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Direct-To-Consumer Tobacco Marketing and Its Association With Tobacco Use Among Adolescents and Young Adults

  • Soneji, Samir
  • Ambrose, Bridget K.
  • Lee, Won
  • Sargent, James
  • Tanski, Susanne1, 2, 3, 2, 4, 5, 6
  • 1 Norris Cotton Cancer Center
  • 2 Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
  • 3 Dartmouth Institute for Health Policy & Clinical Practice
  • 4 Office of Science
  • 5 Center for Tobacco Products
  • 6 U.S. Food and Drug Administration, Rockville, Maryland
Published Article
Journal of Adolescent Health
Publication Date
Jan 01, 2014
Accepted Date
Jan 24, 2014
DOI: 10.1016/j.jadohealth.2014.01.019


ObjectiveWe assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (current), and smoking ≥100 cigarettes in lifetime (established) among adolescents and young adults. MethodsWe surveyed a U.S. telephone sample of 3,342 15- to 23-year-olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N = 2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. ResultsOverall, 12% of 15- to 17-year-olds and 26% of 18- to 23-year-olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority nonsmoking respondents were more likely to see tobacco websites than nonsmoking whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio 2.2, 95% confidence interval 1.3–3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (adjusted odds ratio 2.7, 95% confidence interval 1.1–6.6). We observed similar relationships for ever having tried smoking and established smoking. ConclusionsDirect-to-consumer tobacco marketing reaches adolescent and young adult nonsmokers and is associated with smoking behavior.

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