Truth Initiative Schroeder Institute, Washington, District of Columbia, USA.
Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Tob Control. 2018 Jul;27(e1):e50-e56. doi: 10.1136/tobaccocontrol-2017-054141. Epub 2018 Feb 22.
We examine adolescent receipt of tobacco coupons and subsequent tobacco use.
Data were from the Population Assessment of Tobacco and Health (PATH) Study (2013-2015). We identified correlates of coupon receipt at Wave 1 (youth sample age 12-17 ; n = 13 651) including demographics, additional vulnerability factors that may place youth at risk of tobacco use and correlates of coupon receipt by channel. We examined associations of Wave 1 coupon receipt with Wave 2 tobacco use using weighted multivariable models.
Overall, 7.6% of US youth received tobacco coupons in the 6 months before Wave 1. Coupon recipients were more likely to be women, living outside urban areas, living with a tobacco user, current and former (vs never) tobacco users, having high internalising mental health symptoms and having a favourite tobacco advertisement. Coupons were received primarily through direct mail (56%), product packs (28%) and online (25%). Never tobacco users at Wave 1 who received coupons were more likely to be ever users at Wave 2 (adjusted OR (aOR)=1.42; 95% CI 1.06 to 1.91). Coupon recipients were more likely to use a new tobacco product between waves (aOR=1.67; 95% CI 1.18 to 2.36) and report past 30-day tobacco use at Wave 2 (aOR=1.81; 95% CI 1.31 to 2.49).
One in 13 US youth (7.6%) received coupons. Vulnerable youth had the greatest odds of coupon receipt. Coupon recipients had greater odds of tobacco use among never users, trying a new tobacco product and current use. Coupon bans, limits on youth coupon exposure, stronger age verification, pack inserts or restricting coupon redemption may help reduce tobacco use among adolescents, particularly for those at greatest risk.
我们研究了青少年获得烟草优惠券以及随后吸烟的情况。
数据来自于人口烟草和健康评估（PATH）研究（2013-2015 年）。我们在第 1 波（年龄在 12-17 岁的青年样本；n=13651）中确定了与优惠券获取相关的因素，包括人口统计学因素、可能使青少年面临烟草使用风险的其他脆弱性因素以及通过渠道获得优惠券的相关因素。我们使用加权多变量模型研究了第 1 波优惠券获取与第 2 波烟草使用之间的关联。
总体而言，7.6%的美国青少年在第 1 波之前的 6 个月内收到了烟草优惠券。优惠券领取者更有可能是女性、居住在城市以外地区、与烟草使用者一起生活、目前和曾经（而非从未）使用烟草、有较高的内在心理健康症状以及有喜欢的烟草广告。优惠券主要通过直邮（56%）、产品包装（28%）和网络（25%）获得。第 1 波从未使用过烟草的人如果收到优惠券，那么在第 2 波更有可能成为曾经使用者（调整后的比值比（aOR）=1.42；95%置信区间 1.06 至 1.91）。优惠券领取者在两个波次之间更有可能使用新的烟草产品（aOR=1.67；95%置信区间 1.18 至 2.36），并报告第 2 波过去 30 天的烟草使用情况（aOR=1.81；95%置信区间 1.31 至 2.49）。
在美国青少年中，每 13 人就有 1 人（7.6%）收到优惠券。弱势青少年获得优惠券的可能性最大。对于从未使用者、尝试新烟草产品和当前使用者来说，领取优惠券的青少年更有可能使用烟草。禁止优惠券、限制青少年接触优惠券、加强年龄验证、包装插页或限制优惠券兑换可能有助于减少青少年的烟草使用，特别是对于那些风险最大的青少年。
