Cigarette advertising and teen smoking initiation.
OBJECTIVE
To test the specificity of the association between cigarette advertising and adolescent smoking initiation.


METHODS
A longitudinal survey of 2102 adolescents, aged 10 to 17 years at baseline, who never smoked was conducted by using masked images of 6 cigarette advertisements and 8 other commercial products with all brand information digitally removed. The exposure variable was a combination of contact frequency and cued recall of brands for cigarette and other advertisements. Multilevel mixed-effects Poisson regressions were used to assess smoking initiation 9 months after the baseline assessment as a function of cigarette-advertisement exposure, other advertisement exposure, and baseline covariates.


RESULTS
Thirteen percent (n = 277) of students initiated smoking during the observation period. Although the incidence of trying smoking was associated with increased exposure to cigarette advertisements (10% in the low, 12% in the medium, and 19% in the high cigarette-advertisement exposure tertile initiated smoking), exposure to other advertisements did not predict smoking initiation. Compared with low exposure to cigarette advertisements, high exposure remained a significant predictor of adolescent smoking initiation after controlling for baseline covariates (adjusted relative risk: 1.46 [95% confidence interval: 1.08-1.97]; P < .05).


CONCLUSIONS
Our results support the notion of a content-related effect of cigarette advertisements and underlines the specificity of the relationship between tobacco marketing and teen smoking; exposure to cigarette advertisements, but not other advertisements, is associated with smoking initiation.
Institute for Therapy and Health Research, IFT-Nord, Harmsstrasse 2, 24114 Kiel, Germany. hanewinkel@ift-nord.de
Reiner
R
Hanewinkel
Barbara
B
Isensee
James D
JD
Sargent
Matthis
M
Morgenstern
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000329:Advertising / Q000191:economics* / Q000639:trends; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010775:Photic Stimulation / Q000379:methods; D012307:Risk Factors; D012907:Smoking / Q000191:economics* / Q000523:psychology* / Q000639:trends