title: Pro-tobacco influences and susceptibility to smoking cigarettes among middle and high school students--United States, 2011.
abstract: OBJECTIVE
  Smoking is a leading cause of cancer, and most smokers begin during adolescence. We examined the proportion of adolescents exposed to pro-tobacco advertising and assessed the association between this exposure and susceptibility to smoking.
  
  
  METHODS
  Data from the 2011 National Youth Tobacco Survey were used to calculate the proportion of susceptible middle school (MS) and high school (HS) students exposed to pro-tobacco advertisements through stores, magazines, and the Internet. Following previous work, susceptibility to smoking cigarettes was defined as "never smoked but open to trying cigarettes."
  
  
  RESULTS
  In 2011, 81.5% of MS students and 86.9% of HS students were exposed to tobacco advertisements in stores; 48.2% of MS students and 54.0% of HS students were exposed to such advertising in magazines. Exposure to tobacco advertisements on the Internet was similar for MS (40.8%) and HS students (40.2%). Of those surveyed, 22.5% of MS students and 24.2% of HS students were susceptible to trying cigarettes. Exposure to magazine advertising declined from 71.8% in 2000 to 46.1% in 2009 among susceptible MS students; however, exposure increased to 55.4% in 2011. Tobacco advertising seen through the Internet among susceptible HS students increased from 25.9% in 2000 to 44.7% in 2011.
  
  
  CONCLUSIONS
  Adolescents continue to be exposed to pro-tobacco advertisements. Adolescents susceptible to smoking are more likely to report exposure to pro-tobacco advertisements. In addition to continued monitoring, more effective interventions to eliminate youth exposure to pro-tobacco marketing are needed.
authors.affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. skd7@cdc.gov
authors.forename: Shanta R
authors.initials: SR
authors.lastname: Dube
authors.forename: René A
authors.initials: RA
authors.lastname: Arrazola
authors.forename: Joann
authors.initials: J
authors.lastname: Lee
authors.forename: Martha
authors.initials: M
authors.lastname: Engstrom
authors.forename: Ann
authors.initials: A
authors.lastname: Malarcher
mesh_terms: D000293:Adolescent; D000329:Advertising; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008402:Mass Media; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D013334:Students / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology