title: Engagement With Online Tobacco Marketing and Associations With Tobacco Product Use Among U.S. Youth.
abstract: OBJECTIVE
  Youth who engage with online tobacco marketing may be more susceptible to tobacco use than unengaged youth. This study examines online engagement with tobacco marketing and its association with tobacco use patterns.
  
  
  METHODS
  Cross-sectional analysis of youths aged 12-17 years who participated in wave 1 of the Population Assessment of Tobacco and Health Study (N = 13,651). Engagement with tobacco marketing was based on 10 survey items including signing up for email alerts about tobacco products in the past 6 months. Logistic regression was used to examine the association of online engagement with tobacco marketing and susceptibility to use any tobacco product among never-tobacco users, ever having tried tobacco, and past 30-day tobacco use.
  
  
  RESULTS
  An estimated 2.94 million U.S. youth (12%) engaged with ≥ one forms of online tobacco marketing. Compared with no engagement, the odds of susceptibility to the use of any tobacco product among never-tobacco users was independently associated with the level of online engagement: adjusted odds ratio (AOR) = 1.48 (95% confidence interval [CI], 1.24-1.76) for one form of engagement and AOR = 2.37 (95% CI, 1.53-3.68) for ≥ two forms of engagement. The odds of ever having tried tobacco were also independently associated with the level of online engagement: AOR = 1.33 (95% CI: 1.11-1.60) for one form of engagement and AOR = 1.54 (95% CI, 1.16-2.03) for ≥ two forms of engagement. The level of online engagement was not independently associated with past 30-day tobacco use.
  
  
  CONCLUSIONS
  Online engagement with tobacco marketing may represent an important risk factor for the onset of tobacco use in youth.
authors.affiliation: Norris Cotton Cancer Center, Dartmouth Institute for Health Policy and 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: Department of Family Medicine and Public Health, Moores Cancer Center, University of California, San Diego, La Jolla, California.
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
authors.affiliation: National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Choi
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
authors.forename: David B
authors.initials: DB
authors.lastname: Portnoy
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Margolis
authors.affiliation: Westat, Rockville, Maryland; Department of Oncology, Cancer Prevention & Control Program, Georgetown University Medical Center, Washington, DC.
authors.forename: Cassandra A
authors.initials: CA
authors.lastname: Stanton
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Moore
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Maansi
authors.initials: M
authors.lastname: Bansal-Travers
authors.affiliation: Westat, Rockville, Maryland.
authors.forename: Charles
authors.initials: C
authors.lastname: Carusi
authors.affiliation: Westat, Rockville, Maryland; Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hyland
authors.affiliation: Norris Cotton Cancer Center, Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: James
authors.initials: J
authors.lastname: Sargent
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D040541:Marketing; D015999:Multivariate Analysis; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D062789:Tobacco Products / Q000706:statistics & numerical data*; D000073869:Tobacco Smoking; D064424:Tobacco Use / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D000072137:Vaping / Q000706:statistics & numerical data
keywords: Adolescents; Cigarette smoking; Engagement with online tobacco marketing