This project addresses the prevention of tobacco related diseases by developing an intervention to block tobacco industry marketing to young adults (age 18-25). Almost all tobacco prevention efforts concentrate on preventing children and adolescents from experimenting with cigarettes despite the fact that the transition from experimentation to regular smoking and addiction often occurs during young adulthood. The tobacco industry has invested millions of dollars in sophisticated marketing research on young adults. Because of current restrictions on marketing to youth, young adults have become an even more important focus of tobacco marketing efforts, which often emphasize events at "adult only" venues (bars, nightclubs and casinos), which are exempt from these restrictions. We hypothesize that successfully competing with industry promotion in these venues will prevent smoking among young adults, preventing both long term morbidity and mortality from smoking. Preliminary data: In our prior research, we identified a high risk subpopulation of young adults in San Diego, CA: the "hipster" subculture, a group focused on the alternative music scene, local artists and designers, and eclectic self expression. We developed a year long pilot social branding intervention to decrease smoking among this group, using social events and social leaders to promote a strong nonsmoking lifestyle. The intervention rationale is based on utilizing industry market research tools to define the target audience and directly countering tobacco industry lifestyle marketing strategies. We now propose to leverage contracts from three additional States to extend this intervention and evaluate it in a multicenter quasi-experimental controlled trial. Study Design: 1) cross-sectional repeated measures design with random samples ofthe population attending bars and nightclubs in four intervention cities and four comparison communities at baseline, during, and after the intervention. The main outcome is self-reported past 30 day smoking prevalence. Cessation by age 30 avoids nearly all the long term health consequences of smoking. The results of this research will improve approaches to young adult targeted messaging both for public health campaigns and for clinical patient counseling to block the transition from experimentation to becoming established addicted smokers.

Public Health Relevance

Tobacco use is responsible for 35% of cancer deaths, and young adults (age 18-25) have the highest smoking prevalence of any age group. All tobacco-related cancers are affected by preventing people from becoming long-term addicted smokers, and cessation by age 30 avoids nearly all the long term ill effects of smoking. This research will evaluates a novel interventions in four States to counter the aggressive tobacco marketing efforts targeting young adults in bars and nightclubs to augment tobacco control policies and block the transition from experimentation to becoming established addicted smokers.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZCA1-SRLB-Y (O1))
Program Officer
Grant, Yvonne F
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Lee, Youn Ok; Bahreinifar, Sareh; Ling, Pamela M (2014) Understanding tobacco-related attitudes among college and noncollege young adult hookah and cigarette users. J Am Coll Health 62:10-8
Jiang, Nan; Lee, Youn Ok; Ling, Pamela M (2014) Association between tobacco and alcohol use among young adult bar patrons: a cross-sectional study in three cities. BMC Public Health 14:500
Jiang, Nan; Lee, Youn O; Ling, Pamela M (2014) Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts. Prev Med 69:166-71
Fallin, Amanda; Neilands, Torsten B; Jordan, Jeffrey W et al. (2014) Secondhand smoke exposure among young adult sexual minority bar and nightclub patrons. Am J Public Health 104:e148-53
Holmes, Louisa M; Marcelli, Enrico A (2014) Neighborhood social cohesion and smoking among legal and unauthorized Brazilian migrants in metropolitan Boston. J Urban Health 91:1175-88
Lee, Youn Ok; Jordan, Jeffery W; Djakaria, Mayo et al. (2014) Using peer crowds to segment Black youth for smoking intervention. Health Promot Pract 15:530-7
Ling, Pamela M; Lee, Youn Ok; Hong, Juliette et al. (2014) Social branding to decrease smoking among young adults in bars. Am J Public Health 104:751-60
Kalkhoran, Sara; Neilands, Torsten B; Ling, Pamela M (2013) Secondhand smoke exposure and smoking behavior among young adult bar patrons. Am J Public Health 103:2048-55