Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults.To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking.The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted.Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1.Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2.Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95% confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95% CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2 (conventional cigarettes: adjusted odds ratio [AOR], 1.43; 95% CL, 1.23-1.65; e-cigarettes: AOR, 1.62; 95% CL, 1.41-1.85; cigars: AOR, 2.01; 95% CL, 1.62-2.49; and smokeless [males only]: AOR, 1.42; 95% CL, 1.07-1.89) and with use of the product (conventional cigarettes: AOR, 1.54; 95% CL, 1.03-2.32; e-cigarettes: AOR, 1.45; 95% CL, 1.19-1.75; cigars: AOR, 2.07; 95% CL, 1.26-3.40). Compared with those not receptive to any product advertising, receptivity to e-cigarette advertising, but not to cigarette advertising, was independently associated with those aged 12 to 21 years having used a cigarette at wave 2 (AOR, 1.60; 95% CL, 1.08-2.38).Receptivity to tobacco advertising was significantly associated with progression toward use in adolescents. Receptivity was highest for e-cigarette advertising and was associated with trying a cigarette.
Background: No physical activity (PA) interventions have specifically targeted Latino men despite marked health disparities in this group. Therefore, we explored the feasibility of designing a PA intervention for Latino men. Methods: We conducted six qualitative interviews with Latino men and used their feedback to modify an existing PA intervention, then conducted a 12-week demonstration trial of the adapted intervention. Results: Themes from interviews included work and family conflicts and preferring team sports. In the demonstration trial of the modified intervention, participants (N = 10) increased PA from 1.3 minutes/week (SD = 4.75) at baseline to 125.5(SD = 154.86) at follow-up (p < .05). Retention was high and participants expressed enthusiasm for the program. Conclusions: Existing interventions could be effectively modified to target physical activity in Latino men.
Latinos report less leisure time physical activity (PA) than non–Latino Whites and suffer disproportionately from diseases related to sedentary lifestyle, yet remain underserved and understudied. Gaining a better understanding of PA behavior in Latinos is critical to intervene on this significant public health issue. This article discusses the growing literature on the facilitators and barriers of PA in Latino men and women and reviews recent interventions to promote activity. Apart from acculturation influences, facilitators of PA in Latinos are similar to those of non–Latino Whites, with most research focusing on self-efficacy and social support. Barriers for Latinas, however, are more culturally distinct, such as a focus on caregiving and cultural standards for body shape. Barriers unique to Latino men largely have not been studied. Researchers have adopted a variety of approaches to increase PA, including using promotores and incorporating culturally appropriate activities, and have had mixed success. However, the community and randomized controlled trials almost exclusively included only women. Studies reviewed here suggest that interventions should target culturally specific barriers beyond language to successfully increase PA in Latinos and highlight a need for formative research and design of interventions for Latino men.
Objective: To assess whether a slow-down in implementing tobacco control policies in California after 2000 influenced trends in smoking behavior. Methods:We assessed the strength of state tobacco control policies using excise tax data (1990-2014), tobacco control expenditures per capita, and workplace and home smoking restrictions (from the Tobacco Use Supplement of the Current Population Survey, 1992-2015).Smoking prevalence was assessed with the National Health Interview Survey, 1985-2015.We compared trends between California and rest of the United States (US) using split regression models with a knot at 2000. Results:Throughout the 1990s, compared to the rest of the US, California had higher cigarette excise taxes, higher expenditures on tobacco control, more smoke-free workplaces, and more smokers with smoke-free homes.Except for smoke-free homes, these differences disappeared after 2000.During the 1990s, smoking prevalence declined much faster in California than in the rest of the US, but the decline slowed significantly after 2000. Conclusions:Smoking prevalence is sensitive to continued implementation of tobacco control policies.
Non-cigarette tobacco marketing is less regulated and may promote cigarette smoking among adolescents. We quantified receptivity to advertising for multiple tobacco products and hypothesized associations with susceptibility to cigarette smoking.
Many smokers believe that electronic nicotine delivery systems (ENDS) and pharmaceutical cessation aids can help them quit smoking or reduce cigarette consumption, but the evidence for e-cigarettes to aid quitting is limited. Examining 3,093 quit attempters in the nationally representative US Population Assessment of Tobacco and Health (PATH) Study, using data from 2013-2015, we evaluated the influence of ENDS and pharmaceutical cessation aids on persistent abstinence (≥30 days) from cigarettes and reduced cigarette consumption, using propensity score matching to balance comparison groups on potential confounders and multiple imputation to handle missing data. At PATH Wave 2, 25.2% of quit attempters reported using ENDS to quit during the previous year, making it the most popular cessation aid in 2014-2015. More quit attempters were persistently cigarette abstinent than were persistently tobacco abstinent (15.5% (standard error, 0.8) vs. 9.6% (standard error, 0.6)). Using ENDS to quit cigarettes increased the probability of persistent cigarette abstinence at Wave 2 (risk difference (RD) = 6%, 95% confidence interval (CI): 2, 10), but using approved pharmaceutical aids did not (for varenicline, RD = 2%, 95% CI: -6, 13; for bupropion, RD = 4%, 95% CI: -6, 17; for nicotine replacement therapy, RD = -3%, 95% CI: -8, 2). Among quit attempters who relapsed, ENDS did not reduce the average daily cigarette consumption (cigarettes per day, -0.18, 95% CI: -1.87, 1.51).
The role of mainstream media in women’s views of female beauty and body image has been well documented. However, few published studies have observed ethnic differences in physiological stress reactivity that may occur from pressures to comply with a particular image of beauty. This study examined whether the exposure to the mainstream ideal body image would negatively affect Latina women’s physiological and psychological functioning, and how their responses differed in comparison to their White counterparts. Participants included college-aged female students from Pitzer College who self-identified as Latina or Caucasian. Participants completed questionnaires assessing, body esteem (MSBRQ-AS; SATAQ; CDFRS), ethnic identity (SEE), state anxiety (STAI-State) and affect (PANAS) prior to and following exposure to Victoria’s Secret or Chrysler automobile commercials. Physiological stress reactivity was assessed through changes in systolic and diastolic blood pressure, as well as salivary cortisol. 3-way ANOVA tests indicated a significant 2-way interaction between condition and time on participants’ levels of diastolic blood pressure, F(1, 27) = 4.266, MSe = 29.803, p =.049, η2 =.136, as well as ratings of appearance evaluation, F(1,36) = 5.733, MSe = 3.692, p =.022, η2 =.137, and body satisfaction F(1,36) = 4.27, MSe = 4.747, p = .046, η2 =.106. Women who viewed the Victoria’s Secret commercials demonstrated increased levels of diastolic blood pressure and reported lower ratings of body esteem in comparison to women who viewed the Chevy Sonic commercials. Potential trends in anxiety reactivity and the internalization of mainstream female beauty in Latina women following exposure to the stimuli are further discussed. EFFECT OF MAINSTREAM MEDIA 3 The Effect of Mainstream Media on Body Image and Stress Reactivity in Latina Females In Western media, the ideal female physique is depicted as significantly below what is considered to be a healthy body weight (National Eating Disorder Association, 2002). Research has shown that viewing these representations may lead to body image disturbance and anxiety, both of which are risk factors for eating disorders (Groesz, Levine, & Murnen, 2002). Analyzing the depictions of beauty presented in US media, Rodin and colleagues (1985) found that the norm highlighted in American advertisements conveys a message in which female beauty is associated with social rewards, such as professional status. This may cause women to internalize an unrealistic ideal as a standard to meet or exceed (Bordo, 1993). It has been demonstrated that fashion models are significantly thinner than 98% of American women (Smolak, 1996). For instance, while the average American woman stands 5 ft. 4 in. tall and weighs 140 lbs., the average fashion model stands 5 ft. 11 in. tall and weighs 117 lbs. (National Eating Disorder Association, 2002). It is likely that these gross differences in body weight and shape between average females and fashion models have negatively affected women’s self image and psychological functioning. Several studies have found that following exposure to mainstream media, women reported higher levels of body dissatisfaction and increased internalization of a thin ideal body shape (Groesz, Levine, and Murnen, 2002; Hofschire & Greenberg, 2002). In studies examining the effects of these images on ethnically diverse women’s self-concept and psychological well-being (Dounchis, Hayden, & Wilfley, 2001; Gordon, Castro, Sitnikov, & Holm-Denoma, 2010; Rubin, Fitts, & Becker, 2003), it has been shown that, similar to Caucasian females, African American and Latina women also consider the dominant beauty EFFECT OF MAINSTREAM MEDIA 4 ideal to be women who are tall and extremely thin with European features (Goodman, 2002; Parker, Nichter, Vuckovic, Sims, & Ritenbaugh, 1995). Despite similarities in describing the dominant ideal body image, some studies have reported differences in the ways in which various ethnic groups respond to mainstream media’s portrayal of female beauty. For instance, one study revealed that in comparison to Caucasian women, Latina women were more accepting of heavier female body types (Paeratakul, White, Williamson, Ryan, & Bray, 2002). Reasoning for this variation has been associated with cultural differences in perceptions of beauty and body image. In contrast with Euro-American cultures, Latin cultures present their own norms and perceptions relating to female beauty and body shape (Warren, Gleaves, Cepeda-Benito, Fernandez, & Rodriguez-Ruiz, 2005). For example, in observing ethnic differences in ideologies related to body image, Rubin and associates (2003) found that Latina and Black women were more likely than Caucasian women to describe the ideal body in terms of style, health, and spirituality, rather than in terms of shape or size. Research suggests that Latina women who are more connected to their culture of origin may not internalize the imagery depicted in mainstream media, viewing ideal female physique in US media with disinterest or ambivalence (Warren et al., 2005). However, some studies have found that Latina women were just as likely to be negatively affected by media depictions as White women, expressing greater concerns about weight gain, lower selfesteem, and body shame (Seo & Torabi, 2006; Viladrich, Bruning, & Weiss, 2009). In relation to body image perceptions, researchers have considered the possibility that acculturation to U.S values might lead to negative body image perceptions in Latina women (Gowen, Hayward, Killen, Robinson, & Taylor, 1999; Pepper & Ruiz, 2007). Acculturation is characterized as a process of attitudinal change that may occur in individuals who either EFFECT OF MAINSTREAM MEDIA 5 reside in multicultural societies or who come into contact with a new culture (Marin, 1992). Thus, one explanation for the discrepancies in the research could be the failure to account for the degree of acculturation as a moderating variable. This study addressed this by examining whether Latina women who report more acculturation toward mainstream US society demonstrated more psychological distress in response to viewing media images of the ideal female body. To date, no published study has examined women’s physiological stress responses to viewing media images of the ideal female body. Thus, it is unclear whether chronic exposure to these images has detrimental physiological effects on women. In a study examining the relationship between dieting and cortisol output in women, Putterman and Linden (2006) discovered that women who placed greater importance on appearance and reported negative perceptions regarding their own body image, also demonstrated higher levels of cortisol in the afternoon than women who did not share similar perspectives. The relationship between blood pressure and body image issues has also been explored, with results indicating that women who reported negative attitudes toward personal body image and eating also demonstrated higher levels of diastolic ambulatory blood pressure than women who reported neutral or positive attitudes (Bedford, Linden, & Barr, 2011). These findings suggest that low body-esteem might be associated with heightened physiological arousal in response to media images of the ideal body. However, no published research has investigated differences in the relationships between body image attitudes and physiological stress. As demonstrated by the previously cited research, Latina women are faced with the task of negotiating between paradoxical cultural domains in which conflicting views of female beauty are valued. Though several studies have analyzed acculturation and body image in Latina women, no published studies have examined whether the pressures to EFFECT OF MAINSTREAM MEDIA 6 comply with opposing cultural attitudes towards body image results in increased stress responses in these women compared to their Caucasian counterparts. This study addressed this gap in the literature by investigating the effect of mainstream media’s depiction of body image on stress reactivity in Latina women. Specifically, this study examined salivary cortisol and cardiovascular reactivity to exposure to the mainstream ideal body image in Latina and Caucasian college students. Based upon past research, it was hypothesized that women who were exposed to Victoria’s Secret advertisements (experimental condition), would report lower levels of body esteem, higher levels of state anxiety, and lastly, higher levels of cortisol and cardiovascular reactivity than women who were exposed to a control condition depicting Chevy Sonic automobile advertisements. In addition, it was predicted that acculturation would moderate psychological and physiological responses in Latina women, such that Latina women who reported more acculturation would have greater stress reactivity to the Victoria’s Secret commercial than those who reported low acculturation. Method Participants Participants enrolled in introductory psychology courses at Pitzer College were invited to complete a pre-screening questionnaire on SurveyMonkey.com to determine eligibility for the study. Individuals who were eligible for the study indicated on the prescreening questionnaire that they were female, at least 18 years of age, and identified as either Latina/Hispanic or White/Caucasian. Twenty-four Caucasian and seventeen Latina female undergraduate students (Mage= 22 years, age range: 18-40 years old) from Pitzer College were recruited for this study. Participants received either research credit or $10 in compensation for their participation. EFFECT OF MAINSTREAM MEDIA 7
Abstract Introduction This study examined the predictive relationships between biomarkers of nicotine exposure and 16-item self-reported level of tobacco dependence (TD) and subsequent tobacco use outcomes. Aims and Methods The Population Assessment of Tobacco and Health (PATH) Study surveyed adult current established tobacco users who provided urine biospecimens at Wave 1 (September 2013–December 2014) and completed the Wave 2 (October 2014–October 2015) interview (n = 6872). Mutually exclusive user groups at Wave 1 included: Cigarette Only, E-cigarette Only, Cigar Only, Hookah Only, Smokeless Tobacco Only, Cigarette Plus E-cigarette, multiple tobacco product users who smoked cigarettes, and multiple tobacco product users who did not smoke cigarettes. Total Nicotine Equivalents (TNE-2) and TD were measured at Wave 1. Approximate one-year outcomes included frequency/quantity used, quitting, and adding/switching to different tobacco products. Results For Cigarette Only smokers and multiple tobacco product users who smoked cigarettes, higher TD and TNE-2 were associated with: a tendency to smoke more, smoking more frequently over time, decreased likelihood of switching away from cigarettes, and decreased probability of quitting after one year. For other product user groups, Wave 1 TD and/or TNE-2 were less consistently related to changes in quantity and frequency of product use, or for adding or switching products, but higher TNE-2 was more consistently predictive of decreased probability of quitting. Conclusions Self-reported TD and nicotine exposure assess common and independent aspects of dependence in relation to tobacco use behaviors for cigarette smokers. For other product user groups, nicotine exposure is a more consistent predictor of quitting than self-reported TD. Implications This study suggests that smoking cigarettes leads to the most coherent pattern of associations consistent with a syndrome of TD. Because cigarettes continue to be prevalent and harmful, efforts to decrease their use may be accelerated via conventional means (eg, smoking cessation interventions and treatments), but also perhaps by decreasing their dependence potential. The implications for noncombustible tobacco products are less clear as the stability of tobacco use patterns that include products such as e-cigarettes continue to evolve. TD, nicotine exposure measures, and consumption could be used in studies that attempt to understand and predict product-specific tobacco use behavioral outcomes.
