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. 2010 Aug;126(2):232-8.
doi: 10.1542/peds.2009-3021. Epub 2010 Jul 19.

A longitudinal study of exposure to retail cigarette advertising and smoking initiation

Lisa Henriksen  1 , Nina C Schleicher, Ellen C Feighery, Stephen P Fortmann
Affiliations

A longitudinal study of exposure to retail cigarette advertising and smoking initiation

Lisa Henriksen et al. Pediatrics. 2010 Aug.

Abstract

Objectives: Accumulating evidence suggests that widespread advertising for cigarettes at the point of sale encourages adolescents to smoke; however, no longitudinal study of exposure to retail tobacco advertising and smoking behavior has been reported.

Methods: A school-based survey included 1681 adolescents (aged 11-14 years) who had never smoked. One measure of exposure assessed the frequency of visiting types of stores that contain the most cigarette advertising. A more detailed measure combined data about visiting stores near school with observations of cigarette advertisements and pack displays in those stores. Follow-up surveys 12 and 30 months after baseline (retention rate: 81%) documented the transition from never to ever smoking, even just a puff.

Results: After 12 months, 18% of adolescents initiated smoking, but the incidence was 29% among students who visited convenience, liquor, or small grocery stores at least twice per week and 9% among those who reported the lowest visit frequency (less than twice per month). Adjusting for multiple risk factors, the odds of initiation remained significantly higher (odds ratio: 1.64 [95% confidence interval: 1.06-2.55]) for adolescents who reported moderate visit frequency (0.5-1.9 visits per week), and the odds of initiation more than doubled for those who visited > or = 2 times per week (odds ratio: 2.58 [95% confidence interval: 1.68-3.97]). Similar associations were observed for the more detailed exposure measure and persisted at 30 months.

Conclusions: Exposure to retail cigarette advertising is a risk factor for smoking initiation. Policies and parenting practices that limit adolescents' exposure to retail cigarette advertising could improve smoking prevention efforts.

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Figures

FIGURE 1
FIGURE 1
Predicted probability of smoking initiation at follow-up on the basis of shopping frequency (visits per week) measured at baseline.
See this image and copyright information in PMC

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