Major Gaps In Tobacco Marketing Related Research Focusing On Asian Americans, American Indian/Alaska Natives, Pregnant Women, LGBT Populations, And Those With Mental Health Or Medical Co-Morbidities

A newly published paper reviewed the literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps.
Findings included:
  • There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities.
  • There were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products.
  • Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities.
  • Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies.
Source: Cruz et al. (2019). Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature. Tobacco Induced Diseases, Sep 18;17:68.

Study Examines How Tobacco Industry Marketing Incorporated American Indian Culture And Traditional Tobacco


As part of this study (Tobacco Control, February 2018) researchers conducted a keyword search of industry documents using document archives from the Truth Tobacco Documents Library. The study found that tobacco industry marketing tactics have incorporated American Indian culture and traditional tobacco since at least the 1930s, with these tactics prominently highlighted during the 1990s with Natural American Spirit cigarettes. Documents revealed the use of American Indian imagery such as traditional headdresses and other cultural symbols in product branding and the portrayal of harmful stereotypes of Native people in advertising. The historical and cultural significance of traditional tobacco was used to validate commercially available tobacco. The researchers concluded that the tobacco industry has misappropriated culture and traditional tobacco by misrepresenting American Indian traditions, values and beliefs to market and sell their products for profit. Recommendations include ongoing monitoring of tobacco industry marketing tactics directed at exploiting Native culture and counter-marketing tactics that raise awareness about the distinction between commercial and traditional tobacco use.

Source: D’Silva et al. (2018). Tobacco industry misappropriation of American Indian culture and traditional tobacco. Tobacco Control, Feb 19, [Epub ahead of print]

Read the abstract at

Did You Know? Youngest Teens (11-14) More Supportive of Tobacco 21


Tobacco 21 (T21) is a population-based strategy to prevent tobacco initiation. A majority of U.S. youths support T21; however, the extent to which individual, interpersonal, and community factors influence T21 support is uncertain. A newly published study examined predictors of T21 support among U.S. youth. Data from the 2015 National Youth Tobacco Survey were analyzed.


Findings included:

·         Among nonusers, students least receptive to peer influence, those youngest in age (11-14 years) and those who believe tobacco is dangerous had higher odds of T21 support.

·         Among users, lower odds of T21 support were observed among those who purchased tobacco and accessed tobacco through social sources or other means in the past 30 days.

·         Younger tobacco users (11-14 years), black, non-Hispanic users, e-cigarette users, and users who believe that tobacco is dangerous had higher odds of T21 support.


The researchers concluded that low receptivity to peer influence and lack of access to tobacco products are associated with T21 support.

Source: Glover-Kudon et al. (2019). Association of Peer Influence and Access to Tobacco Products With U.S. Youths’ Support of Tobacco 21 Laws, 2015. Journal of Adolescent Health, 65(2), 202-209.

WEBINAR: “Smoking No Longer Appealed to Me: Long Term Quitting Behavior After a Real World Menthol Tobacco Ban”


January 14, 2020

11:00 AM – 12:00 PM PST

Guest Speaker: Dr. Michael Chaiton


Learning Objectives:
  • Understand the role of flavours in smoking cessation
  • Demonstrate the impact of a menthol ban in Canada on smoking behavior
  • Identify the challenges and facilitators to a successful implementation of a menthol ban



Dr. Michael Chaiton

Dr. Michael Chaiton is a Scientist at the Centre for Addiction and Mental Health and Associate Professor at the Dalla Lana School of Public Health, University of Toronto. He has a PhD in Epidemiology from the University of Toronto and has been active in tobacco control since 2000 when he started working for Physicians for a Smoke-Free Canada and the International Non-Governmental Coalition against Tobacco. He is co-director of the Collaborative Specialization on Addiction Studies and is instructor of the graduate level course Tobacco and Health: From Cells to Society. His work includes understanding the impact of policy on smoking cessation including NIH funded studies evaluating the impact of the menthol ban in Canada.

Did You Know: In 2018, 64% of Youth Smokers Used Flavored Tobacco Products


The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students.


Findings included:

  • In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014.
  • Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015.
  • During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students.


The researchers concluded that full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths.


Source: Cullen et al. (2019). Flavored Tobacco Product Use Among Middle and High School Students – United States, 2014-2018. MMWR Morbidity and Mortality Weekly Report, Oct 4;68(39):839-844.

Did You Know: Tobacco Industry Targets American Indians and Alaska Natives Through Emails


Non-Hispanic American Indians and Alaska Natives (NH AI/AN) have the highest commercial tobacco use (CTU) among U.S. racial/ethnic groups. A newly published study examined prevalence of tobacco industry marketing exposure and correlates of CTU among NH AI/AN compared to other racial/ethnic groups. Data from the Population Assessment of Tobacco and Health Study were analyzed.


Findings included:

  • NH AI/AN had a higher prevalence of exposure to retail tobaccoads (65% vs 59%), mail (20% vs.14%) and email (17% vs.11%) marketing than NH Whites.
  • CTU was higher among NH AI/AN than NH Whites and among adults who reported exposure to tobacco ads, mail, and email marketing.


There is higher tobacco marketing exposure in stores and via mail for NH AI/AN. Email marketing exposure was higher, even after controlling for tobacco-related risk factors. The tobacco industry may be targeting NH AI/AN through emails, which include coupons and other marketing promotions.


Source: Carroll et al. (2019). Tobacco Industry Marketing Exposure and Commercial Tobacco Product Use Disparities among American Indians and Alaska Natives. Substance Use & Misuse, Sep 23:1-10. [Epub ahead of print]

Study Demonstrates Link Between Social Support, Sexual Identity Status and Tobacco Use Disorder


A recently published study assessed associations between social support and DSM-5 tobacco use disorder by sex and sexual minority identity.


Tobacco related findings included:

  • Sexual minority adults had higher odds of tobacco use disorder compared to heterosexual adults.
  • Sexual minority women experienced the highest proportion of tobacco use disorder.
  • Higher social provision was associated with lower rates of tobacco use disorder.
  • Compared to heterosexual adults, sexual minority women with at least one child under the age of 18 had higher odds of tobacco use disorder.


The researchers concluded that there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and tobacco use disorder which differ by sex and sexual identity status.


Source: Kahle et al. (2019). Functional and structural social support, substance use and sexual orientation from a nationally representative sample of U.S. adults. Addiction, Oct 9. [Epub ahead of print]

Study Examines Why Youth Engage with Online Tobacco Marketing


A newly published study examined the reasons why adolescents and young adults engage with online tobacco marketing. A sample of 2619 adolescents (13-17 years) and 2625 young adults (18-24 years) living in the US participated in an online survey in July-August 2017.


Findings included:

  • Across all tobacco use statuses, the leading reasons for engagement were curiosity or desire for general knowledge about tobacco products (3.9%); incidental, unintended or forced exposure to tobacco ad (3.8%); and seeking discounts, coupons, incentives, or contests (2.9%).
  • Susceptible never tobacco users were more likely to engage because of curiosity or general knowledge than non-susceptible never tobacco users.
  • Past 30-day tobacco users were more likely to engage because of discounts, coupons, incentives, or contests and product appeal than ever, but not past 30-day tobacco users.


The researchers concluded that stricter state and federal regulation of tobacco marketing, specifically tobacco ads and coupons, and stronger self-regulation by social networking sites could reduce youth engagement with online tobacco marketing.

Source: Soneji et al. (2019). Reasons for engagement with online tobacco marketing among US adolescents and young adults. Tobacco Induced Diseases, Jan 10;17:02.

Homeless Youth Tobacco Use Impacted by Tobacco Advertisement for Electronic Cigarettes and Hookah

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A recently published study examined associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated lifetime use. A probability sample of 469 young tobacco users experiencing homelessness (mean age = 22; 71% male; 29% non-Hispanic White) was recruited from 25 service and street sites in Los Angeles County. The researchers found that advertising appeal was positively associated with future intentions to use again for electronic cigarettes and hookah, but not cigars, or cigarillos.

Results suggest that advertising appeal may increase use of certain tobacco products among youth experiencing homelessness. However, differences in themes emphasized by advertising for specific tobacco products could differentially influence use in this population.


Source: Shadel et al. (2019). Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness. American Journal of Health Promotion, Oct 3. [Epub ahead of print]

Did You Know: Youth Exiting Foster Care Are At High Risk For Smoking


Among the struggles faced by youth currently in or recently exiting foster care, tobacco use remains a low priority for practitioners and researchers, alike. A recently published study aimed to determine the prevalence of lifetime and current combustible and non-combustible tobacco use among youth exiting foster care, and report on the prevalence of nicotine dependence, motivation to quit, and preferred methods of tobacco cessation. Youth aged 18-24 who were transitioning from foster care (N = 154) completed a survey of tobacco product use.


Findings included:

  • Most participants (76%) reported lifetime use of combustible cigarettes, while almost half (42%) were current combustible cigarette smokers.
  • Current use of electronic cigarettes was comparable to general population rates.
  • Many participants (76%) reported interest in quitting and willingness to try through patches/gum (56%) and technology-based (61%) approaches.


The researchers concluded that youth exiting foster care are at high risk for smoking and other tobacco product use, as well as dependence, yet are rarely screened for use or advised to quit.


Source: Braciszewski et al. (2019). Combustible Cigarette Smoking and Alternative Tobacco Use in a Sample of Youth Transitioning from Foster Care. Children and Youth Services Review, 96:231-236.