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 yearlong 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 of the 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.
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