Kelvin Choi

Receipt and redemption of cigarette coupons, perceptions of cigarette companies and smoking cessation

Background Although it is known that cigarette companies use cigarette coupons to market their products, little is known about the characteristics of those who receive these coupons. The influence of receipt and redemption of these coupons is also unknown. Methods Participants of the Minnesota Adult Tobacco Survey Cohort Study who were smokers in 2008, completed surveys in 2008 and 2009, and had smoked for at least 6 months between those surveys, were included. In 2009, participants reported whether they had received cigarette coupons in the past 12 months, and whether they had used the coupons. They also reported their perceptions of cigarette companies and their smoking status. Multivariate logistic regressions were used to assess associations between receiving and redeeming coupons, perceptions of cigarette companies, and smoking status. Results Overall, 49.4% of the sample reported receiving cigarette coupons, and 39.9% redeemed them (80.1% of those who received these coupons). Female, younger and heavier smokers were more likely to report receiving these coupons (p<0.05). Smokers who received these coupons were more likely to agree that cigarette companies care about their health and do the best they can to make cigarettes safe, and less likely to agree that cigarette companies lie (p<0.05). Smokers who used these coupons were less likely to quit smoking (p<0.05). Conclusions Our findings suggest a negative association between cigarette coupons and smoking cessation. Longitudinal studies are needed to establish whether cigarette coupons influence smoking behaviour to inform the necessity for policies to prohibit the use of these coupons to assist smokers to quit smoking.

Time to Get Serious About Skin Cancer Prevention

In this commentary, we discuss the skin cancer epidemic in the United States and provide data to indicate that the United States public is not protecting itself from ultraviolet radiation, the primary risk factor for melanoma, and nonmelanoma skin cancer. In our opinion, skin cancer control in this country may be hindered by uncertainty about the effectiveness of sun protection strategies, inconsistent messages about the relative effectiveness of sun protection measures by federal and national organizations, and conventional research approaches that have identified few effective sun protection interventions for adults and targeted individuals for behavior change without considering the environmental context. A policy and research agenda is put forth to remedy the apparent insufficiencies in the current approach to skin cancer prevention in the United States. Cancer Epidemiol Biomarkers Prev; 21(11); 1893–901. ©2012 AACR.

Multilevel Predictors of Smoking Initiation among Adolescents: Findings from the Minnesota Adolescent Community Cohort (MACC) Study

OBJECTIVE To understand how factors at multiple levels of influence impact adolescent smoking initiation. METHOD Data from the Minnesota Adolescent Community Cohort, a population-based cohort, were analyzed. Adolescents were recruited from randomly selected geopolitical units (GPUs) in Minnesota at ages 12 to 13 (n=1953), and were surveyed every six months (2000-2006) until 18. The association between baseline social factors and smoking initiation was analyzed using logistic regression. Linear regression was used to analyze predictors and age of initiation among smokers (n=603). RESULTS Higher proportion of 15-16 year-olds who smoke at the area-level (GPU) was associated with younger initiation (15.47 vs 15.87, p<.05). Higher proportion of the population employed and higher median household income were associated with older initiation (15.90 vs. 15.56 p<.05). Parent education, living with parents or siblings who smoke, living in homes that allow smoking, and having friends who smoke at baseline were associated with smoking initiation or younger initiation (p<.05). Participants whose parents had less than a high school education were 1.6 times more likely than those with college educated parents to have smoked at least a whole cigarette (CI=1.06, 2.26). CONCLUSION Factors at multiple levels of influence effect adolescent smoking initiation. Smoking by older age peers and lower SES predicts earlier smoking.

Awareness, perceptions and use of snus among young adults from the upper Midwest region of the USA

Background Since its introduction in 2006, snus has been aggressively marketed by tobacco companies. However, little is known about the awareness, perceptions and use of snus among young adults after Camel and Marlboro snus were sold nationwide in 2010. Methods Data were collected from 2607 young adults (ages 20–28) who participated in the Minnesota Adolescent Community Cohort Study in 2010–2011. Data include awareness of snus, ever and past 30-day use, perceived potential of snus as a quit aid, and perceived harmfulness and addictiveness of snus relative to cigarettes. The authors assessed the associations between these outcome variables and socio-demographic characteristics. Results Overall, 64.8% of participants were aware of snus, 14.5% ever used snus and 3.2% used snus in the past 30 days. Men and participants who smoked >100 cigarettes in their lifetime were associated with these three outcomes (p<0.05). Among those who were aware of snus, 16.3% agreed snus can help people quit smoking, 17.3% agreed snus is less harmful than cigarettes and 11.3% agreed snus is less addictive than cigarettes. These perceptions were associated with ever use and the past 30-day use of snus (p<0.05). Conclusions In this regional sample of US young adults, the majority of young adults were aware of snus, and over one in 10 had used snus. More young adults in the sample than the overall US adult population believed that snus is less harmful than cigarettes. Perceptions of snus are associated with snus use. Strategic health communication interventions targeting young adults to confront the positive perceptions associated with snus may be needed to curb the interest in snus.

Tobacco product prices before and after a statewide tobacco tax increase

Background In 2013, the State of Minnesota Legislature passed a tobacco tax increase that increased the combined cigarette excise and sales tax by US

Tobacco Direct Mail Marketing and Smoking Behaviors in a Cohort of Adolescents and Young Adults From the U.S. Upper Midwest: A Prospective Analysis

1.75 (from US

Minnesota smokers’ perceived helpfulness of 2009 federal tobacco tax increase in assisting smoking cessation: a prospective cohort study

1.60 to US

E-Cigarette Use Among Florida Youth With and Without Asthma

3.35) and increased the tax on non-cigarette tobacco products from 70% to 95% of the wholesale price. The current study explores the change in tobacco prices in retail locations and whether the tax increase was fully passed to consumers. Methods An observational study of tobacco retail prices was performed in a sample of 61 convenience stores in Minnesota, North Dakota, South Dakota and Wisconsin. Six rounds of data were collected between May 2013 and January 2014. In each round, purchases were made at the same stores for the same four tobacco products (Camel Blue cigarettes, Marlboro Gold cigarettes, Grizzly Wintergreen moist smokeless tobacco and Copenhagen Wintergreen moist smokeless tobacco). Results For all studied tobacco products, prices in Minnesota increased significantly after the tax increase (Round 1–Round 6). After controlling for price changes in neighbouring states, the average price difference in Minnesota for the two cigarette brands increased by US

Availability of snus and its sale to minors in a large Minnesota city

1.89 and US

E-cigarette use and asthma in a multiethnic sample of adolescents

1.81, which are both more than the US