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Open Access Publications from the University of California

Scholarly Works (8 results)

  • Article
  • Peer Reviewed
UC San Diego Previously Published Works (2015)

Emerging evidence suggests bisexual populations are at increased risk for a variety of negative health outcomes, including tobacco use. Lesbian, gay, and bisexual (LGB) populations are at increased risk for cigarette smoking, but research on LGB subpopulations' use of tobacco products beyond cigarettes and tobacco use differences across LGB subgroups is in its infancy. This study explores differences in use of tobacco products across LGB subgroups, including gender differences among bisexuals.

This study reports results from a 2013 nationally-representative cross-sectional online survey of US adults (N = 17 087). Weighted tobacco use prevalence and adjusted logistic regression results are reported.

LGB populations reported higher current use of any tobacco product (35.7%) and current use of cigarettes (32.0%), e-cigarettes (8.9%), regular (5.5%) and small cigars (11.6%), compared with non-LGB. Bisexual (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 1.7-3.9) and lesbian (OR = 1.7, 95% CI: 1.0-2.7) women have higher odds of any tobacco use than heterosexual women; including greater odds of regular (OR = 2.9, 95% CI: 1.2-7.0 and OR = 2.2, 95% CI: 1.3-3.9; respectively) and small cigar use (OR = 2.4, 95% CI: 1.4-4.1 and OR = 3.2, 95% CI: 2.0-5.1; respectively). Gay men had lower odds of cigar use (OR = 0.4, 95% CI: 0.2-0.8) than heterosexual men.

This is the first US adult population study to assess differences in use of various tobacco products across adult LGB subpopulations and by gender, confirming their increased risk of use and illuminating differences by subgroup and gender. Exploring LGB as a unified population appears inadequate to accurately characterize LGB tobacco use risk. Tobacco-related LGB health inequities, particularly among bisexual and lesbian women, may be greater than previously indicated.

This manuscript provides important contributions to the field of tobacco control and prevention, and more specifically to LGB tobacco-related health disparities research. This is among the first population level studies to explore various tobacco use across LGB populations and across genders, comparing results to non-LGB populations in a national study. We provide novel evidence that bisexual women in particular, have a higher risk for use of various tobacco products, compared with other LGB subpopulations. In order to address this disparity, tobacco control professionals need to be made aware of these important differences in tobacco use behavior.

    • Article
    • Peer Reviewed
    UC San Diego Previously Published Works (2017)

    Background

    The rapid diffusion of social media in the past decade has allowed community members to sway the discourse on elections. We use analyses of social media to provide insight into why the strong public support 1 year prior to the election did not result in an increased tobacco tax from the 2012 California Proposition 29 vote.

    Methods

    Using the Twitter historical Firehose, we chose all tweets on Proposition 29 posted between 1 January and 5 June 2012 differentiating between early and late campaign periods. Tweets were coded for valence, theme and source. We analysed metadata to characterise accounts. Television ratings data in 9 major California media markets were used to show the strength of the 2 campaigns.

    Results

    'No on 29' launched television advertising earlier and with much higher household gross rating points (GRPs) than the 'Yes on 29' campaign. Among 17 099 relevant tweets from 8769 unique accounts, 53% supported Proposition 29, 27% opposed and 20% were neutral. Just under half (43%) were from accounts affiliated with the campaigns. Two-thirds of campaign messages originated outside California. The 'Yes' campaign focused on simple health messages, which were equally represented in both campaign periods. However, anti-tax tweets increased at relative to pro-tax tweets in the second period.

    Conclusions

    Although the Prop 29 campaigns did not effectively engage the Californian twitter communities, analysis of tweets provided an earlier indication than public polls of the loss of public supporting this election. Prospective Twitter analysis should be added to campaign evaluation strategies.
      Cover page: Twitter analysis of California's failed campaign to raise the state's tobacco tax by popular vote in 2012
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2019)

      Background

      LGBT populations use tobacco at disparately higher rates nationwide, compared to national averages. The tobacco industry has a history targeting LGBT with marketing efforts, likely contributing to this disparity. This study explores whether exposure to tobacco content on traditional and social media is associated with tobacco use among LGBT and non-LGBT.

      Methods

      This study reports results from LGBT (N = 1092) and non-LGBT (N = 16430) respondents to a 2013 nationally representative cross-sectional online survey of US adults (N = 17522). Frequency and weighted prevalence were estimated and adjusted logistic regression analyses were conducted.

      Results

      LGBT reported significantly higher rates of past 30-day tobacco media exposure compared to non-LGBT, this effect was strongest among LGBT who were smokers (p < .05). LGBT more frequently reported exposure to, searching for, or sharing messages related to tobacco couponing, e-cigarettes, and anti-tobacco on new or social media (eg, Twitter, Facebook, etc.) than did non-LGBT (p < .05). Non-LGBT reported more exposure from traditional media sources such as television, most notably anti-tobacco messages (p = .0088). LGBT had higher odds of past 30-day use of cigarettes, e-cigarettes, and cigars compared to non-LGBT, adjusting for past 30-day media exposure and covariates (p ≤ .0001).

      Conclusions

      LGBT (particularly LGBT smokers) are more likely to be exposed to and interact with tobacco-related messages on new and social media than their non-LGBT counterparts. Higher levels of tobacco media exposure were significantly associated with higher likelihood of tobacco use. This suggests tobacco control must work toward reaching LGBT across a variety of media platforms, particularly new and social media outlets.

      Implications

      This study provides important information about LGBT communities tobacco-related disparities in increased exposure to pro-tobacco messages via social media, where the tobacco industry has moved since the MSA. Further, LGBT when assessed as a single population appear to identify having decreased exposure to anti-tobacco messages via traditional media, where we know a large portion of tobacco control and prevention messages are placed. The study points to the need for targeted and tailored approaches by tobacco control to market to LGBT using on-line resources and tools in order to help reduce LGBT tobacco-related health disparities. Although there have been localized campaigns, only just recently have such LGBT-tailored national campaigns been developed by the CDC, FDA, and Legacy, assessment of the content, effectiveness, and reach of both local and national campaigns will be important next steps.
        Cover page: Lesbian, Gay, Bisexual, and Transgender (LGBT) View it Differently Than Non-LGBT: Exposure to Tobacco-related Couponing, E-cigarette Advertisements, and Anti-tobacco Messages on Social and Traditional Media
        • Article
        • Peer Reviewed
        Tobacco-Related Disease Research Program Funded Publications (2014)
        Background

        Tobacco industry cigarette advertising is associated with increased adolescent smoking, while counter tobacco advertising is associated with reduced smoking. As these campaigns compete for influence, there is a need to understand their inter-relationship on youth smoking.

        Methods

        This study reports data from a national population of families (n=1036) with an oldest child aged 10–13 years, identified by random digit dialling. Parent and child dyads completed baseline questionnaires in 2003. Adolescents were resurveyed in 2007–2008 (response rate 74%). Adjusted logistic regression explores associations between receptivity to cigarette and tobacco control advertising and adolescent smoking initiation.

        Results

        In 2007–2008, 57.9% of adolescents reported a favourite tobacco control advertisement and 43.3% reported being receptive to cigarette advertisements. Thirty per cent reported receptivity to cigarette and tobacco control advertisements. Among those receptive to cigarette advertising, having a favourite anti-smoking advertisement had a borderline significant association with a 30% lower smoking rate. Anti-industry tobacco control messages were three times more likely to be favourites of those who were receptive to cigarette advertising than other tobacco control advertising.

        Conclusions

        Receptivity to tobacco control advertising appeared to ameliorate the promotion of initiation from cigarette advertising. Anti-industry advertising appears to be the most effective counter for tobacco control and should be considered for wider use. A larger longitudinal study is needed to confirm these findings.

          • Article
          • Peer Reviewed
          Tobacco-Related Disease Research Program Funded Publications (2014)
          Background

          Tobacco industry cigarette advertising is associated with increased adolescent smoking, while counter tobacco advertising is associated with reduced smoking. As these campaigns compete for influence, there is a need to understand their inter-relationship on youth smoking.

          Methods

          This study reports data from a national population of families (n=1036) with an oldest child aged 10–13 years, identified by random digit dialling. Parent and child dyads completed baseline questionnaires in 2003. Adolescents were resurveyed in 2007–2008 (response rate 74%). Adjusted logistic regression explores associations between receptivity to cigarette and tobacco control advertising and adolescent smoking initiation.

          Results

          In 2007–2008, 57.9% of adolescents reported a favourite tobacco control advertisement and 43.3% reported being receptive to cigarette advertisements. Thirty per cent reported receptivity to cigarette and tobacco control advertisements. Among those receptive to cigarette advertising, having a favourite anti-smoking advertisement had a borderline significant association with a 30% lower smoking rate. Anti-industry tobacco control messages were three times more likely to be favourites of those who were receptive to cigarette advertising than other tobacco control advertising.

          Conclusions

          Receptivity to tobacco control advertising appeared to ameliorate the promotion of initiation from cigarette advertising. Anti-industry advertising appears to be the most effective counter for tobacco control and should be considered for wider use. A larger longitudinal study is needed to confirm these findings.

            • Article
            • Peer Reviewed
            Tobacco-Related Disease Research Program Funded Publications (2014)
            Background

            Tobacco industry cigarette advertising is associated with increased adolescent smoking, while counter tobacco advertising is associated with reduced smoking. As these campaigns compete for influence, there is a need to understand their inter-relationship on youth smoking.

            Methods

            This study reports data from a national population of families (n=1036) with an oldest child aged 10–13 years, identified by random digit dialling. Parent and child dyads completed baseline questionnaires in 2003. Adolescents were resurveyed in 2007–2008 (response rate 74%). Adjusted logistic regression explores associations between receptivity to cigarette and tobacco control advertising and adolescent smoking initiation.

            Results

            In 2007–2008, 57.9% of adolescents reported a favourite tobacco control advertisement and 43.3% reported being receptive to cigarette advertisements. Thirty per cent reported receptivity to cigarette and tobacco control advertisements. Among those receptive to cigarette advertising, having a favourite anti-smoking advertisement had a borderline significant association with a 30% lower smoking rate. Anti-industry tobacco control messages were three times more likely to be favourites of those who were receptive to cigarette advertising than other tobacco control advertising.

            Conclusions

            Receptivity to tobacco control advertising appeared to ameliorate the promotion of initiation from cigarette advertising. Anti-industry advertising appears to be the most effective counter for tobacco control and should be considered for wider use. A larger longitudinal study is needed to confirm these findings.

              • Article
              • Peer Reviewed
              UC San Diego Previously Published Works (2014)

              Purpose

              To improve smoking prevention efforts, better methods for identifying at-risk youth are needed. The widely used measure of susceptibility to smoking identifies at-risk adolescents; however, it correctly identifies only about one third of future smokers. Adding curiosity about smoking to this susceptibility index may allow us to identify a greater proportion of future smokers while they are still pre-teens.

              Methods

              We use longitudinal data from a recent national study on parenting to prevent problem behaviors. Only oldest children between 10 and 13years of age were eligible. Participants were identified by RDD survey and followed for 6years. All baseline never smokers with at least one follow-up assessment were included (n=878). The association of curiosity about smoking with future smoking behavior was assessed. Then, curiosity was added to form an enhanced susceptibility index and sensitivity, specificity and positive predictive value were calculated.

              Results

              Among committed never smokers at baseline, those who were 'definitely not curious' were less likely to progress toward smoking than both those who were 'probably not curious' (ORadj=1.89; 95% CI=1.03-3.47) or 'probably/definitely curious' (ORadj=2.88; 95% CI=1.11-7.45). Incorporating curiosity into the susceptibility index increased the proportion identified as at-risk to smoke from 25.1% to 46.9%. The sensitivity (true positives) for this enhanced susceptibility index for both experimentation and established smoking increased from 37-40% to over 50%, although the positive predictive value did not improve.

              Conclusion

              The addition of curiosity significantly improves the identification and classification of which adolescents will experiment with smoking or become established smokers.
                Cover page: Curiosity predicts smoking experimentation independent of susceptibility in a US national sample
                • Article
                • Peer Reviewed
                UC San Diego Previously Published Works (2017)

                Background

                This study extends research on receptivity to tobacco marketing over a key developmental period for cigarette smoking experimentation.

                Purpose

                The purpose of this study was to understand the effect of receptivity to tobacco marketing and exposure to friends who smoke on smoking experimentation.

                Methods

                Participants were 10 to 13 years old who had never tried cigarettes (n = 878), interviewed six times at 8-month intervals.

                Results

                At baseline, 25% percent of the 10 and 11 years old in the sample of never smokers were receptive to tobacco marketing, while less than 5% had friends who smoked. Having a friend who smoked at study baseline and acquiring such friends for the first time during the study were the strongest predictors of smoking experimentation. Initial receptivity to tobacco marketing increased the risk of smoking experimentation independently of having friends who smoke at baseline or acquiring friends who smoke throughout the study period.

                Conclusions

                The high level of receptivity observed even among 10 and 11 years old and its robust relationship with cigarette smoking experimentation independent of the significant risk associated with having friends who smoke suggests that successful prevention of receptivity may require intervention at an early age.
                  Cover page: Pre-adolescent Receptivity to Tobacco Marketing and Its Relationship to Acquiring Friends Who Smoke and Cigarette Smoking Initiation
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