Exposure to flavored tobacco advertising and associations with future use in young adults: implications for health equity

项目摘要 对调味烟草产品的潜在禁令是减少青少年和年轻人开始使用烟草产品的一种政策选择 成年人了然而，很少有研究探讨其减少烟草造成的弱势群体差距的潜力 广告曝光，风味产品的感知，以及差异化使用。 本研究的目的是解决 有针对性的FTPs营销如何影响弱势群体对烟草的看法、易感性和开始吸烟的情况 人口 （从华盛顿内吸烟率最高的3个病房招募，非裔美国人%， 最低社会经济地位） (VP)与华盛顿的年轻人中的非弱势群体（非VP）相比。它将解决 政策禁止或限制调味烟草产品以减少烟草并最终减少癌症的可能性 差异并增强烟草营销风险分配的公平性。 目前的研究将建立在 Ehrman Liksman模型（ELM），一个关于广告如何导致说服的认知处理模型。的 ELM认为，烟草广告起作用的一种方式是将烟草与“外围线索”、积极属性联系起来 包括可能有助于对调味产品的正面评价和降低危害感知的调味剂。跨 样本n = 256 VP和非VP年轻成人非烟草使用者，这项多水平研究（商店和个人水平） 我将在ELM的基础上研究FTP广告在现实世界中的差异，强调销售点 (POS)使用14天的生态瞬时评估（EMA）。它将检验暴露的影响 自我报告的对FTPs的看法（伤害较低，更具吸引力）。参与者将在2周和6周进行评估， 基线后3个月，检查FTP广告和态度对易感性、意图和 烟草使用模式（FTPs和非FTPs）作为VP组状态的函数。POS暴露将由以下人员进行验证： 受访者到访的商店内的烟草广告照片。我们的具体目标是（1） 识别频率 FTP和非FTP广告的数量和类型，以及以FTP描述符为特征的产品的数量和类型（例如，薄荷醇， 樱桃）在VP和非VP年轻人访问的烟草零售商中，（2） 比较伤害认知的差异， FTP与非FTP广告和描述符在VP和非VP年轻人中的吸引力，以及（3）检查 FTP广告和描述性暴露对敏感性、使用意图和启动FTP的预测效用 (and VP和非VP年轻成人6个月随访时的非FTP）。这种三角测量数据的独特方法 在商店和个人的认知水平将产生及时的信息，因为越来越多的人使用FTP， 确定新的政策和办法，消除弱势群体中的烟草不平等现象。实现本组织的目标 R21将确定这些关联是否存在，并为更大规模的研究提供基础。 干预措施 纠正对FTP的误解，促进FTP去规范化 在年轻人中 ，并检查 限制FTP可用性和广告的本地政策可能产生的影响 特别是在弱势群体中。这 这项研究还可以为审查其他有害产品在销售点的针对性营销提供依据。

PROJECT SUMMARY 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 population (recruited from 3 wards within Washington, DC with the highest smoking rates, % African American, and lowest SES) (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 interventions 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.