Caroline Schooler

Seventh graders' self-reported exposure to cigarette marketing and its relationship to their smoking behavior.

OBJECTIVES This study examined among youth the extent of their perceived exposure to cigarette marketing and the relationship of their perceptions to their smoking behavior. METHODS Surveys measuring exposure to cigarette advertisements and promotions were completed by 571 seventh graders in San Jose, Calif. RESULTS Eighty-eight percent of these 13-year-olds reported exposure to cigarette marketing: the majority often saw ads in magazines, on billboards, and at stores and events, and one quarter owned cigarette promotional items. After social influences to smoke were controlled for, exposure to cigarette marketing was related to self-reported smoking behavior. Likelihood of experimenting with smoking was 2.2 times greater among those who owned promotional items and 2.8 times greater among those who had received mail from a tobacco company. Seeing cigarette advertisements in magazines increased this likelihood by 21%, and seeing tobacco marketing in stores increased it by 38%. CONCLUSIONS Youth are daily and widely exposed to tobacco industry marketing efforts; this exposure is related to smoking behavior. More effective regulation is needed.

Seeing, wanting, owning: the relationship between receptivity to tobacco marketing and smoking susceptibility in young people

OBJECTIVE To assess the effect of the tobacco industry’s marketing practices on adolescents by examining the relationship between their receptivity to these practices and their susceptibility to start smoking. DESIGN Paper-and-pencil surveys measuring association with other smokers, exposure to tobacco industry marketing strategies, experience with smoking, and resolve not to smoke in the future. SETTING 25 randomly selected classrooms in five middle schools in San Jose, California. SUBJECTS 571 seventh graders with an average age of 13 years and 8 months; 57% were female. Forty-five per cent of the students were Asian, 38% were Hispanic, 12% were white, and 5% were black. MAIN OUTCOME MEASURES Exposure to social influences, receptivity to marketing strategies, susceptibility to start smoking. RESULTS About 70% of the participants indicated at least moderate receptivity to tobacco marketing materials. Children who are more receptive are also more susceptible to start smoking. In addition to demographics and social influences, receptivity to tobacco marketing materials was found to be strongly associated with susceptibility. CONCLUSIONS Tobacco companies conduct marketing campaigns that effectively capture teenage attention and stimulate desire for their promotional items. These marketing strategies may function to move young teenagers from non-smoking status toward regular use of tobacco. Our results demonstrate that there is a clear association between tobacco marketing practices and youngsters’ susceptibility to smoke. The findings, along with other research, provide compelling support for regulating the manner in which tobacco products are marketed, to protect young people from the tobacco industry’s strategies to reach them.

Achieving Improvements in Overall Health Orientation Effects of Campaign Exposure, Information Seeking, and Health Media Use

Public health campaign success is conceptualized in terms of improvements in three cardiovascular disease-related behaviors (diet, exercise, and smoking) and their precursors, including knowledge and self-efficacy. Two cross-sectional data waves (baseline and sixth year, N = 4,214) from the Stanford Five-City Project (FCP) are analyzed to test a model of campaign influences. Exposure to FCP campaign messages is correlated with health information seeking and interpersonal communication, which in turn are correlated with health behaviors. The central premise of the model is then tested on a longitudinal sample (N = 1,225) over a 3-year period with similar results. An overall health orientation index is introduced and recommendations are made for enhancing public health campaign effectiveness.

Synthesis of findings and issues from community prevention trials

Purpose: Lessons from three decades of community prevention trials are discussed to provide directions for the future of community health promotion efforts. Methods: The rationale for and characteristics of community prevention trials for cardiovascular disease (CVD) risk reduction are presented. Published articles regarding the main effects and component studies of community prevention trials regarding CVD were reviewed. Results: All early and most recent community prevention trials carried out in diverse populations demonstrated population-wide effects on CVD risk factors, particularly blood pressure levels and smoking prevalence. Moreover, subgroup component studies (e.g., schools, worksites, events) demonstrate the efficacy of many risk reduction strategies. These results support a dose-response relationship by evidence of stronger effects where adequate exposure to the intervention was achieved. Conclusions: Although much remains untested in theory and practice, data indicate that community-based efforts to reduce the risk of CVD can influence behavior. Additional research is needed to increase understanding of the optimal mix and sequencing of components of these programs. In addition, this review indicates the importance of incorporating strategies to influence environmental change. Recommendations for the future include research regarding evaluation methods and the interaction of environmental and educational strategies, as well as dissemination research and concurrent international technology transfer of the vast number of lessons learned and the many widely accepted practice principles of community-based interventions.

The perceived influence of cigarette advertisements and smoking susceptibility among seventh graders

A perceptual bias, the third person effect, has been observed where individuals believe themselves to differ from others regarding the perceived influence of media messages. Given the frequency with which youth encounter prosmoking messages and the reported negative effects of these messages, it is of value to study whether youth perceive cigarette advertisements to influence themselves and their friends and peers. This study examined the associations between exposure to social and information prosmoking environments, the perceived influence of cigarette advertisements on self, best friends, and other youth, and smoking susceptibility. A sample of 571 seventh graders completed surveys on tobacco advertisements and promotions. Using Students-t, chi-square, ANOVA tests and proportional odds models, we found significant associations between perceived influence of cigarette advertisements and exposure to social and information prosmoking environments as well as smoking susceptibility. These data suggest that youth be taught that everyone is vulnerable to the tobacco industrys strategies and be given skills to resist prosmoking advertising.

Effects of the Stanford Five-City Project Media Advocacy Program

The authors investigated the effects of a media advocacy program to build support for cardiovascular disease (CVD)-related policy changes and to encourage adoption of heart-healthy behaviors in the Stanford Five-City Project, a long-term trial of community-wide CVD risk reduction. The authors content analyzed 4,824 health articles in two treatment city newspapers and two reference city newspapers between 1977 and 1990. One treatment city newspaper responded well to the program; the other did not. In the Salinas Californian, the number of CVD-related articles increased during the campaign; these articles became more prominent and conspicuous, the focus on prevention increased, and more of these articles were written by local staff. Maintenance of these effects after the campaign was mixed. Results suggest that frequent, regular, systematic contact with media professionals and provision of materials influence newspaper coverage of health-related topics, which has important implications for shaping public opinion and policy change.

Cigarette Advertising to Counter New Years Resolutions

One process through which tobacco advertising may work is by reducing rates of quitting. Theories of addiction support the notion that relapse can be prompted by environmental cues. Further, because withdrawal symptoms occur over a predictable time frame, and because the most popular time to quit smoking is the beginning of the year, as a New Years resolution, tobacco companies can make use of advertising to remind quitters of their need to smoke. Study 1 examined advertising in 10 popular magazines. It found a higher number of ads in January and February than the rest of the year after 1984. Study 2 examined cigarette advertising on the back cover of 10 other popular magazines. This study also found a higher rate of cigarette advertisements in January and February than for the rest of the year. The results suggest that cigarette marketers may be attempting to preempt quitting by cuing smoking behavior.One process through which tobacco advertising may work is by reducing rates of quitting. T heories of addiction support the notion that relapse can be prompted by environmental cues. Further, because withdrawal symptoms occur over a predictable time frame, and because the most popular time to quit smoking is the beginning of the year, as a New Y earÏs resolution, tobacco companies can make use of adver± tising to remind quitters of their need to smoke. Study 1 examined advertising in 10 popular magazines. It found a higher number of ads in January and February than the rest of the year after 1984. Study 2 examined cigarette advertising on the back cover of 10 other popular magazines. T his study also found a higher rate of cigarette advertisements in January and February than for the rest of the year. T he results suggest that cigarette marketers may be attempting to preempt quitting by cuing smoking behavior.

Exploring a Model of Symbolic Social Communication The Case of 'Magic' Johnson

We propose a model of symbolic social communication to explain the process whereby sociocultural identity mediates relationships among receivers, sources and messages to shape message effects. This exploratory study examines how two at-risk groups of African American men responded to various HIV prevention messages delivered by celebrity and professional sources. We interviewed 47 men from a homeless shelter and 50 male college students. Members of both groups were likely to select Johnson as the best person to deliver HIV prevention messages among a list of African American celebrity and professional sources. Results suggest the symbolic meanings embedded in celebrities and message topics are important and enduring influences on message effects. The images and ideas that a source represents are transferred to the advocated behavior, attitude or knowledge change and thus shape how messages are interpreted and received. Further understanding of how culture influences the effects of persuasive messages is critical for the improvement of health-communication campaigns.

Contributions of Health Behavior Research to Community Health Promotion Programs

Health behaviors and health status are influenced not only by biological and psychological factors, but also by economic, political, and sociocultural factors (Aiken & Mott, 1970; Blum, 1981; Brown, 1984; Flora, Jackson, & Maccoby, 1989; Warren, 1972). For example, leading causes of death in the United States (cardiovascular disease and cancer) have been shown to be related to lifestyle elements such as diet, exercise, and smoking (U.S. Department of Health and Human Services, 1991). Intentional injury is another significant cause of death, especially among youths, that is strongly influenced by environmental and familial characteristics (American Psychological Association, 1993; Elliott, 1994). The important impact that societal factors have on health behavior highlights the significance of health promotion strategies targeting entire communities.