products is a policy option to reduce tobacco product initiation by youth and young
adults. However, few studies examine its potential to reduce disparities in vulnerable populations due to tobacco
advertising exposure, perceptions of flavored products, and differential use.
The purpose of this study is to address
how targeted marketing of FTPs may influence perceptions of, susceptibility to and initiation of tobacco in a vulnerable
(recruited from 3 wards within Washington, DC with the highest smoking rates, % African American, and
(VP) vs. a non-vulnerable population (non-VP) of young adults in Washington, DC. It will address the
potential of a policy ban or restrictions on flavored tobacco products to reduce tobacco and, ultimately, cancer
disparities and enhance equity in the distribution of tobacco marketing risk.
The current study will build on the
Elaboration Likelihood Model (ELM), a model of cognitive processing of how advertising results in persuasion. The
ELM suggests that one way tobacco advertising works is by linking tobacco to `peripheral cues,' positive attributes
including flavoring that may contribute to positive appraisal and lower harm perceptions of flavored products. Across a
sample of n = 256 VP and non-VP young adult non-tobacco users, this multi-level study (store- and individual-level)
will build on the ELM to examine differences in real-world exposure to FTP advertising, emphasizing point of sale
(POS) exposure, using 14 days of ecological momentary assessment (EMA). It will examine the influence of exposure
on self-reported perceptions of FTPs (lower harm, more appeal). Participants will be assessed at 2-weeks and 6-
months post-baseline to examine differential impacts of FTP advertising and attitudes on susceptibility, intentions, and
tobacco use patterns (for FTPs and non-FTPs) as a function of VP group status. POS exposure will be validated by
photographs of tobacco advertising in stores visited by respondents. Our specific aims are to (1)
Identify the frequency
of FTP and non-FTP advertising, and number and types of products characterized by FTP descriptors (e.g., menthol,
cherry) in tobacco retailers visited by VP and non-VP young adults, (2)
Compare differences in harm perceptions and
appeal of FTP vs non-FTP advertisements and descriptors across VP and non-VP young adults and (3) Examine the
predictive utility of FTP advertising and descriptor exposure on susceptibility, intentions to use, and initiation of FTPs
(and non-FTPs) at 6-month follow-up across VP and non-VP young adults. This unique approach to triangulate data
at the store and individual cognitive level will yield timely information given the increase in use of FTPs and the need to
identify new policies and approaches to combat tobacco disparities in vulnerable groups. Achieving the aims of this
R21 will establish whether these associations exist and provide the foundation for a larger study developing
correcting FTP misperceptions, promoting FTP de-normalization
among young adults
, and examining
the likely impact of local policies to restrict FTP availability and advertising
particularly in vulnerable communities. This
study can also provide a basis for examining targeted marketing of other harmful products at POS.
Characteristics and Reach Equity of Policies Restricting Flavored Tobacco Product Sales in the United States.
, Amato M.S.
, Anesetti-Rothermel A.
, Carnegie B.
, Safi Z.
, Benson A.F.
, Czaplicki L.
, Simpson R.
, Zhou Y.
, Akbar M.
, et al.
Health promotion practice, 2020 01; 21(1_suppl), p. 44S-53S.