Targeting trendsetters to reduce smoking among young adults in bars

Significance: Young adults (age 18-25) have disproportionately high smoking rates. Commercial market segmentation strategies can be used to identify and reach high risk subgroups for interventions. Objective: Evaluate the effects of a psychographically targeted social marketing intervention on smoking behavior among young adult trendsetters in San Diego Methods: Time location sampling and repeated cross-sectional surveys of 1000 young adults attending bars in San Diego CA at baseline and 3 years follow up. Trendsetters were members of a single socio-cultural group with social concern scores in the highest quartile. Results: Compared to baseline, a significant decrease in current (past 30 day) smoking was observed in the total sample attending Hipster bars from 55.9% to 47.9% at the 32-month follow up (p=0.003, OR=0.71 95% CI [0.57, 0.89]). Among those who identified most strongly as hipsters, we observed a significant decrease in smoking from 60.8% at baseline to 50.0% at 32 months (p=0.001, OR=0.62 95% CI [0.47, 0.82]). Among the hipsters with highest levels of social concern, we observed a 22% decrease in smoking from 77.4% to 60.3% at 32 months (p=0.006, OR=0.42 [0.23, 0.78]). Both campaign exposure and decreases in smoking prevalence were largest among the highly socially concerned hipsters. We also observed an unexpected significant decrease in past month binge drinking from 78.5% to 65.2% at 32 months (p<0.001, OR=0.51 [0.40, 0.66]) compared to baseline). Discussion: This intervention effectively reached high risk young adults in bars. Smoking decreased significantly, with the greatest reductions among those most at risk.