Nicholas Peiper1, Camila Aramburú2, Kirsten Thompson3, Melissa Abadi4. 1. Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA; Department of Epidemiology and Population Health, University of Louisville, 485 East Gray Street, Louisville 40202, KY, USA. Electronic address: npeiper@pire.org. 2. Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA. Electronic address: caramburu@pire.org. 3. Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA. Electronic address: kthompson@pire.org. 4. Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville 40202, KY, USA. Electronic address: mabadi@pire.org.
Abstract
BACKGROUND: This study identified patterns of tobacco marketing exposures among youth and examined their associations with substance use and tobacco prevention strategies. METHODS: In Fall 2018, 2,058 middle and high school students (ages 11-18) in an Appalachian county completed a substance use and behavioral health surveillance survey. We conducted latent class analysis (LCA) to identify exposure classes based on responses to 14 tobacco marketing exposures. Multinomial logistic regression was then performed to determine associations between the latent classes with past 30-day substance use and tobacco prevention strategies (e.g., school policies, parental rules, prevention messages). RESULTS: Four latent classes of marketing exposure were identified among middle school students: low exposure, television, social media, and high exposure. Multinomial logistic regression found significant associations between e-cigarette use with the social media and high exposure classes, while prescription drug use was associated with the social media class and alcohol use with the high exposure class. For high school students, five classes were identified: low exposure, social media, environmental, cigarettes, and high exposure. E-cigarette and prescription drug use were associated with the social media and high exposure classes. Cigarette use was associated with the social media class. School rules prohibiting e-cigarettes were associated with the television class for middle school students. Self-reported exposure to prevention messages about the harms of tobacco were associated with multiple exposure classes for both middle (television and social media) and high school (social media and cigarettes) students, suggesting that both pro- and anti-tobacco communications have become ubiquitous and may be saturating youth. CONCLUSION: This study demonstrates the need for stricter tobacco marketing regulations and multi-level interventions beginning in early adolescence that focus on increasing media-based literacy for youth to better discern tobacco prevention messages from pro-tobacco communications.
BACKGROUND: This study identified patterns of tobacco marketing exposures among youth and examined their associations with substance use and tobacco prevention strategies. METHODS: In Fall 2018, 2,058 middle and high school students (ages 11-18) in an Appalachian county completed a substance use and behavioral health surveillance survey. We conducted latent class analysis (LCA) to identify exposure classes based on responses to 14 tobacco marketing exposures. Multinomial logistic regression was then performed to determine associations between the latent classes with past 30-day substance use and tobacco prevention strategies (e.g., school policies, parental rules, prevention messages). RESULTS: Four latent classes of marketing exposure were identified among middle school students: low exposure, television, social media, and high exposure. Multinomial logistic regression found significant associations between e-cigarette use with the social media and high exposure classes, while prescription drug use was associated with the social media class and alcohol use with the high exposure class. For high school students, five classes were identified: low exposure, social media, environmental, cigarettes, and high exposure. E-cigarette and prescription drug use were associated with the social media and high exposure classes. Cigarette use was associated with the social media class. School rules prohibiting e-cigarettes were associated with the television class for middle school students. Self-reported exposure to prevention messages about the harms of tobacco were associated with multiple exposure classes for both middle (television and social media) and high school (social media and cigarettes) students, suggesting that both pro- and anti-tobacco communications have become ubiquitous and may be saturating youth. CONCLUSION: This study demonstrates the need for stricter tobacco marketing regulations and multi-level interventions beginning in early adolescence that focus on increasing media-based literacy for youth to better discern tobacco prevention messages from pro-tobacco communications.
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