Advertising Receptivity and Youth Initiation of Smokeless Tobacco

ABSTRACT

Background: Cross-sectional data suggests that adolescents’ receptivity to the advertising of smokeless tobacco is correlated with use of chewing tobacco or snuff. Lack of longitudinal data has precluded determination of whether advertising receptivity precedes or follows initiation of smokeless tobacco. Objectives: The objective of this study was to test for the association between advertising receptivity and subsequent initiation of smokeless tobacco among adolescent males. Methods: Adolescent males from the 1993–1999 Teen Longitudinal California Tobacco Survey were selected at the baseline survey for never having used smokeless tobacco. Separate longitudinal analyses corresponded to two dependent variables, ever use of smokeless tobacco (1993–1996; N = 1,388) and use on 20 or more occasions (1993–1999; N = 1,014). Models were adjusted for demographic variables, risk factors for smokeless tobacco use, and exposure to users of smokeless tobacco. Results: Advertising receptivity at baseline was predictive of ever use by late adolescence (RR(95% CI) = 2.0 (1.5, 2.8)) and regular use by young adulthood (RR(95% CI) = 3.7 (2.1, 6.7)) in models that were adjusted for covariates. Conclusions/ Importance: The findings challenge the tobacco industry's assertion that tobacco marketing does not impact youth initiation. This is particularly relevant to tobacco control in the United States because the 2009 Tobacco Control Act places fewer restrictions on smokeless tobacco products compared to cigarettes.

KEYWORDS:

• Smokeless tobacco
• adolescence
• marketing
• advertising receptivity
• tobacco industry

Additional information

Notes on contributors

David S. Timberlake

David S. Timberlake, Ph.D., is a faculty member in the Program in Public Health at the University of California, Irvine. His research focuses on issues in tobacco regulatory science, ranging from the marketing of smokeless tobacco to the regulation of modified risk tobacco products (e.g., snus). He is particularly interested in the translation of epidemiologic findings on alternate tobacco products to tobacco control policy.