Receptivity to tobacco industry and tobacco control media messages and smoking behavior in a national sample

Background: Receptivity to tobacco industry marketing is associated with future smoking. Public health counter-marketing campaigns have been associated with reduced smoking. There is a need to understand the inter-relationship of ad receptivity and smoking behavior. Methods: In 2003, a national sample of primary caregivers and pre-teens were enrolled in a study of the effect of parenting behavior on smoking initiation (N=1036); participants were surveyed multiple times. In 2007-8, 766 youth were re-surveyed, baseline never smokers with complete data were retained for analysis (N=670). Self-reported data include: sociodemographics, home and peer smoking, tobacco advertisement (ad) preferences, smoking bans, smoking risk, and schooling. Smoking was assessed by the question “Have you ever smoked a cigarette, even a few puffs?”. Separate questions assess favorite tobacco-related ads (favorite tobacco control only, favorite cigarette ad only, both, or no favorite tobacco ad). Adjusted regression explores cross-sectional associations with smoking experimentation. Results: Overall, 70.9% of adolescents reported a favorite tobacco-related ad; 57.8% reported a favorite tobacco control ad and 43.1% reported an industry ad. Nearly one third (30%) of adolescents reported both favorite tobacco industry and control ads. The few adolescents who only reported a favorite industry (13.1%) were twice as likely to have experimented than those reporting only a tobacco control ad (OR=2.0,95%CI:1.045-3.92). The probability of experimentation was lower and non-significant for those reporting both types of ads (OR=1.35, 95%CI:0.76-2.39). Conclusions: Public health campaigns may effectively counter the known influence of tobacco marketing in smoking initiation. Results need to be confirmed in a longitudinal study.