Pierce J P, Choi W S, Gilpin E A, Farkas A J, Berry C C
Cancer Prevention and Control Program, Cancer Center, University of California, San Diego, La Jolla 92093-0901, USA.
JAMA. 1998 Feb 18;279(7):511-5. doi: 10.1001/jama.279.7.511.
Whether tobacco advertising and promotion increases the likelihood that youths will begin smoking has important public policy implications.
To evaluate the association between receptivity to tobacco advertising and promotional activities and progress in the smoking uptake process, defined sequentially as never smokers who would not consider experimenting with smoking, never smokers who would consider experimenting, experimenters (smoked at least once but fewer than 100 cigarettes), or established smokers (smoked at least 100 cigarettes).
Prospective cohort study with a 3-year follow-up through November 1996.
A total of 1752 adolescent never smokers who were not susceptible to smoking when first interviewed in 1993 in a population-based random-digit dial telephone survey in California were reinterviewed in 1996.
Becoming susceptible to smoking or experimenting by 1996.
More than half the sample (n=979) named a favorite cigarette advertisement in 1993 and Joe Camel advertisements were the most popular. Less than 5% (n=92) at baseline possessed a promotional item but a further 10%(n=172) were willing to use an item. While having a favorite advertisement in 1993 predicted which adolescents would progress by 1996 (odds ratio [OR] = 1.82; 95% confidence interval [CI], 1.04-3.20), possession or willingness to use a promotional item was even more strongly associated with future progression (OR=2.89; 95% CI, 1.47-5.68). From these data, we estimate that 34% of all experimentation in California between 1993 and 1996 can be attributed to tobacco promotional activities. Nationally, this would be over 700000 adolescents each year.
These findings provide the first longitudinal evidence to our knowledge that tobacco promotional activities are causally related to the onset of smoking.
烟草广告和促销活动是否会增加青少年开始吸烟的可能性，这具有重要的公共政策意义。
评估对烟草广告和促销活动的接受程度与吸烟起始过程进展之间的关联，吸烟起始过程依次定义为从不吸烟者（不会考虑尝试吸烟）、从不吸烟者（会考虑尝试）、尝试吸烟者（至少吸过一次但不足100支香烟）或已吸烟者（至少吸过100支香烟）。
前瞻性队列研究，随访3年至1996年11月。
1993年在加利福尼亚州一项基于人群的随机数字拨号电话调查中首次接受访谈时对吸烟不易感的1752名青少年从不吸烟者，于1996年再次接受访谈。
到1996年时变得对吸烟易感或开始尝试吸烟。
超过一半的样本（n = 979）在1993年说出了最喜欢的香烟广告，其中骆驼乔广告最受欢迎。基线时不到5%（n = 92）的人拥有促销物品，但另有10%（n = 172）的人愿意使用促销物品。虽然在1993年有最喜欢的广告可预测哪些青少年到1996年时会有进展（优势比[OR]=1.82；95%置信区间[CI]，1.04 - 3.20），但拥有或愿意使用促销物品与未来进展的关联更强（OR = 2.89；95% CI，1.47 - 5.68）。根据这些数据，我们估计1993年至1996年加利福尼亚州所有尝试吸烟行为中有34%可归因于烟草促销活动。在全国范围内，每年这一数字将超过70万青少年。
据我们所知，这些发现提供了首个纵向证据，表明烟草促销活动与吸烟起始存在因果关系。
