In FY2015, we analyzed several population-based datasets to investigate disparities in tobacco use patterns and risk factors, as well as interventions to reduce tobacco use. We found that, according to the 2012 National Youth Tobacco Survey, Hispanic youth are more likely than non-Hispanic White youth to be susceptible to cigarette smoking, and are less likely than non-Hispanic White youth to believe that tobacco products are dangerous to their health. We also found that non-Hispanic Black youth never-smokers and Native American youth current-smokers are more likely to be exposed to tobacco coupons compared to their non-Hispanic White counterparts. This exposure is associated with (1) the higher likelihood of believing the social benefits of smoking (e.g., making someone look cool and fit in), (2) the lower likelihood of believing tobacco products are dangerous to health, (3) the higher likelihood to try smoking (among never smokers) and (4) the higher likelihood of intending to purchase cigarettes in the immediate future (among ever smokers). Similar findings related to exposure to tobacco coupons are also observed in a cohort of adolescents and young adults who participated in the Minnesota Adolescent Community Cohort (MACC) Study. The data showed that exposure to tobacco direct mail marketing (mostly tobacco coupons) is associated with subsequently becoming a current smokers and lower likelihood to quit smoking. We also studied the impact of new tobacco products. According to the data from the MACC Study, a considerable proportion of young adults hold favorable beliefs about electronic cigarettes, and these favorable beliefs are associated with subsequent experimentation with electronic cigarettes for smokers and non-smokers alike. Additional analysis showed the electronic cigarette use does not promote smoking cessation in this population. We also found that use of snus (a novel smokeless tobacco product) is associated with subsequently becoming a current smoker, and does not promote smoking cessation or reduction in the young adult population. In terms of interventions, we analyzed data from purchases conducted at 61 convenience stores before and after a Minnesota state tobacco tax increase. We found that prices for cigarettes increased above and beyond the tax increase among the stores we visited, suggesting tobacco companies may be over-shifting the price increase to consumer to create public opposition against tax increases, while providing coupons/price promotions to ease smokers into high cigarette prices. Lastly, we applied a behavioral theory framework to analyze baseline survey data to inform the development of an intervention to increase tobacco cessation benefit use among unionized blue-collar workers. Through this analysis, we identified important beliefs (e.g., attitudes related to treatment efficacy, monetary implications of using cessation benefits) to form the basis for designing an effective media campaign to promote tobacco cessation benefit use in this lower income, lower education group of smokers.
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