College of Public Health, The Ohio State University, Columbus, OH, USA.
Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
Addict Behav. 2022 Nov;134:107415. doi: 10.1016/j.addbeh.2022.107415. Epub 2022 Jun 23.
A growing body of evidence indicates that exposure to tobacco advertising among adolescents increases the likelihood of subsequent tobacco use. It is important to understand the process by which this occurs, in order to appropriately target factors for intervention. The objective of this study was to test whether attitudes towards tobacco advertising mediates the impact of advertising exposure on tobacco use.
From an ongoing prospective cohort study of male adolescents (aged 11-16 at baseline), we recruited a subset of tobacco users and non-users to participate in an additional ecological momentary assessment (EMA) project (N = 164). Adolescents completed smartphone-based surveys 2-3 times/day over a 10-day period with items assessing their exposures and attitudes towards tobacco-related advertising. If participants reported exposure to tobacco advertising, they were asked about their attitudes toward it (how much they enjoyed it, liked it, and found it appealing).
Adolescents who reported a greater amount of advertising exposure during the EMA period were more likely to report past-30-day tobacco use at their next cohort follow-up (6-12 months later). Moreover, the impact of advertising exposure on subsequent use was mediated by attitudes toward the tobacco advertisements, as reported during the EMA. This effect remained after controlling for baseline tobacco use.
By pairing EMA with long-term follow-up, we identified attitudes as a mediator between adolescent advertising exposure and subsequent tobacco use. Interventions to lessen adolescents' positive attitudes toward tobacco advertisements may help disrupt this impact.
越来越多的证据表明，青少年接触烟草广告会增加他们后续使用烟草的可能性。了解这一过程的发生机制对于有针对性地干预因素非常重要。本研究的目的是检验青少年对烟草广告的态度是否在广告暴露对烟草使用的影响中起中介作用。
从一项正在进行的男性青少年（基线时年龄为 11-16 岁）的前瞻性队列研究中，我们招募了一部分烟草使用者和非使用者参与额外的生态瞬时评估（EMA）项目（N=164）。青少年在 10 天的时间里，每天通过智能手机完成 2-3 次调查，内容包括他们接触和对烟草相关广告的态度。如果参与者报告接触到烟草广告，他们会被问到对这些广告的态度（他们有多喜欢、欣赏和觉得有吸引力）。
在 EMA 期间报告接触到更多广告的青少年在下一次队列随访（6-12 个月后）时更有可能报告过去 30 天的烟草使用。此外，广告暴露对后续使用的影响是由 EMA 期间报告的对烟草广告的态度所介导的。在控制了基线烟草使用后，这种影响仍然存在。
通过将 EMA 与长期随访相结合，我们发现态度是青少年广告暴露与随后的烟草使用之间的一个中介因素。减少青少年对烟草广告的积极态度的干预措施可能有助于打破这种影响。
