- Email: [email protected]
Ethnic Groups in California
Brief Reports
Adolescent Receptivity to Tobacco Marketing by Racial/Ethnic Groups in California Joshua H. West, MPH, Romina A. Romero, MPH, Dennis R. Trinidad, PhD, MPH Background: Previous research has examined tobacco marketing receptivity across racial/ethnic groups but none has done so across the various levels of the smoking uptake continuum. Identifying adolescent groups that may be more or less receptive to industry marketing, particularly across the levels of smoking uptake, provides important information that may be useful in focusing efforts to eliminate smoking disparities. Methods:
Data came from 5857 adolescents (66.6% response rate) from the 2002 California Tobacco Survey and were analyzed in 2006. An index measure of receptivity to tobacco marketing was based on advertisement recall and willingness to use/own a tobacco promotional item. Respondents were classified along a smoking uptake continuum as committed never smokers, susceptible never smokers, or any smoking. Logistic regression models controlling for possible confounding variables were fit to test for the association between receptivity and race/ethnicity across levels of smoking uptake.
Results:
African Americans (odds ratio [OR]⫽0.77; 95% confidence interval [CI]⫽0.61– 0.96) and Asian/Pacific Islanders (OR⫽0.80; 95% CI⫽0.66 – 0.97) were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing after controlling for possible confounders. For susceptible never smokers, African Americans (OR ⫽0.67; 95% CI⫽0.47– 0.93) and Asian/Pacific Islanders (OR⫽0.72; 95% CI⫽0.54 – 0.95) were less likely than non-Hispanic white adolescents to be receptive.
Conclusions: There may be features of the African-American and Asian/Pacific Islander cultures that are protective against receptivity to tobacco marketing, even among those who are susceptible never smokers. Prevention strategies emphasizing such features for adolescents of other races/ethnicities may be beneficial in reducing smoking disparities. (Am J Prev Med 2007;33(2):121–123) © 2007 American Journal of Preventive Medicine
Introduction
T
obacco industry marketing to adolescents has been associated with marked increases in adolescent smoking.1,2 Reports have shown that adolescent smoking rates among African Americans and Asian/Pacific Islanders are lower than those of Hispanics/Latinos and non-Hispanic whites.3,4 These lower rates may be related to less receptivity toward tobacco industry marketing practices.5,6 Previous research, including that by Chen et al.5 has examined tobacco marketing receptivity across race/ethnic groups but none has done so across the various levels of the smoking uptake continuum. Identifying adolescent groups that may be more or less receptive to industry marketing, particularly across levels of smoking uptake,
From the Cancer Prevention and Control, Moore’s UCSD Cancer Center, University of California San Diego, La Jolla, California Address correspondence and reprint requests to: Dennis R. Trinidad, PhD, MPH, Cancer Prevention and Control, Moore’s UCSD Cancer Center, 3855 Health Sciences Drive #0901, La Jolla CA 92093-0901. E-mail: [email protected].
can provide important information that may be useful in focusing efforts to eliminate smoking disparities.
Methods Data Source The California Tobacco Surveys (CTS) are large, populationbased, random-digit-dialed telephone surveys that monitor changes in tobacco use and attitudes in California. They have been conducted every 3 years since as part of the evaluation of the California Tobacco Control program. Data from the 2002 CTS were analyzed for this report. The detailed methods for each CTS are described elsewhere.4 A total of 5857 adolescents aged 12 to 17 years were interviewed (response rate⫽66.6%).
Measures Because the CTS allowed self-identification of more than one race/ethnic category, all who identified themselves as Hispanic/Latino were grouped as such even if they selected other race/ethnic categories. Of the remainder, a similar methodology was applied for all of those who self-identified as African American, followed by Asian/Pacific Islander, and
Am J Prev Med 2007;33(2) © 2007 American Journal of Preventive Medicine • Published by Elsevier Inc.
0749-3797/07/$–see front matter doi:10.1016/j.amepre.2007.03.014
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then non-Hispanic white. This grouping is used in the CTS.4 Information on age and gender was also collected. An index measure of overall receptivity to tobacco marketing was created using three variables. Respondents were coded as “not receptive” if they were unwilling to use a tobacco promotional item, did not have a favorite tobacco advertisement, and reported not having seen a tobacco logo on television during a sporting event in the past year. This is an accepted measure of receptivity that has been previously validated.7,8 A respondent was considered to be at least a smoking experimenter if they had ever tried a cigarette or more (any smoking). Nonsmokers were then asked if they thought they would smoke in the next year, if they would smoke if a friend offered them a cigarette, and if they thought they would try a cigarette soon. Committed never smokers (CNS) were those who responded “definitely not” to all three questions. All other response combinations were classified as susceptible never smokers (SNS). Respondents who had any best friends that smoked were contrasted with respondents who reported having no friends that smoked. Respondents were asked what language they primarily spoke at home; responses were coded as English or non-English. Self-perceived academic achievement was recorded and ranged from much better than average to below average.
Statistical Analysis Analyses were conducted in 2006. The 2002 CTS was weighted so that estimates representative of the entire California population could be computed. Base weights were computed from the probability of household selection and the probability of being selected for an extended interview and were then further adjusted for nonresponse to the latest available California census data. Logistic regression models controlled for age, gender, race/ethnicity, school performance, smoking status, language spoken at home, and best friends’ smoking and were fit to examine race/ethnic differences in tobacco marketing receptivity across smoking uptake levels. For analyses of receptivity by smoking status, CNS adolescents were selected as the comparison group because they were most likely to have the lowest levels of receptivity to tobacco marketing.
Results The mean age of the adolescents surveyed was 14.5 years and about half were male (50.3%). Approximately 6.6% were African American, 9.6% Asian/Pacific Islander, 31.5% Hispanic/Latino, 47.3% non-Hispanic white, and 5% were from other race/ethnic groups. In terms of smoking status, 42.9% were CNS, 40.4% were SNS, and 16.7% were at least experimenters. About 8.8% of African American adolescents were at least experimenters compared with 11.6% of Asian/Pacific Islanders, 17.4% of Hispanics/Latinos, 16.8% of nonHispanic whites, and 19.3% from other groups.
Receptivity to Tobacco Marketing Adolescent receptivity to tobacco marketing increases as adolescents progress from CNS to a smoker of any type. Just 36.5% of CNS were receptive to tobacco marketing, whereas 46.7% of SNS and 56.4% of adolescents that reported any smoking were receptive to tobacco marketing. Approximately 39.1% of AfricanAmerican adolescents were receptive to tobacco marketing, compared with 39.9% of Asian/Pacific Islanders, 41.7% of Hispanics/Latinos, and 46.2% of non-Hispanic whites. Adjusted logistic regression models showed that African Americans (OR⫽0.77; 95% CI⫽0.61– 0.96) and Asian/Pacific Islanders (OR⫽0.80; 95% CI⫽0.66 – 0.97) were significantly less likely than non-Hispanic white adolescents to be receptive to tobacco marketing. Receptivity among Hispanics/Latinos did not differ significantly compared with non-Hispanic whites (OR⫽0.87; 95% CI⫽0.76 –1.01). Table 1 presents the percentages that were receptive, along with the ORs and 95% CIs for receptivity, by race/ethnicity across smoking uptake levels from adjusted logistic regression. For CNS, there were no differences across race/ethnic groups. For SNS, African American (OR⫽0.67; 95% CI⫽0.47– 0.93) and Asian/ Pacific Islander (OR⫽0.72; 95% CI⫽0.54 – 0.95) re-
Table 1. Tobacco marketing receptivity by race/ethnicity and stage of smoking uptake
Non-Hispanic white Asian/Pacific Islander African American Hispanic/Latino Other
Committed never smoker
Susceptible never smoker
% receptive OR (95% CI)
% receptive OR (95% CI)
% receptive OR (95% CI)
Any smoking
38.6% 1.00 35.3% 0.89 (0.67, 1.21) 31.8% 0.73 (0.53, 1.02) 34.2% 0.92 (0.73, 1.61) 35.5% 0.89 (0.59, 1.35)
50.8% 1.00 41.3% 0.72 (0.54, 0.95)* 40.7% 0.67 (0.47, 0.93)* 43.3% 0.82 (0.67, 1.02) 55.7% 1.26 (0.86, 1.85)
57.1% 1.00 50.7% 0.79 (0.47, 1.32) 66.7% 1.46 (0.74, 2.86) 53.5% 0.89 (0.64, 1.24) 66.1% 1.45 (0.82, 2.54)
Note: All models controlled for age, gender, academic achievement, home language, and best friend smoking. *p⬍0.05. CI, confidence interval; OR, odds ratio.
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spondents were less receptive to marketing than nonHispanic white adolescents. Among SNS, receptivity among Hispanics/Latinos did not differ significantly compared with non-Hispanic whites (OR⫽0.82; 95% CI⫽0.67–1.02). Among smokers of any type, there were no differences across race/ethnic groups to tobacco marketing.
classification of Asian/Pacific Islander and Hispanic/ Latino used in the CTS is broad and assumes homogeneity when there are differences across the population subgroups. Future studies may benefit by examining differences among specific subgroups of Asian/Pacific Islanders and Hispanics/Latinos and taking into account acculturation levels.
Discussion
Conclusion
African-American and Asian/Pacific Islander adolescents were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing, after controlling for several possible confounding factors. This is consistent with lower smoking rates among California’s African-American and Asian/Pacific Islander adolescents that are reported elsewhere.9 Also, African-American and Asian/Pacific Islander adolescents who were classified as SNS were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing. These findings suggest that there may be features of the African-American and Asian/ Pacific Islander cultures that not only affect receptivity to tobacco marketing but also contribute to lower smoking rates. Of particular interest is the recent research by Mermelstein showing that African-American and Asian/ Pacific Islander teens reported that their parents expressed very strong mandates against smoking.10 Such strong parental mandates may be associated with both lower marketing receptivity and smoking rates. Prevention strategies that focus on increasing the adoption of such cultural features for adolescents of other race/ ethnic groups may be beneficial and could contribute to reductions in smoking disparities. Differences in receptivity by race/ethnicity were mitigated for those on both ends of the smoking continuum that were categorized for this study (CNS and those who had at least experimented with smoking). Stronger leanings toward not smoking or smoking among adolescents on both ends of the smoking uptake continuum may contribute to less notable differences by race/ethnicity. SNS may be less decisive about their future smoking expectations; therefore, cultural factors such as those described previously may serve to reduce their receptivity to tobacco marketing. It is also possible that for those who have already experimented with smoking, receptivity to marketing is a less sensitive measure. Actual exposure to tobacco marketing could not be assessed, thus the authors cannot be certain that the low receptivity rates among African-American and Asian/Pacific Islander adolescents were not due to less exposure to tobacco marketing. It should also be acknowledged that the authors’ findings may be due to less-effective tobacco industry marketing targeting these groups. Additionally, all measures were self-reported. There is a potential for misreporting of smoking- related behaviors and intentions, especially when the social acceptability of smoking is declining. The
With lower receptivity among African-American and Asian/Pacific Islander adolescents, even those classified as SNS, future studies examining exposure and receptivity to tobacco industry marketing among young adult African Americans and Asian/Pacific Islanders are needed to examine how receptivity develops when the majority of African Americans and Asian/Pacific Islanders initiate smoking.11
August 2007
This work was supported by grant No. 12KT-0158 from the Tobacco-Related Disease Research Program of the University of California and grant No. CA93982-04S1 from the National Cancer Institute. Data for the 2002 California Tobacco Surveys were collected under contract 01-16370 from the California Department of Health Services, Tobacco Control Section, Sacramento, California. No financial conflict of interest was reported by the authors of this paper.
References 1. Pierce JP, Gilpin E, Burns DM, Whalen E, Rosbrook B, Shopland D, Johnson M. Does tobacco advertising target young people to start smoking? Evidence from California. JAMA 1991;266:3154 –58. 2. Pierce JP, Gilpin EA. News media coverage of smoking and health is associated with changes in population rates of smoking cessation but not initiation. Tob Control 2001;10:145–53. 3. US Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups--African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: a report of the surgeon general. 1998. 4. Social Sciences Data Collection University of California San Diego. Final reports, technical documentation, questionnaires and data sets for the California tobacco surveys. 1990 –2002;2003. 5. Chen X, Cruz TB, Schuster DV, Unger JB, Johnson CA. Receptivity to pro-tobacco media and its impact on cigarette smoking among ethnic minority youth in California. J Health Commun 2002;7:95–111. 6. Feighery E, Borzekowski DL, Schooler C, Flora J. Seeing, wanting, owning: the relationship between receptivity to tobacco marketing and smoking susceptibility in young people. Tob Control 1998;7:123–28. 7. Pierce J, Choi W, Gilpin E, Farkas A, Berry C. Tobacco industry promotion of cigarettes and adolescent smoking. JAMA 1998;279:511–15. 8. Pierce J, Distefan J, Kaplan R, Gilpin E. The role of curiosity in smoking initiation. Addict Behav 2005;30:685–96. 9. Gilpin EA, White MM, White VM, Distefan JM, Trinidad DR, James L, Lee L, Major J, Kealey S, Pierce JP. Tobacco control successes in California: a focus on young people, results from the California tobacco surveys, 1992–2002. 2004. 10. Mermelstein R. Explanations of ethnic and gender differences in youth smoking: a multi-site, qualitative investigation. The tobacco control network writing group. Nicotine Tob Res 1999;1:S91– 8. 11. Trinidad DR, Gilpin EA, Lee L, Pierce JP. Do the majority of Asian American and African American smokers start as adults? Am J Prev Med 2004;26:156 –58.
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Adolescent Receptivity to Tobacco Marketing by Racial/Ethnic Groups in California Joshua H. West, MPH, Romina A. Romero, MPH, Dennis R. Trinidad, PhD, MPH Background: Previous research has examined tobacco marketing receptivity across racial/ethnic groups but none has done so across the various levels of the smoking uptake continuum. Identifying adolescent groups that may be more or less receptive to industry marketing, particularly across the levels of smoking uptake, provides important information that may be useful in focusing efforts to eliminate smoking disparities. Methods:
Data came from 5857 adolescents (66.6% response rate) from the 2002 California Tobacco Survey and were analyzed in 2006. An index measure of receptivity to tobacco marketing was based on advertisement recall and willingness to use/own a tobacco promotional item. Respondents were classified along a smoking uptake continuum as committed never smokers, susceptible never smokers, or any smoking. Logistic regression models controlling for possible confounding variables were fit to test for the association between receptivity and race/ethnicity across levels of smoking uptake.
Results:
African Americans (odds ratio [OR]⫽0.77; 95% confidence interval [CI]⫽0.61– 0.96) and Asian/Pacific Islanders (OR⫽0.80; 95% CI⫽0.66 – 0.97) were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing after controlling for possible confounders. For susceptible never smokers, African Americans (OR ⫽0.67; 95% CI⫽0.47– 0.93) and Asian/Pacific Islanders (OR⫽0.72; 95% CI⫽0.54 – 0.95) were less likely than non-Hispanic white adolescents to be receptive.
Conclusions: There may be features of the African-American and Asian/Pacific Islander cultures that are protective against receptivity to tobacco marketing, even among those who are susceptible never smokers. Prevention strategies emphasizing such features for adolescents of other races/ethnicities may be beneficial in reducing smoking disparities. (Am J Prev Med 2007;33(2):121–123) © 2007 American Journal of Preventive Medicine
Introduction
T
obacco industry marketing to adolescents has been associated with marked increases in adolescent smoking.1,2 Reports have shown that adolescent smoking rates among African Americans and Asian/Pacific Islanders are lower than those of Hispanics/Latinos and non-Hispanic whites.3,4 These lower rates may be related to less receptivity toward tobacco industry marketing practices.5,6 Previous research, including that by Chen et al.5 has examined tobacco marketing receptivity across race/ethnic groups but none has done so across the various levels of the smoking uptake continuum. Identifying adolescent groups that may be more or less receptive to industry marketing, particularly across levels of smoking uptake,
From the Cancer Prevention and Control, Moore’s UCSD Cancer Center, University of California San Diego, La Jolla, California Address correspondence and reprint requests to: Dennis R. Trinidad, PhD, MPH, Cancer Prevention and Control, Moore’s UCSD Cancer Center, 3855 Health Sciences Drive #0901, La Jolla CA 92093-0901. E-mail: [email protected].
can provide important information that may be useful in focusing efforts to eliminate smoking disparities.
Methods Data Source The California Tobacco Surveys (CTS) are large, populationbased, random-digit-dialed telephone surveys that monitor changes in tobacco use and attitudes in California. They have been conducted every 3 years since as part of the evaluation of the California Tobacco Control program. Data from the 2002 CTS were analyzed for this report. The detailed methods for each CTS are described elsewhere.4 A total of 5857 adolescents aged 12 to 17 years were interviewed (response rate⫽66.6%).
Measures Because the CTS allowed self-identification of more than one race/ethnic category, all who identified themselves as Hispanic/Latino were grouped as such even if they selected other race/ethnic categories. Of the remainder, a similar methodology was applied for all of those who self-identified as African American, followed by Asian/Pacific Islander, and
Am J Prev Med 2007;33(2) © 2007 American Journal of Preventive Medicine • Published by Elsevier Inc.
0749-3797/07/$–see front matter doi:10.1016/j.amepre.2007.03.014
121
then non-Hispanic white. This grouping is used in the CTS.4 Information on age and gender was also collected. An index measure of overall receptivity to tobacco marketing was created using three variables. Respondents were coded as “not receptive” if they were unwilling to use a tobacco promotional item, did not have a favorite tobacco advertisement, and reported not having seen a tobacco logo on television during a sporting event in the past year. This is an accepted measure of receptivity that has been previously validated.7,8 A respondent was considered to be at least a smoking experimenter if they had ever tried a cigarette or more (any smoking). Nonsmokers were then asked if they thought they would smoke in the next year, if they would smoke if a friend offered them a cigarette, and if they thought they would try a cigarette soon. Committed never smokers (CNS) were those who responded “definitely not” to all three questions. All other response combinations were classified as susceptible never smokers (SNS). Respondents who had any best friends that smoked were contrasted with respondents who reported having no friends that smoked. Respondents were asked what language they primarily spoke at home; responses were coded as English or non-English. Self-perceived academic achievement was recorded and ranged from much better than average to below average.
Statistical Analysis Analyses were conducted in 2006. The 2002 CTS was weighted so that estimates representative of the entire California population could be computed. Base weights were computed from the probability of household selection and the probability of being selected for an extended interview and were then further adjusted for nonresponse to the latest available California census data. Logistic regression models controlled for age, gender, race/ethnicity, school performance, smoking status, language spoken at home, and best friends’ smoking and were fit to examine race/ethnic differences in tobacco marketing receptivity across smoking uptake levels. For analyses of receptivity by smoking status, CNS adolescents were selected as the comparison group because they were most likely to have the lowest levels of receptivity to tobacco marketing.
Results The mean age of the adolescents surveyed was 14.5 years and about half were male (50.3%). Approximately 6.6% were African American, 9.6% Asian/Pacific Islander, 31.5% Hispanic/Latino, 47.3% non-Hispanic white, and 5% were from other race/ethnic groups. In terms of smoking status, 42.9% were CNS, 40.4% were SNS, and 16.7% were at least experimenters. About 8.8% of African American adolescents were at least experimenters compared with 11.6% of Asian/Pacific Islanders, 17.4% of Hispanics/Latinos, 16.8% of nonHispanic whites, and 19.3% from other groups.
Receptivity to Tobacco Marketing Adolescent receptivity to tobacco marketing increases as adolescents progress from CNS to a smoker of any type. Just 36.5% of CNS were receptive to tobacco marketing, whereas 46.7% of SNS and 56.4% of adolescents that reported any smoking were receptive to tobacco marketing. Approximately 39.1% of AfricanAmerican adolescents were receptive to tobacco marketing, compared with 39.9% of Asian/Pacific Islanders, 41.7% of Hispanics/Latinos, and 46.2% of non-Hispanic whites. Adjusted logistic regression models showed that African Americans (OR⫽0.77; 95% CI⫽0.61– 0.96) and Asian/Pacific Islanders (OR⫽0.80; 95% CI⫽0.66 – 0.97) were significantly less likely than non-Hispanic white adolescents to be receptive to tobacco marketing. Receptivity among Hispanics/Latinos did not differ significantly compared with non-Hispanic whites (OR⫽0.87; 95% CI⫽0.76 –1.01). Table 1 presents the percentages that were receptive, along with the ORs and 95% CIs for receptivity, by race/ethnicity across smoking uptake levels from adjusted logistic regression. For CNS, there were no differences across race/ethnic groups. For SNS, African American (OR⫽0.67; 95% CI⫽0.47– 0.93) and Asian/ Pacific Islander (OR⫽0.72; 95% CI⫽0.54 – 0.95) re-
Table 1. Tobacco marketing receptivity by race/ethnicity and stage of smoking uptake
Non-Hispanic white Asian/Pacific Islander African American Hispanic/Latino Other
Committed never smoker
Susceptible never smoker
% receptive OR (95% CI)
% receptive OR (95% CI)
% receptive OR (95% CI)
Any smoking
38.6% 1.00 35.3% 0.89 (0.67, 1.21) 31.8% 0.73 (0.53, 1.02) 34.2% 0.92 (0.73, 1.61) 35.5% 0.89 (0.59, 1.35)
50.8% 1.00 41.3% 0.72 (0.54, 0.95)* 40.7% 0.67 (0.47, 0.93)* 43.3% 0.82 (0.67, 1.02) 55.7% 1.26 (0.86, 1.85)
57.1% 1.00 50.7% 0.79 (0.47, 1.32) 66.7% 1.46 (0.74, 2.86) 53.5% 0.89 (0.64, 1.24) 66.1% 1.45 (0.82, 2.54)
Note: All models controlled for age, gender, academic achievement, home language, and best friend smoking. *p⬍0.05. CI, confidence interval; OR, odds ratio.
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spondents were less receptive to marketing than nonHispanic white adolescents. Among SNS, receptivity among Hispanics/Latinos did not differ significantly compared with non-Hispanic whites (OR⫽0.82; 95% CI⫽0.67–1.02). Among smokers of any type, there were no differences across race/ethnic groups to tobacco marketing.
classification of Asian/Pacific Islander and Hispanic/ Latino used in the CTS is broad and assumes homogeneity when there are differences across the population subgroups. Future studies may benefit by examining differences among specific subgroups of Asian/Pacific Islanders and Hispanics/Latinos and taking into account acculturation levels.
Discussion
Conclusion
African-American and Asian/Pacific Islander adolescents were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing, after controlling for several possible confounding factors. This is consistent with lower smoking rates among California’s African-American and Asian/Pacific Islander adolescents that are reported elsewhere.9 Also, African-American and Asian/Pacific Islander adolescents who were classified as SNS were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing. These findings suggest that there may be features of the African-American and Asian/ Pacific Islander cultures that not only affect receptivity to tobacco marketing but also contribute to lower smoking rates. Of particular interest is the recent research by Mermelstein showing that African-American and Asian/ Pacific Islander teens reported that their parents expressed very strong mandates against smoking.10 Such strong parental mandates may be associated with both lower marketing receptivity and smoking rates. Prevention strategies that focus on increasing the adoption of such cultural features for adolescents of other race/ ethnic groups may be beneficial and could contribute to reductions in smoking disparities. Differences in receptivity by race/ethnicity were mitigated for those on both ends of the smoking continuum that were categorized for this study (CNS and those who had at least experimented with smoking). Stronger leanings toward not smoking or smoking among adolescents on both ends of the smoking uptake continuum may contribute to less notable differences by race/ethnicity. SNS may be less decisive about their future smoking expectations; therefore, cultural factors such as those described previously may serve to reduce their receptivity to tobacco marketing. It is also possible that for those who have already experimented with smoking, receptivity to marketing is a less sensitive measure. Actual exposure to tobacco marketing could not be assessed, thus the authors cannot be certain that the low receptivity rates among African-American and Asian/Pacific Islander adolescents were not due to less exposure to tobacco marketing. It should also be acknowledged that the authors’ findings may be due to less-effective tobacco industry marketing targeting these groups. Additionally, all measures were self-reported. There is a potential for misreporting of smoking- related behaviors and intentions, especially when the social acceptability of smoking is declining. The
With lower receptivity among African-American and Asian/Pacific Islander adolescents, even those classified as SNS, future studies examining exposure and receptivity to tobacco industry marketing among young adult African Americans and Asian/Pacific Islanders are needed to examine how receptivity develops when the majority of African Americans and Asian/Pacific Islanders initiate smoking.11
August 2007
This work was supported by grant No. 12KT-0158 from the Tobacco-Related Disease Research Program of the University of California and grant No. CA93982-04S1 from the National Cancer Institute. Data for the 2002 California Tobacco Surveys were collected under contract 01-16370 from the California Department of Health Services, Tobacco Control Section, Sacramento, California. No financial conflict of interest was reported by the authors of this paper.
References 1. Pierce JP, Gilpin E, Burns DM, Whalen E, Rosbrook B, Shopland D, Johnson M. Does tobacco advertising target young people to start smoking? Evidence from California. JAMA 1991;266:3154 –58. 2. Pierce JP, Gilpin EA. News media coverage of smoking and health is associated with changes in population rates of smoking cessation but not initiation. Tob Control 2001;10:145–53. 3. US Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups--African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: a report of the surgeon general. 1998. 4. Social Sciences Data Collection University of California San Diego. Final reports, technical documentation, questionnaires and data sets for the California tobacco surveys. 1990 –2002;2003. 5. Chen X, Cruz TB, Schuster DV, Unger JB, Johnson CA. Receptivity to pro-tobacco media and its impact on cigarette smoking among ethnic minority youth in California. J Health Commun 2002;7:95–111. 6. Feighery E, Borzekowski DL, Schooler C, Flora J. Seeing, wanting, owning: the relationship between receptivity to tobacco marketing and smoking susceptibility in young people. Tob Control 1998;7:123–28. 7. Pierce J, Choi W, Gilpin E, Farkas A, Berry C. Tobacco industry promotion of cigarettes and adolescent smoking. JAMA 1998;279:511–15. 8. Pierce J, Distefan J, Kaplan R, Gilpin E. The role of curiosity in smoking initiation. Addict Behav 2005;30:685–96. 9. Gilpin EA, White MM, White VM, Distefan JM, Trinidad DR, James L, Lee L, Major J, Kealey S, Pierce JP. Tobacco control successes in California: a focus on young people, results from the California tobacco surveys, 1992–2002. 2004. 10. Mermelstein R. Explanations of ethnic and gender differences in youth smoking: a multi-site, qualitative investigation. The tobacco control network writing group. Nicotine Tob Res 1999;1:S91– 8. 11. Trinidad DR, Gilpin EA, Lee L, Pierce JP. Do the majority of Asian American and African American smokers start as adults? Am J Prev Med 2004;26:156 –58.
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