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      Young adult non-smokers’ exposure to real-world tobacco marketing: results of an ecological momentary assessment pilot study

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          Abstract

          Background

          The aims of this pilot study were to assess and characterize non-current smoking young adults’ exposure to tobacco marketing through an ecological momentary assessment protocol.

          Methods

          Ecological momentary assessment (EMA) consists of repeated measurement of momentary phenomena and is well-suited to capture sporadic experiences in the real-world, such as exposure to tobacco marketing. EMA has the potential to capture detailed information about real-world marketing exposures in ways that reduce recall bias and increase ecological validity. In this study, young adults (n = 31; ages 18–25) responded to random prompts regarding their momentary exposure to tobacco marketing via text messages on their smartphones for 14 days (n = 1798 observations). Unadjusted and adjusted analyses were conducted using multilevel logistic regression to assess the odds of exposure accounting for correlation of multiple repeated measures within individuals while controlling for variability between individuals.

          Results

          Respondents reported, on average, two momentary exposures to tobacco advertising in the 14-day study period. In adjusted analyses, African–American (aOR 3.36; 95% CI 1.07, 10.54) and Hispanic respondents (aOR 5.08; 95% CI 1.28, 20.13) were more likely to report exposure to tobacco advertising. Respondents were also more likely to report exposure when also exposed to others using tobacco products and when they were at stores compared with at home (aOR 14.82; 95% CI 3.61, 60.88).

          Conclusion

          Non-smoking young adults report exposure to tobacco marketing particularly at the point-of-sale, with the highest likelihood of exposure among African-American and Hispanic young people. EMA protocols can be effective in assessing the potential impact of point-of-sale tobacco marketing on young adults.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13104-017-2758-7) contains supplementary material, which is available to authorized users.

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          Most cited references31

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          Ecological momentary assessment (EMA) in studies of substance use.

          Ecological momentary assessment (EMA) is particularly suitable for studying substance use, because use is episodic and thought to be related to mood and context. This article reviews EMA methods in substance use research, focusing on tobacco and alcohol use and relapse, where EMA has been most applied. Common EMA designs combine event-based reports of substance use with time-based assessments. Approaches to data organization and analysis have been very diverse, particularly regarding their treatment of time. Compliance with signaled assessments is often high. Compliance with recording of substance use appears good but is harder to validate. Treatment applications of EMA are emerging. EMA captures substance use patterns not measured by questionnaires or retrospective data and holds promise for substance use research.
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            A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing.

            We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.
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              Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality.

              We sought to determine whether there is evidence of a causal link between exposure to tobacco promotion and the initiation of tobacco use by children. We conducted a structured search in Medline, PsycINFO, and ABI/INFORM Global to identify relevant empirical research. The literature was examined against the Hill epidemiologic criteria for determining causality. (1) Children are exposed to tobacco promotion before the initiation of tobacco use; (2) exposure increases the risk for initiation; (3) there is a dose-response relationship, with greater exposure resulting in higher risk; (4) the increased risk is robust; it is observed with various study methods, in multiple populations, and with various forms of promotion and persists after controlling for other factors; (5) scientifically plausible mechanisms whereby promotion could influence initiation exist; and (6) no explanation other than causality can account for the evidence. Promotions foster positive attitudes, beliefs, and expectations regarding tobacco use. This fosters intentions to use and increases the likelihood of initiation. Greater exposure to promotion leads to higher risk. This is seen in diverse cultures and persists when other risk factors, such as socioeconomic status or parental and peer smoking, are controlled. Causality is the only plausible scientific explanation for the observed data. The evidence satisfies the Hill criteria, indicating that exposure to tobacco promotion causes children to initiate tobacco use.
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                Author and article information

                Contributors
                srose@truthinitiative.org
                arothermel@truthinitiative.org
                hoda.elmasry1@gmail.com
                niaura@nyu.edu
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                31 August 2017
                31 August 2017
                2017
                : 10
                : 435
                Affiliations
                [1 ]ISNI 0000 0000 8944 3799, GRID grid.417962.f, Schroeder Institute at Truth Initiative, ; Washington, DC USA
                [2 ]ISNI 0000 0004 1936 8753, GRID grid.137628.9, College of Global Public Health, , New York University, ; New York, NY USA
                Article
                2758
                10.1186/s13104-017-2758-7
                5580291
                28859667
                edb6f84c-a7a1-4c7d-a410-07708f6cc65c
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 January 2017
                : 23 August 2017
                Funding
                Funded by: Truth Initiative
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Medicine
                district of columbia,marketing,pilot projects,tobacco,young adult,health equity
                Medicine
                district of columbia, marketing, pilot projects, tobacco, young adult, health equity

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