In Vivo Assessment of Young Adults' Exposure to Cigarette Advertising

描述（由申请人提供）：有充分的证据表明，在18岁以下的儿童和青少年中，接触香烟广告与吸烟之间存在关系。记录这种关系的研究五花八门。他们的研究范围从对小样本的高度控制的实验实验室研究到对初中生和高中生的大量不同人群的自然的准实验研究。然而，这种设计和方法的多样性代表了这一文献的一个弱点：研究人员在选择研究设计、测量和方法时不得不做出固有的权衡，这使得很难得出关于香烟广告效果的精确结论。此外，烟草业已将其营销注意力转向大学生，因此现有的关于香烟广告效果的文献在多大程度上可以推广到年龄较大的青少年是未知的。本修订（A1）项目的总体目标是采用生态瞬时评估（EMA）来解决这些问题。EMA使用掌上电脑在“实时”和“现实生活”中监测心理现象。它提供了实验室设置的测量精度，以及自然的准实验领域研究的外部有效性。因此，它有很大的潜力来解决这一调查领域的方法差距，并显著提高在未充分研究的人群中围绕香烟广告与吸烟行为之间关系的证据的强度。然而，EMA并没有被用来调查香烟广告和吸烟之间的关系。因此，将这种方法应用于这一研究领域存在真正的挑战，这些挑战需要在更大规模地使用之前仔细解决。这一发展性R21项目的第一阶段将涉及一系列形成性研究，旨在使EMA适应于研究大学生接触香烟广告的情况。这些形成性研究的数据将用于本项目的最后阶段：EMA的短期现场测试，以研究大学生对香烟广告的接触。现场测试的参与者将使用EMA记录他们在30天间隔内接触香烟广告和营销的所有情况，并在每次接触广告后立即回答有关他们对吸烟的想法和感受的问题。此外，在评估期间的不同时间点，参与者将被随机提示他们对吸烟的想法和感受。实际上，此现场测试将利用病例对照设计，其中广告暴露集的“病例”与随机抽样的非暴露集的“对照组”进行对比。将收集有关EMA使用的可行性、障碍和促进因素的数据，并使用来自现场测试的暴露数据来促进对大学样本中暴露频率及其在体内影响的理解。这项研究将为该领域提供关于如何最有效地评估和模拟香烟广告对吸烟的影响的新信息，并为开展更大规模、更长期的研究提供信息。公共卫生相关性：烟草业重新将广告和营销工作的重点放在年轻人，特别是大学生身上。重要的是要了解有多少大学生接触到这些营销努力，以及它们对他们的吸烟态度和行为有什么影响。了解香烟广告如何以及为什么影响大学生是至关重要的，这对于告知针对大学水平的更有效的预防吸烟计划至关重要。

DESCRIPTION (provided by applicant): There is ample evidence to suggest that a relationship exists between exposure to cigarette advertising and smoking in children and adolescents under the age of 18. Studies documenting this relationship have been extremely varied. They have ranged from highly controlled experimental laboratory studies of small select samples to naturalistic quasi-experimental studies of large diverse populations of middle and high school students. However, this diversity of design and method represents a weakness of this literature: the inherent trade-offs researchers have had to make in choosing study designs, measures, and approaches make it difficult to draw precise conclusions about cigarette advertising effects. In addition, the tobacco industry has turned its marketing attention toward college students so the extent to which the extant literature on cigarette advertising effects can be generalized to older adolescents is not known. The Overall Aim of this revised (A1) project is to adapt ecological momentary assessment (EMA) to address these questions. EMA uses palmtop computers to monitor psychological phenomenon in "real time" and in "real life". It affords the measurement precision of a laboratory setting, and the external validity of naturalistic quasi-experimental field studies. As such, it has significant potential to address the methodological gaps in this domain of inquiry and to markedly improve on the strength of evidence surrounding the relationship between cigarette advertising and smoking behavior in an understudied population. However, EMA has not been used to investigate the relationship between cigarette advertising and smoking. As such, there are real challenges to adapting this methodology to this domain of inquiry and these challenges need to be carefully addressed before it can be used on a larger scale. The first phase of this developmental R21 project will involve a series of formative studies designed to adapt EMA for studying exposure to cigarette advertising in college students. The data from these formative studies will be used to inform the final phase of this project: a short term field test of EMA for studying exposure to cigarette advertising in college students. Participants in the field test will use EMA to record all of their exposures to cigarette advertising and marketing during a 30 day interval, and answer questions about their thoughts and feelings about smoking immediately after each advertising exposure. In addition, participants will be randomly prompted at various points during the assessment interval about their thoughts and feelings about smoking. In effect, then, this field test will utilize a case control design where "cases" of advertising exposure episodes are contrasted with "controls" of randomly sampled non-exposure episodes. Data on feasibility, and barriers and facilitators to EMA use will be collected and exposure data from the field test will be used to advance an understanding of exposure frequency and its effects in vivo in a college sample. This study will provide new information for the field about how to most effectively assess and model the effects of cigarette advertising on smoking, and inform the conduct of larger, longer term studies. PUBLIC HEALTH RELEVANCE: The tobacco industry has refocused its advertising and marketing efforts on young adults in general and college students in particular. It is important to understand how much college students are being exposed to these marketing efforts, and what effects they have on their smoking attitudes and behaviors. Understanding how and why cigarette advertising affects college students is crucial for informing more effective smoking prevention programs aimed at the university level.