title: Direct-to-consumer tobacco marketing and its association with tobacco use among adolescents and young adults.
abstract: OBJECTIVE
  We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (current), and smoking ≥100 cigarettes in lifetime (established) among adolescents and young adults.
  
  
  METHODS
  We surveyed a U.S. telephone sample of 3,342 15- to 23-year-olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N = 2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking.
  
  
  RESULTS
  Overall, 12% of 15- to 17-year-olds and 26% of 18- to 23-year-olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority nonsmoking respondents were more likely to see tobacco websites than nonsmoking whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio 2.2, 95% confidence interval 1.3-3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (adjusted odds ratio 2.7, 95% confidence interval 1.1-6.6). We observed similar relationships for ever having tried smoking and established smoking.
  
  
  CONCLUSIONS
  Direct-to-consumer tobacco marketing reaches adolescent and young adult nonsmokers and is associated with smoking behavior.
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Electronic address: samir.soneji@dartmouth.edu.
authors.forename: Samir
authors.initials: S
authors.lastname: Soneji
authors.affiliation: Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Rockville, Maryland.
authors.forename: Bridget K
authors.initials: BK
authors.lastname: Ambrose
authors.affiliation: Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Rockville, Maryland.
authors.forename: Won
authors.initials: W
authors.lastname: Lee
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: James
authors.initials: J
authors.lastname: Sargent
authors.affiliation: Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Susanne
authors.initials: S
authors.lastname: Tanski
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016001:Confidence Intervals; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D040541:Marketing / Q000379:methods*; D016017:Odds Ratio; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D019460:Tobacco Industry / Q000379:methods*; D064424:Tobacco Use / Q000453:epidemiology; D014481:United States; D055815:Young Adult
keywords: Adolescents; Direct-to-consumer marketing; Tobacco; Young Adults