Adolescents' Self-Reported Exposure to Advertisements for Flavored Tobacco Products After Implementation of a Statewide Ban on Flavored Tobacco Product Sales and Advertising in Massachusetts

Overview

Journal Public Health Rep

Publisher Sage Publications

Specialty Public Health

Date 2024 Dec 9

PMID 39651538

Authors

Danielle Clark

Karen Emmons

Elaine Hanby

Jessica Liu

Matthew J Reynolds

Jonathan Winickoff

Andy S L Tan

Affiliations

Soon will be listed here.

Abstract

Objectives: Massachusetts signed into law An Act Modernizing Tobacco Control (hereinafter, the Act) in 2019, which restricted retail sales of flavored tobacco products, including menthol cigarettes. This study assessed differences in advertising exposure to flavored tobacco products among adolescents in Massachusetts compared with adolescents in 4 neighboring states after passage of the Act.

Methods: We collected monthly cross-sectional survey data from April 2021 through August 2022 among a convenience sample of adolescents (aged 13-17 y) in Massachusetts and 4 control states: Connecticut, New Hampshire, Rhode Island, and Vermont. We measured self-reported past-30-day exposure to advertising for flavored electronic cigarette (e-cigarette) products and flavored cigarettes or other tobacco products across 9 channels.

Results: After implementation of the Act, adolescents in Massachusetts, compared with adolescents in the 4 control states, reported significantly lower levels of exposure to advertisements for flavored e-cigarettes (convenience store: adjusted odds ratio [AOR] = 0.80 [95% CI, 0.66-0.96]; supermarket/grocery store: AOR = 0.66 [95% CI, 0.52-0.84]; gas station: AOR = 0.61 [95% CI, 0.51-0.75]) and flavored cigarette/other tobacco products (convenience store: AOR = 0.69 [95% CI, 0.57-0.83]; supermarket/grocery store: AOR = 0.63 [95% CI, 0.49-0.79]; gas station: AOR = 0.55 [95% CI, 0.45-0.66]) in retail channels, which were the intended targets of the Act. We found no significant differences in flavored tobacco product advertising exposure for non-retail channels (television, radio, posters/billboards, newspapers/magazines, social media, and streaming services/movies in a theater).

Conclusions: Future research should further examine the effects of statewide flavored tobacco sales restrictions on the availability of and exposure to advertisements for flavored tobacco products.

References

Gentzke A, Wang T, Cornelius M, Park-Lee E, Ren C, Sawdey M . Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ. 2022; 71(5):1-29. PMC: 8923300. DOI: 10.15585/mmwr.ss7105a1. View

Kowitt S, Finan L, Lipperman-Kreda S . Objective and perceived measures of tobacco marketing are uniquely associated with cigar use. Tob Control. 2021; 32(4):428-434. PMC: 9444056. DOI: 10.1136/tobaccocontrol-2021-056601. View

Kingsley M, Setodji C, Pane J, Shadel W, Song G, Robertson J . Longer-Term Impact of the Flavored Tobacco Restriction in Two Massachusetts Communities: A Mixed-Methods Study. Nicotine Tob Res. 2021; 23(11):1928-1935. DOI: 10.1093/ntr/ntab115. View

Kingsley M, Song G, Robertson J, Henley P, Ursprung W . Impact of flavoured tobacco restriction policies on flavoured product availability in Massachusetts. Tob Control. 2019; 29(2):175-182. DOI: 10.1136/tobaccocontrol-2018-054703. View

Hanewinkel R, Isensee B, Sargent J, Morgenstern M . Cigarette advertising and teen smoking initiation. Pediatrics. 2011; 127(2):e271-8. DOI: 10.1542/peds.2010-2934. View

Usidame B, Miller E, Cohen J . Assessing the Relationship between Retail Store Tobacco Advertising and Local Tobacco Control Policies: A Massachusetts Case Study. J Environ Public Health. 2019; 2019:1823636. PMC: 6766668. DOI: 10.1155/2019/1823636. View

Vasiljevic M, Petrescu D, Marteau T . Impact of advertisements promoting candy-like flavoured e-cigarettes on appeal of tobacco smoking among children: an experimental study. Tob Control. 2016; 25(e2):e107-e112. PMC: 5284337. DOI: 10.1136/tobaccocontrol-2015-052593. View

Dube S, Arrazola R, Lee J, Engstrom M, Malarcher A . Pro-tobacco influences and susceptibility to smoking cigarettes among middle and high school students--United States, 2011. J Adolesc Health. 2013; 52(5 Suppl):S45-51. PMC: 4610118. DOI: 10.1016/j.jadohealth.2012.07.007. View

Giovenco D, Casseus M, Duncan D, Coups E, Lewis M, Delnevo C . Association Between Electronic Cigarette Marketing Near Schools and E-cigarette Use Among Youth. J Adolesc Health. 2016; 59(6):627-634. DOI: 10.1016/j.jadohealth.2016.08.007. View

10.

Choi K, Rose S, Zhou Y, Rahman B, Hair E . Exposure to Multimedia Tobacco Marketing and Product Use Among Youth: A Longitudinal Analysis. Nicotine Tob Res. 2019; 22(6):1036-1040. PMC: 7395665. DOI: 10.1093/ntr/ntz096. View

11.

Garrison K, OMalley S, Gueorguieva R, Krishnan-Sarin S . A fMRI study on the impact of advertising for flavored e-cigarettes on susceptible young adults. Drug Alcohol Depend. 2018; 186:233-241. PMC: 5948598. DOI: 10.1016/j.drugalcdep.2018.01.026. View

12.

Pasch K, Nicksic N, Opara S, Jackson C, Harrell M, Perry C . Recall of Point-of-Sale Marketing Predicts Cigar and E-Cigarette Use Among Texas Youth. Nicotine Tob Res. 2017; 20(8):962-969. PMC: 6037067. DOI: 10.1093/ntr/ntx237. View