Visual Media Influences on Adolescent Smoking Behavior (Y10-14 Renewal)

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DESCRIPTION (provided by applicant): Smoking is the primary cause of lung cancer in US adults, and an important cause of mortality from other conditions. Alcohol use is also an important cause of gastrointestinal cancers. Onset of smoking and alcohol use occurs during adolescence and young adulthood, and research provides extensive documentation of social influence effects on use of both substances. This study focuses on entertainment media and marketing influences. Up to now, each has been studied in relative isolation, and primarily among adolescents. In this study, we propose to assess exposure to movie and television images of smoking and alcohol use, as well as field a unique assessment of exposure to tobacco and alcohol marketing. To accomplish these goals, we will conduct a random digit dial, two-wave survey of 1500 U.S. adolescents and 1500 young adults, including landline and cell phone lists. The surveys will be separated by 2 months, and their sequence randomly assigned. One survey will assess exposure to entertainment media images of smoking, tobacco marketing, tobacco use and tobacco attitudes. The other survey will do the same for alcohol. The assessment of exposure to entertainment media employs a previously validated method that relies on recognition of movie and television series titles, along with content coding of these media venues for substance use, extending this method from movies to television. The assessment of exposure to marketing relies on cued (alcohol and tobacco marketing images with the brand removed) recall (how often the subject has seen the ad and whether he/she can identify what brand is being advertised). The survey will allow us to compare, for the first time, exposure to marketing of premium brands in the target segment (young adults) with exposure among adolescents, in order to directly assess effectiveness of industry efforts to limit exposure among youth. Moreover, we will ascertain simultaneously, the association of media and marketing exposures with the various stages of smoking and alcohol use for both age groups; this has never been done to our knowledge. The research activity supported by this competing revision is labor-intensive and will employ staff in telephone banks across every region of the country; the work is expected to result in hiring of additional staff, as well as enabling increased hours of current part-timers to staff these activities, thus providing an ideal response to Recovery Act aims. This study provides an unsurpassed opportunity to estimate the relative cross-sectional associations for exposure to entertainment media and marketing with substance use in adolescents and young adults. U.S. movies and television shows are distributed worldwide, and marketing of substances as well; thus, the research could have far-reaching public health implications for young persons everywhere. Finally, the study offers an opportunity to compare the effects of tobacco marketing, which is highly restricted due to agreements like the Master Settlement Agreement, with the relatively unrestricted marketing of alcohol. PUBLIC HEALTH RELEVANCE: Tobacco and alcohol use are the two largest causes of preventable mortality in the United States. This project examines how use of tobacco and alcohol in adolescents and young adults may be related to exposure to images of tobacco and alcohol in movies and television, and to industry-sponsored marketing/advertising campaigns. This research has great public health importance, as exposures of tobacco and alcohol within entertainment media and marketing/advertising campaigns could be reduced, either by voluntary industry initiatives or by greater government oversight.