Author ORCID Identifier


Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Jidong Huang

Second Advisor

Scott R. Weaver

Third Advisor

Claire A. Spears

Fourth Advisor

Pamela Ling

Fifth Advisor

Michael P. Eriksen

Sixth Advisor

Terry F. Pechacek


Research on the differences in tobacco use among youth by racial/ethnic subgroups is limited. Few studies comprehensively examined the racial/ethnic disparities in tobacco advertising exposure via various marketing channels and the potential mechanisms through which these advertisements promote tobacco use. This dissertation addresses these critical gaps in three interconnected yet independent studies, which investigated past 30-day (current) tobacco product use among U.S. youth by racial/ethnic subgroups in 2013-2019 (first study), examined racial/ethnic disparities in exposure to e-cigarette advertising (second study), and examined the mediating effects of harm perceptions on the association between e-cigarette advertising exposure and subsequent e-cigarette use (third study).

Using data from the Population Assessment of Tobacco and Health (Wave 1 – 5), the first study found substantial differences in e-cigarette use and any tobacco use across certain racial/ethnic subgroups, which was not reported in previous studies. The second study revealed a high level of exposure to e-cigarette advertisements among youth in 2018 (79.8%, 95%CI: 77.1-82.2) and in 2019 (74.9%, 95%CI: 72.5-77.1). It also found that non-Hispanic Black and non-Hispanic Asian youth were more likely to be exposed to e-cigarette advertisements through television and online/social media channels compared with non-Hispanic White youth. The third study found that the indirect effect of e-cigarette advertisements on current e-cigarette use through absolute (or relative) harm perceptions of using e-cigarettes was significant for advertising exposure through multiple marketing channels.

The findings from this dissertation provide new insights into the research on youth tobacco use. The results suggest that certain racial/ethnic youth subgroups (i.e., Korean, Hispanic Cuban, and Puerto Rican) are at higher risks of tobacco use and may require targeted prevention efforts. In addition, stronger regulations may be needed to restrict tobacco advertisements targeting youth, particularly those targeting racially and ethnically minoritized youth subpopulations. In addition, anti-tobacco media campaigns may be more effective if the messaging takes into account the harm perception of tobacco use among U.S. youth.


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