title: Quantifying the persistence of pro-smoking media effects on college students' smoking risk.
abstract: OBJECTIVE
  To quantify the persistence of pro-smoking media exposure effects on college students' intentions to smoke and smoking refusal self-efficacy.
  
  
  METHODS
  A total of 134 college students (ages 18-24 years) were enrolled in an ecological momentary assessment study in which they carried handheld data collection devices for 3 weeks and reported their exposures to pro-smoking media as they occurred in the real world. Smoking intentions and smoking refusal self-efficacy were assessed after each exposure to pro-smoking media and at random prompts during each day of the 3-week assessment period. A generalized additive model was used to determine how long the effect of an exposure to pro-smoking media persisted.
  
  
  RESULTS
  The effect of pro-smoking media exposures persisted for 7 days. After exposure, smoking intentions immediately increased (.56; 95% confidence interval [CI]: [.26, .87]) and then steadily decreased (-.12; 95% CI: [-.19, -.05]) each day for 7 days, while smoking refusal self-efficacy immediately decreased (-.42; 95% CI: [-.75, -.10]) and then steadily increased (.09; 95% CI: [.02, .16]) each day for 7 days. Daily changes occurring after 7 days were not statistically significant, suggesting that smoking intentions and refusal self-efficacy had stabilized and were no longer affected by pro-smoking media exposure.
  
  
  CONCLUSIONS
  Exposures to pro-smoking media may have strong implications for emerging young adults smoking risk as the impact of an individual exposure appears to persist for at least a week.
authors.affiliation: RAND Corporation, Pittsburgh, Pennsylvania. Electronic address: setodji@rand.org.
authors.forename: Claude M
authors.initials: CM
authors.lastname: Setodji
authors.affiliation: RAND Corporation, Pittsburgh, Pennsylvania.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Martino
authors.affiliation: RAND Corporation, Pittsburgh, Pennsylvania.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Scharf
authors.affiliation: RAND Corporation, Pittsburgh, Pennsylvania.
authors.forename: William G
authors.initials: WG
authors.lastname: Shadel
mesh_terms: D000293:Adolescent; D000329:Advertising; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008402:Mass Media; D010414:Pennsylvania / Q000453:epidemiology; D012306:Risk; D012907:Smoking / Q000453:epidemiology*; D014495:Universities; D055815:Young Adult
keywords: Cigarette advertising; Movies; Persistence; Smoking