Racial differences in cigarette brand recognition and impact on youth smoking

Abstract

BackgroundAfrican Americans are disproportionately exposed to cigarette advertisements, particularly for menthol brands. Tobacco industry documents outline strategic efforts to promote menthol cigarettes to African Americans at the point of sale, and studies have observed more outdoor and retail menthol advertisements in neighborhoods with more African-American residents. Little research has been conducted to examine the effect of this target marketing on adolescents’ recognition of cigarette brand advertising and on smoking uptake. To our knowledge, this is the first study to examine racial differences in brand recognition and to assess the prospective relationship between brand recognition and smoking uptake.MethodsSchool-based surveys assessing tobacco use and environmental and social influences to smoke were administered to 6th through 9th graders (ages 11 to 15) in an urban and racially diverse California school district. The primary outcome for the cross-sectional analysis (n = 2,589) was brand recognition, measured by students’ identification of masked tobacco advertisements from the point of sale. The primary outcome for the longitudinal analysis (n = 1,179) was progression from never to ever smoking within 12 months.ResultsAt baseline, 52% of students recognized the Camel brand, 36% Marlboro, and 32% Newport. African-American students were three times more likely than others to recognize Newport (OR = 3.03, CI = 2.45, 3.74, p < 0.01) and less likely than others to recognize Marlboro (OR = 0.60, CI = 0.48, 0.73, p < 0.01). At follow-up, 17% of never smokers reported trying smoking. In this racially diverse sample, brand recognition of Camel and Marlboro did not predict smoking initiation. Regardless of race, students who recognized the Newport brand at baseline were more likely to initiate smoking at follow-up (OR = 1.49, CI = 1.04, 2.15, p < 0.05) after adjusting for shopping frequency and other risk factors.ConclusionsThe study findings illustrate that African-American youth are better able to recognize Newport cigarette advertisements, even after adjustment for exposure to smoking by parents and peers. In addition, recognition of Newport cigarette advertising predicted smoking initiation, regardless of race. This longitudinal study contributes to a growing body of evidence that supports a ban on menthol flavored cigarettes in the US as well as stronger regulation of tobacco advertising at the point of sale.

Point-of-sale tobacco promotion and youth smoking: a meta-analysis

“…The main limitation to this meta-analysis is that, with the exception of two cohort studies,18 25 the studies included were cross-sectional, thus limiting a causal inference. However, as noted previously,9 the use of the smoking susceptibility outcome in cross-sectional studies provides greater confidence about the causal influence of POS tobacco promotion on smoking risk, compared with current smoking or ever-smoking.…”

An Official American Thoracic Society Research Statement: Current Understanding and Future Research Needs in Tobacco Control and Treatment

“…African American students aged 11 to 15 years were three times more likely than other students to recognize the Newport brand and less likely to recognize Marlboro. Regardless of race, recognition of Newport cigarette advertising at baseline was associated with higher rates of smoking initiation within 12 months (40).…”

The influence of menthol, e-cigarettes and other tobacco products on young adults’ self-reported changes in past year smoking

“…Menthol's appeal to young, inexperienced smokers is due in part to its ability to mask the harshness of tobacco smoke, making cigarettes easier to smoke 8. As such, recent studies have examined the role of menthol cigarettes in smoking progression among youth 9 10. Others have expressed concern that electronic cigarettes (e-cigarettes) may also serve as a gateway to nicotine addiction and subsequent cigarette use among adolescents 11 12.…”