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  • How U.S. adults describe various tobacco products and marijuana: The successes and failures of tobacco industry marketing and public health

    Background: Use rates of alternative tobacco products and marijuana have increased, as have marketing efforts to alter perceptions and ultimately promote use. Thus, we examined the extent to which positive, negative, and neutral descriptors were associated with various tobacco products and marijuana among adults in the U.S. Design/Methods: In 2013, we conducted a cross-sectional survey among 2,500 U.S. adults recruited through an online survey panel. We assessed tobacco and marijuana use and which of 24 positive, negative, and neutral descriptive words participants associated with tobacco products and marijuana. We conducted descriptive, bivariate, and multivariate analyses to examine prevalence and correlates of these perceptions. Results: In the past month, 36.7% used cigarettes, 5.7% large cigars, 6.6% little cigars, 4.9% cigarillos, 3.5% hookah, 7.6% e-cigarettes, 3.7% chew, and 9.9% marijuana. We identified the two descriptors most commonly associated with each product: cigarettes - addictive (70.5%) and smelly (60.0%); cigars - smelly (53.8%) and risky (45.7%); hookah - unattractive (34.3%) and risky (36.9%); e-cigarettes - unattractive (32.0%) and risky (26.5%); chew - gross (56.3%) and unattractive (55.0%); and marijuana - smelly (47.2) and risky (53.9%). We also examined which product was most commonly associated with each descriptor: cigarettes - addictive (70.5%); social (24.7%); stressed out (33.7%); depressed (21.8%); glamorous (4.8%); smelly (60.0%); and risky (54.1%); cigars - sophisticated (9.9%); macho (14.3%); and mature (12.1%); hookah - sexy (5.6%); worldly (13.5%); and exotic (18.1%); e-cigarettes - safe (18.6%) and trendy or hip (13.0%); chew - rugged (15.7%); gross (56.3%); dirty (53.3%); and unattractive (55.0%); and marijuana - rebellious (33.9%); youthful (17.5%); party (39.7%); cool (9.8%); and intriguing (9.4%). Conclusion: The attributes assigned to these products align with strategies attempting to promote these products. However, these products are generally perceived negatively, indicating that there are ample opportunities to leverage the negative perceptions of tobacco and marijuana toward the prevention of use. This information could inform counter-marketing efforts. Berg, C. J. & Lewis, M. (2015, March). How U.S. adults describe various tobacco products and marijuana: The successes and failures of tobacco industry marketing and public health. Presentation at the 2015 World Conference on Tobacco or Health, Abu Dhabi, United Arab Emirates.

  • How US adults find out about electronic cigarettes: Implications for public health messages

    Introduction: Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that have become increasingly popular in the United States. We sought to understand how U.S. adults hear about e-cigarettes. Methods: A U.S. national sample of 17,522 adults (?18 years old) completed an online survey in March 2013 assessing their awareness of and sources of information about e-cigarettes. Results: Most respondents (86%) had heard of e-cigarettes. Current and former smokers were more likely to be aware of e-cigarettes than non-smokers. Males, younger adults, non-Hispanic Whites, and those with higher education were also more likely to have heard of e-cigarettes than females, older adults, other races or ethnicities, or those with lower education. The most commonly reported sources of information were another person, ads on television, and seeing e-cigarettes being sold, although the relative frequency of these sources differed for current, former, and never-smokers. Former and current smokers were more likely to have heard about e-cigarettes from e-cigarette users than were never-smokers. Adults age 30 or younger were more likely than adults over age 30 to have heard about e-cigarettes online. Conclusions: Nearly all U.S. adults had heard of e-cigarettes in 2013. By focusing on the most common channels of information, public health campaigns can more efficiently communicate information about e-cigarette safety and consider necessary regulations should companies use these channels for marketing that targets youth, non-tobacco users, and other at-risk groups.

  • If a picture paints a thousand words, what do millions of pictures and words do?

    SRNT, Chicago, IL, 2016. Emery S. If a picture paints a thousand words, what do millions of pictures and words do? Presentation at the Pre-conference Conference, March 1.

  • Impact of alcohol use and bar attendance on smoking and quit attempts among young adult bar patrons

    Objectives. We examined cigarette smoking and quit attempts in the context of alcohol use and bar attendance among young adult bar patrons with different smoking patterns. Methods. We used randomized time location sampling to collect data among adult bar patrons aged 21 to 26 years in San Diego, California (n=1235; response rate=73%). We used multinomial and multivariate logistic regression models to analyze the association between smoking and quit attempts and both drinking and binge drinking among occasional, regular, very light, and heavier smokers, controlling for age, gender, race/ethnicity, and education. Results. Young adult bar patrons reported high rates of smoking and co-use of cigarettes and alcohol. Binge drinking predicted smoking status, especially occasional and very light smoking. All types of smokers reported alcohol use, and bar attendance made it harder to quit. Alcohol use was negatively associated with quit attempts for very light smokers, but positively associated with quitting among heavier smokers. Conclusions. Smoking and co-use of cigarettes and alcohol are common among young adult bar patrons, but there are important differences by smoking patterns. Tobacco interventions for young adults should prioritize bars and address alcohol use.

  • Impact of the 2009 Federal Tobacco Excise Tax Increase on Youth tobacco Use

  • Implementing the Smoke-Free Homes program through 2-1-1s: Five grant awardees share their experiences.

    Implementing the Smoke-Free Homes program through 2-1-1s: Five grant awardees share their experiences. Kreuter MW, Bundy L, Harvey D, House D, Rittmann S, Kahl T. (May 24, 2016). Presented at The Alliance of Information & Referral Systems’ 38th Annual I&R Training and Education Conference, St. Louis, MO.

  • Increasing trust in social media research through improving disclosure standards

    Kostygina G, Emery S, et al. (2017, May). Increasing trust in social media research through improving disclosure standards. 72nd American Association for Opinion Research Annual Meeting, New Orleans, LA.

  • Inferring social influence of anti-tobacco mass media campaigns

    Zhan Q, Zhang J, Yu P, Emery S, Xie J (2016, December). Inferring social influence of anti-tobacco mass media campaigns. IEEE International Conference on Bioinformatics and Biomedicine Conference Proceedings, Shenzhen, China.

  • Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades?

    This paper reviews the literature on smoking cessation interventions, with a focus on the last 20?years (1991 to 2010). These two decades witnessed major development in a wide range of cessation interventions, from pharmacotherapy to tobacco price increases. It was expected that these interventions would work conjointly to increase the cessation rate on the population level. This paper examines population data from the USA, from 1991 to 2010, using the National Health Interview Surveys. Results indicate there is no consistent trend of increase in the population cessation rate over the last two decades. Various explanations are presented for this lack of improvement, and the key concept of impact = effectiveness × reach is critically examined. Finally, it suggests that the field of cessation has focused so much on developing and promoting interventions to improve smokers' odds of success that it has largely neglected to investigate how to get more smokers to try to quit and to try more frequently. Future research should examine whether increasing the rate of quit attempts would be key to improving the population cessation rate.

  • Intragroup variance in LGB tobacco use behaviors: Evidence that subgroups matter, notably bisexual women

    Introduction: Emerging evidence suggests bisexual populations are at increased risk for a variety of negative health outcomes, including tobacco use. Lesbian, gay, and bisexual (LGB) populations are at increased risk for cigarette smoking, but research on LGB subpopulations’ use of tobacco products beyond cigarettes and tobacco use differences across LGB subgroups is in its infancy. This study explores differences in use of tobacco products across LGB subgroups, including gender differences among bisexuals. Methods: This study reports results from a 2013 nationally-representative cross-sectional online survey of US adults (N = 17 087). Weighted tobacco use prevalence and adjusted logistic regression results are reported. Results: LGB populations reported higher current use of any tobacco product (35.7%) and current use of cigarettes (32.0%), e-cigarettes (8.9%), regular (5.5%) and small cigars (11.6%), compared with non-LGB. Bisexual (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 1.7–3.9) and lesbian (OR = 1.7, 95% CI: 1.0–2.7) women have higher odds of any tobacco use than heterosexual women; including greater odds of regular (OR = 2.9, 95% CI: 1.2–7.0 and OR = 2.2, 95% CI: 1.3–3.9; respectively) and small cigar use (OR = 2.4, 95% CI: 1.4–4.1 and OR = 3.2, 95% CI: 2.0–5.1; respectively). Gay men had lower odds of cigar use (OR = 0.4, 95% CI: 0.2–0.8) than heterosexual men. Conclusions: This is the first US adult population study to assess differences in use of various tobacco products across adult LGB subpopulations and by gender, confirming their increased risk of use and illuminating differences by subgroup and gender. Exploring LGB as a unified population appears inadequate to accurately characterize LGB tobacco use risk. Tobacco-related LGB health inequities, particularly among bisexual and lesbian women, may be greater than previously indicated. Implications: This manuscript provides important contributions to the field of tobacco control and prevention, and more specifically to LGB tobacco-related health disparities research. This is among the first population level studies to explore various tobacco use across LGB populations and across genders, comparing results to non-LGB populations in a national study. We provide novel evidence that bisexual women in particular, have a higher risk for use of various tobacco products, compared with other LGB subpopulations. In order to address this disparity, tobacco control professionals need to be made aware of these important differences in tobacco use behavior.