Author

Yu WangFollow

Author ORCID Identifier

https://orcid.org/0000-0002-1481-5329

Date of Award

Spring 5-13-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Health

First Advisor

Jidong Huang

Second Advisor

Scott R. Weaver

Third Advisor

David L. Ashley

Fourth Advisor

Shannon R. Self-Brown

Fifth Advisor

Sherry L. Emery

Abstract

This dissertation aims to examine the role of anti-tobacco campaign and tobacco marketing in tobacco use behaviors among US adults and adolescents. Study One examined the association between Tips From Former Smokers (Tips) campaign exposure and smoking cessation behaviors, and explored potential differences between adult heterosexual smokers and sexual minoritized smokers. Study Two investigated the short-term and longer-term associations between receipt of cigarette discounts/coupons and smoking cessation among adult smokers with intention to quit. Study Three estimated e-cigarette advertising exposure and its association with e-cigarette initiation and susceptibility among US adolescents.

Study One used data from the Population Assessment of Tobacco and Health (PATH) study Adult Cohort Wave 5 survey, and found that frequent Tips exposure was associated with higher odds of quit intentions and attempts overall. However, these associations were significantly stronger for heterosexual smokers than sexual minorized smokers, as indicated by the significant interaction terms (aOR=0.58, 95% CI=0.36-0.96 for intention to quit within 12 months; aOR=0.41, 95% CI=0.24-0.70 for serious quit attempts in the past 12 month; and aOR=0.40, 95% CI=0.24-0.67 for number of serious quit attempts in the past 12 months). Study Two used data from the PATH study Adult Cohort Wave 3, 4, and 5 surveys, and found that baseline current established cigarette smokers who received cigarette discounts/coupons at baseline were less likely to quit completely at one-year follow-up (aOR=0.66, 95% CI=0.48-0.90) and at two-year follow-up (aOR=0.74, 95% CI=0.61-0.90). Study Three used data from the PATH study Youth Cohort Wave 4, 4.5, and 5 surveys, and found that more than 60% of US adolescents were exposed to e-cigarette advertising in the past 30 days in 2017-2019. Among adolescents who had never used e-cigarettes, those who reported e-cigarette advertising exposure were more likely to feel curious about using e-cigarettes (aOR=1.56, 95% CI=1.43-1.70), and more likely to become ever e-cigarette users (aOR=1.21, 95% CI=1.05-1.41) and current e-cigarette users (aOR=1.42, 95% CI=1.16-1.75) at follow-up.

Efforts are needed to increase the reach and exposure frequency of anti-tobacco campaigns. Targeted interventions and services are needed to increase tobacco cessation among vulnerable populations. Stronger regulations are needed to restrict tobacco marketing.

DOI

https://doi.org/10.57709/28697757

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