Jennifer Cantrell

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Jennifer Cantrell

Associate Research Professor of Social and Behavioral Sciences

Professional overview

Dr. Jennifer Cantrell's background is in social and behavioral science, policy evaluation, survey research, measurement, social epidemiology and health disparities. Her research focuses on the impact of policies and population-level interventions on health. Her work utilizes theory and methods from epidemiology, marketing, sociology, economics and psychology to understand the role of multiple structural factors on health risk behaviors and health outcomes. With a focus on tobacco use, Dr. Cantrell has evaluated national anti-smoking mass media efforts, including the award-winning truth campaign and the Centers for Disease Control’s Tips for Former Smokers campaign. As part of this work, she has developed and tested new methodologies for conducting effective population-based evaluation and surveillance. Dr. Cantrell’s research examines the ways that pro- and anti-tobacco marketing, digital media, tobacco regulatory policies, and community processes shape youth tobacco prevention, adult cessation and tobacco-related disparities.

Dr. Cantrell has published extensively and received national and international media coverage for her work. Her research has been funded by the National Institute of Drug Abuse, National Institute on Minority Health and Health Disparities, and the Centers for Disease Control and Prevention. 

Dr. Cantrell has been praised for her contributions to NCI Tobacco Control Monograph 22, for her work on Chapter 10: A Socioecological Approach to Addressing Tobacco-Related Health Disparities. She has also been a valued member of the advisory committee and a member of the program subcommittee of the health disparities network for the Society for Research on Nicotine & Tobacco (SRNT). 

Areas of research and study

Alcohol, Tobacco and Driving Policies
Behavioral Science
Health Disparities
Population Health
Public Health Policy
Social Behaviors
Social epidemiology

Publications

Publications

Cost and threshold analysis of the finishit campaign to prevent youth smoking in the United States

Weir, B. W., Cantrell, M., Holtgrave, D. R., Greenberg, M. S., Kennedy, R. D., Rath, J. M., Hair, E. C., & Vallone, D.

Publication year

2018

Journal title

International journal of environmental research and public health

Volume

15

Issue

8
Abstract
In 2014, Truth Initiative launched the national FinishIt campaign to prevent smoking initiation among youth and young adults. The significant changes in the communications landscape requires further analysis to determine resource requirements for public education campaigns relative to their impact. This analysis estimates the cost of the FinishIt campaign based on data from expenditure records and uses published estimates of the lifetime treatment costs and quality-adjusted life years associated with smoking. The total cost of the FinishIt campaign for 2014–2016 was $162 million. Under assumptions associated with the pessimistic base-case (no medical care costs saved through prevention), 917 smoking careers would need to be averted for the campaign to be cost-effective. Assuming smoking leads to increased medical care costs, 7186 smoking careers would need to be averted for the campaign to be cost-saving. Given these thresholds (917 and 7186) and the estimate of the impact of the previous truth campaign, the investments in the Truth Initiative’s FinishIt campaign are likely warranted for preventing smoking careers among youth and young adults.

Effects of the truth FinishIt brand on tobacco outcomes

Evans, W. D., Rath, J. M., Hair, E. C., Snider, J. W., Pitzer, L., Greenberg, M., Xiao, H., Cantrell, J., & Vallone, D.

Publication year

2018

Journal title

Preventive Medicine Reports

Volume

9

Page(s)

6-11
Abstract
Since 2000, the truth campaign has grown as a social marketing brand. Back then, truth employed branding to compete directly with the tobacco industry. In 2014, the launch of truth FinishIt reflected changes in the brand's strategy, the tobacco control environment, and youth/young adult behavior. Building on a previous validation study, the current study examined brand equity in truth FinishIt, as measured by validated multi-dimensional scales, and tobacco related attitudes, beliefs, and behavior based on two waves of the Truth Longitudinal Cohort data from 2015 and 2016. A fixed effects logistic regression was used to estimate the change in brand equity between panel survey waves 3 and 4 on past 30-day smoking among ever and current smokers. Additional models determined the effects of brand equity predicting tobacco attitudes/use at follow up among the full sample. All analyses controlled for demographic factors. A one-point increase in the brand equity scale between the two waves was associated with a 66% greater chance of not smoking among ever smokers (OR 1.66, CI 1.11–2.48, p < 0.05) and an 80% greater chance of not smoking among current smokers (OR 1.80, CI 1.05–3.10, p < 0.05). Higher overall truth brand equity at wave 3 predicted less smoking at wave 4 and more positive anti-tobacco attitudes. Being male, younger, and non-white predicted some of the tobacco related attitudes. Future research should examine long-term effects of brand equity on tobacco use and how tobacco control can optimize the use of branding in campaigns.

Estimating the Pathways of an Antitobacco Campaign

Hair, E. C., Cantrell, M., Pitzer, L., Bennett, M. A., Romberg, A. R., Xiao, H., Rath, J. M., Halenar, M. J., & Vallone, D.

Publication year

2018

Journal title

Journal of Adolescent Health

Volume

63

Issue

4

Page(s)

401-406
Abstract
Purpose: This study examined mechanisms through which the truth campaign, a national mass media antismoking campaign, influences smoking-related attitudes, and progression of tobacco use over time in youth and young adults. Methods: Structural equation modeling tested causal pathways derived from formative research and behavioral theory with a nationally representative longitudinal sample of 15–21-year-olds (n = 8747) over 24 months. Data were collected from 2014 to 2016, and analyses were conducted in 2017. Results: Greater ad awareness predicted strengthening of attitudes targeted by the campaign (i.e., feelings of independence from tobacco, antitobacco industry sentiment, decreasing acceptance of social smoking, and decreasing acceptance of smoking imagery), and attitude changes were significantly associated with greater support for an antitobacco social movement (e.g., agreement to the item “I would be part of a movement to end smoking”). Greater social movement support predicted a slower rate of progression on smoking intensity after two years of the campaign. Conclusions: Findings suggest that engaging youth and young adults in a cause-based social movement for promoting health can be a powerful strategy to drive positive behavior change. Messages targeting attitudes that resonate with values important to this age group, including independence and connectedness, are particularly effective. Investments in national antitobacco public education campaigns are key policy interventions which continue to help prevent tobacco use among youth and young adults.

Evidence of the impact of the truth finishit campaign

Vallone, D., Cantrell, J., Bennett, M., Smith, A. A., Rath, J. M., Xiao, H., Greenberg, M., & Hair, E. C.

Publication year

2018

Journal title

Nicotine and Tobacco Research

Volume

20

Issue

5

Page(s)

543-551
Abstract
Introduction: Over the past decade, public education mass media campaigns have been shown to be successful in changing tobacco-related attitudes, intentions, and behaviors among youth and young adults. In 2014, the national truth® campaign re-launched a new phase of the campaign targeted at a broad audience of youth and young adults, aged 15-21, to help end the tobacco epidemic. Methods: The study sample for this analysis is drawn from the Truth Longitudinal Cohort (TLC), a probability-based, nationally representative cohort designed to evaluate the relationship between awareness of truth media messages and changes in targeted attitudes, beliefs, and behaviors over time. The sample for this study was limited to those with data at baseline and three subsequent follow-up surveys (n = 7536). Results: Logistic regression models indicate that truth ad awareness is significantly associated with increases in targeted anti-tobacco attitudes as well as reduced intentions to smoke over time, holding constant baseline attitudes and intentions. Results also suggest a dose-response relationship in that higher levels of truth ad awareness were significantly associated with higher likelihood of reporting agreement across all five attitudinal constructs: anti-smoking imagery, anti-social smoking sentiment, anti-tobacco social movement, anti-tobacco industry sentiment, and independence. Conclusions: Longitudinal results indicate a significant dose-response relationship between awareness of the new phase of the truth campaign and campaign-targeted attitudes and intentions not to smoke among youth and young adults. Implications: Findings from this study confirm that a carefully designed anti-tobacco public education campaign aimed at youth and young adults is a key population-level intervention within the context of an expanding tobacco product landscape and a cluttered media environment. As tobacco use patterns shift and new products emerge, evidence-based public education campaigns can play a central role in helping the next generation to reject tobacco. Public education mass media campaigns are a key component to changing tobacco use attitudes and behavior, particularly among youth and young adults.

Examining perceptions about IQOS heated tobacco product: Consumer studies in Japan and Switzerland

Hair, E. C., Bennett, M., Sheen, E., Cantrell, M., Briggs, J., Fenn, Z., Willett, J. G., & Vallone, D.

Publication year

2018

Journal title

Tobacco Control

Volume

27

Page(s)

s70-s73
Abstract
Objective To examine consumer perceptions, attitudes and behaviours regarding the heated tobacco product, IQOS, as well as to document the product's marketing strategies to determine its potential for appealing to youth and young adults. Method Truth Initiative, in collaboration with Flamingo, collected qualitative data via: (1) expert interviews, (2) semiotic analysis of IQOS packing and marketing materials, and (3) 12 focus groups with adults in Switzerland (ages 19-44 years; June 6-9, 2016) and Japan (ages 20-39 years; June 22-24, 2016) (n=68 for both groups). Results Expert interviews and IQOS packing and marketing analyses revealed the product is being marketed as a clean, chic and pure product, which resonated very well in Japan given the strong cultural values of order, cleanliness, quality and respect for others. Focus groups results indicated Japanese IQOS users used the product for socialising with non-smokers. Focus group participants in both Japan and Switzerland reported lower levels of satisfaction with the product relative to combustible cigarettes, although many found the product packaging to be appealing. While participants identified several benefits and barriers related to IQOS, few reported any potential health benefits of use compared with combustible tobacco products. Conclusion IQOS was marketed as a sophisticated, high tech and aspirational product. Because youth and young adults are more interested in such product positioning, this approach raises some concern about youth appeal. This research shows cultural factors appeared to affect the appeal of this messaging, indicating that prevalence and uptake data will likely not be similar from country to country.

Patterns in first and daily cigarette initiation among youth and young adults from 2002 to 2015

Cantrell, J., Bennett, M., Mowery, P., Xiao, H., Rath, J., Hair, E., & Vallone, D.

Publication year

2018

Journal title

PloS one

Volume

13

Issue

8
Abstract
This study’s objective was to describe long-term trends and patterns in first cigarette use (cigarette initiation) and daily cigarette use (daily initiation) among youth and young adults in the U.S. We used cross-sectional survey data from the National Survey on Drug Use and Health, 2002–2015, to estimate annual incidence of first cigarette use (N = 270,556) and first daily cigarette use (N = 373,464) for each year by age groups, race/ethnicity and gender, examining trends over time and the average annual change in initiation for each group. Several clear patterns emerged: 1) cigarette initiation and daily initiation significantly decreased over time among those aged 12–14 and 15–17 and these trends were consistent among nearly all racial/ethnic and gender subgroups; 2) among 18–21 year olds, cigarette initiation sharply increased through 2009, surpassing rates among 15–17 year olds, and sharply declined through 2015 while remaining higher than rates among the younger group, and this trend was consistent for almost all racial/ethnic subgroups; 3) daily initiation for those aged 18–21 significantly declined, and this was significant among most subgroups 4) there was no change in cigarette initiation and daily initiation for 22–25 year olds overall and most subgroups; 5) there was a significant increase in cigarette initiation for 22–25 year old Hispanics males and daily initiation for 22–25 year old males. This study provides a comprehensive look at trends in cigarette and daily initiation among U.S. youth and young adults. Despite notable declines in smoking initiation among youth and young adult populations over the last two decades, targeted prevention and policy efforts are needed for subgroups at higher risk, including young adults and Hispanic males.

Recognition, use and perceptions of JUUL among youth and young adults

Willett, J. G., Bennett, M., Hair, E. C., Xiao, H., Greenberg, M. S., Harvey, E., Cantrell, J., & Vallone, D.

Publication year

2018

Journal title

Tobacco Control

Recruiting and retaining youth and young adults: Challenges and opportunities in survey research for tobacco control

Cantrell, J., Hair, E. C., Smith, A., Bennett, M., Rath, J. M., Thomas, R. K., Fahimi, M., Dennis, J. M., & Vallone, D.

Publication year

2018

Journal title

Tobacco Control

Volume

27

Issue

2

Page(s)

147-154
Abstract
Introduction Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21. Methods We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness Results Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates. Conclusions This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe.

Swisher Sweets 'Artist Project': Using musical events to promote cigars

Ganz, O., Rose, S. W., & Cantrell, J.

Publication year

2018

Journal title

Tobacco Control

Harnessing Youth and Young Adult Culture: Improving the Reach and Engagement of the truth® Campaign

Hair, E., Pitzer, L., Bennett, M., Halenar, M., Rath, J., Cantrell, J., Dorrler, N., Asche, E., & Vallone, D.

Publication year

2017

Journal title

Journal of Health Communication

Volume

22

Issue

7

Page(s)

568-575
Abstract
The national youth and young adult tobacco prevention mass media campaign, truth®, relaunched in 2014 with the goal of creating “the generation that ends smoking.” The objective of this study was to assess whether the strategy of airing truth ads during popular, culturally relevant televised events was associated with higher ad and brand awareness and increases in social media engagement. Awareness of six truth advertisements that aired during popular television events and self-reported social media engagement were assessed via cross-sectional online surveys of youth and young adults aged 15–21 years. Social engagement was also measured using separate Twitter and YouTube metrics. Logistic regression models predicted self-reported social engagement and any ad awareness, and a negative binomial regression predicted the total social media engagement across digital platforms. The study found that viewing a popular televised event was associated with higher odds of ad awareness and social engagement. The results also indicate that levels of social media engagement for an event period are greater than for a nonevent period. The findings demonstrate that premiering advertisements during a popular, culturally relevant televised event is associated with higher awareness of truth ads and increased social engagement related to the campaign, controlling for variables that might also influence the response to campaign messages.

Mobile marketing: An emerging strategy to promote electronic nicotine delivery systems

Cantrell, J., Ganz, O., Emelle, B., Moore, R., Rath, J., Hair, E. C., & Vallone, D.

Publication year

2017

Journal title

Tobacco Control

Progression to established patterns of cigarette smoking among young adults

Hair, E., Bennett, M., Williams, V., Johnson, A., Rath, J., Cantrell, J., Villanti, A., Enders, C., & Vallone, D.

Publication year

2017

Journal title

Drug and alcohol dependence

Volume

177

Page(s)

77-83
Abstract
Background As tobacco control policies have been implemented across the U.S. over the past decade, patterns of smoking cigarettes have significantly changed, particularly among young adults. For many users, the typical daily use pattern of smoking several packs of cigarettes per day has been supplanted by a variety of use patterns, often referred to as light, intermittent, and occasional smoking. Methods The aim of this study was to examine progression to established smoking patterns among a nationally representative, longitudinal sample of young adults (n = 9791). Using repeated measures latent class techniques (RMLCA), we modeled the distribution of cigarette smoking intensity over time and latent class categories. Results Findings demonstrate that young adults fall into three discrete classes that reflect probabilities for never to low use, daily use, and variable cigarette use for progression to established use of cigarettes: 79.3% fall into the class of “never or ever users” of cigarettes (no current use of cigarettes), 11.3% fall into the class of “rapid escalators” or daily users of cigarettes, and 9.4% fall into the “dabbler” class. Smoking patterns were found to be stable by the age of 21. Conclusions Intervening prior to age 21 has the potential to disrupt progression to established smoking and reduce the long-term health consequences of smoking in this age group.

The effect of branding to promote healthy behavior: Reducing tobacco use among youth and young adults

Vallone, D., Greenberg, M., Xiao, H., Bennett, M., Cantrell, J., Rath, J., & Hair, E.

Publication year

2017

Journal title

International journal of environmental research and public health

Volume

14

Issue

12
Abstract
Policy interventions such as public health mass media campaigns disseminate messages in order to improve health-related knowledge, attitudes, beliefs and behaviors at the population level. Only more recently have campaigns that promote health-related behaviors adopted branding, a well-established marketing strategy, to influence how consumers think and feel about a message. This study examines whether positive brand equity for the national truth® campaign is associated with lower likelihood of cigarette use over time using the nationally representative Truth Longitudinal Cohort of youth and young adults, aged 15-21. Logistic regression models were used to examine the relationship between brand equity and the likelihood of reporting past 30-day smoking over a 12-month period. Respondents who reported positive brand equity were significantly less likely to report past 30-day smoking 12 months later (OR = 0.66, p < 0.05), controlling for covariates known to influence tobacco use behavior. Findings also translate the effect size difference to a population estimate of more than 300,000 youth and young adults having been prevented from current smoking over the course of a year. Building brand equity is a strategic process for health promotion campaigns, not only to improve message recall and salience but also to influence behavioral outcomes.

The Relationship between Advertising-Induced Anger and Self-efficacy on Persuasive Outcomes: A Test of the Anger Activism Model Using the Truth Campaign

Ilakkuvan, V., Turner, M. M., Cantrell, J., Hair, E., & Vallone, D.

Publication year

2017

Journal title

Family and Community Health

Volume

40

Issue

1

Page(s)

72-80
Abstract
Turner's Anger Activism Model (AAM) contends anger and efficacy interact in a unique way to determine message responses to campaign materials. This study tested the AAM using responses to 2 truth antismoking advertisements collected in August-October 2014 via an online, cross-sectional survey of 15- to 21-year-olds. Those aware of each of the truth advertisements (n = 319 for each) were organized into 4 anger/efficacy groups. Analysis of variance and regressions were conducted to understand group differences in message-related cognitions (persuasiveness, receptivity, conversation). Message cognitions were highest among the high anger/high efficacy group and lowest among the low anger/low efficacy group.

Trajectories of hookah use: Harm perceptions from youth to young adulthood

Hair, E., Rath, J. M., Pitzer, L., Emelle, B., Ganz, O., Halenar, M. J., Cantrell, J., & Vallone, D.

Publication year

2017

Journal title

American Journal of Health Behavior

Volume

41

Issue

3

Page(s)

240-247
Abstract
Objectives: Hookah use has increased in United States, especially among young adults. This study investigates the role of harm perceptions of hookah use over a 2-year period in a nationally representative sample of youth and young adults as they transition to young adulthood. Methods: Using a probability-based, nationally representative, longitudinal cohort of youth aged 15-21, we analyzed the 7536 participants who completed all 4 waves. Ordered logit growth models examined changes over time in hookah use, and whether that relationship varies by baseline harm perceptions. Results: Results show that age, sex, parental education, race, and smoking status are significant predictors of hookah use. Additionally, those who perceive hookah as "less harmful" than cigarettes have the highest probability of current hookah use over time, compared to those with more accurate harm perceptions. Conclusions: This study helps confirm the influence of harm perceptions of hookah tobacco on hookah use among youth and young adults. Increased public education efforts aimed at youth and young adults can help shift knowledge, attitudes and beliefs regarding the health consequences of hookah use.

Validity of a Subjective Financial Situation Measure to Assess Socioeconomic Status in US Young Adults

Williams, V. F., Smith, A. A., Villanti, A. C., Rath, J. M., Hair, E. C., Cantrell, J., Teplitskaya, L., & Vallone, D. M.

Publication year

2017

Journal title

Journal of Public Health Management and Practice

Volume

23

Issue

5

Page(s)

487-495
Abstract
Purpose: Young adulthood is an important period for preventing the establishment of negative health behaviors that can influence trajectories to chronic disease and early death. Given the evolving nature of educational attainment and income variation during this developmental period, identifying indicators of socioeconomic status (SES) remains a challenge. This study examines measures of subjective and objective indicators of SES to predict health risk for young adults. Methods: This study uses data from the Truth Initiative Young Adult Cohort Study from respondents aged 18 to 34 years who completed 3 consecutive surveys between June 2011 and August 2012 (n = 2182). Analyses were conducted to compare a measure of subjective financial situation (SFS) to commonly used SES measures for adults and adolescents. Age-stratified, multivariable logistic regression was used to model the relationship between 5 SES indicators (SFS, household income, respondent education, parental education, and subjective childhood financial situation) and dichotomized versions of 3 health status measures (body mass index, self-reported health status, and quality of life), controlling for gender, race/ethnicity, and region. Results: Findings indicate that SFS is associated with other commonly used SES measures. Prospective associations with health outcomes revealed that SFS is a stronger predictor of health outcomes among young adults aged 18 to 24 years as compared with other SES measures. Conclusion: This study provides evidence that subjective financial situation may be more robust than traditional SES indicators in predicting health outcomes among young adults, particularly for 18- to 24-year-olds, and should be considered a viable candidate measure for assessing SES among this age group.

Agents of social change: A model for targeting and engaging generation Z across platforms: How a nonprofit rebuilt an advertising campaign to curb smoking by teens and young adults

Vallone, D., Smith, A., Kenney, T., Greenberg, M., Hair, E., Cantrell, J., Rath, J., & Koval, R.

Publication year

2016

Journal title

Journal of Advertising Research

Volume

56

Issue

4

Page(s)

414-425
Abstract
The Truth Initiative strives to protect a new generation of youths who are prime prospects for the tobacco industry, by engaging that audience and reigniting their interest. The current authors oversaw a three-phase study that included recruiting a national cohort sample-believed to be the first of its kind-of more than 10,000 members of Generation Z, ages 15 to 21 years old. The authors’ methods informed a new cross-platform campaign that fueled brand awareness and prompted changes in attitudes against smoking, while generating $88.6 million in earned media value with 78.5 million earned media impressions.

Design and Feasibility Testing of the truth FinishIt Tobacco Countermarketing Brand Equity Scale

Evans, W. D., Rath, J., Pitzer, L., Hair, E. C., Snider, J., Cantrell, J., & Vallone, D.

Publication year

2016

Journal title

Journal of Health Communication

Volume

21

Issue

7

Page(s)

800-808
Abstract
The original truth campaign was a branded, national smoking prevention mass media effort focused on at-risk youth ages 12–17. Today the truth brand focuses on the goal of finishing tobacco (truth FinishIt). There have been significant changes in the tobacco control landscape, leading FinishIt to focus on 15- to 21-year-olds. The present article reports on formative research and media monitoring data collected to pilot test a new truth FinishIt brand equity scale. The goals of this study were to (a) content analyze truth FinishIt mass media ads, (b) assess truth’s social media and followers’ perceptions of truth’s digital brand identity, and (c) develop and feasibility test a new version of the truth FinishIt brand equity scale using data from an existing Truth Initiative media monitoring study. Through factor analysis, we identified a brand equity scale, as in previous research, consisting of 4 main constructs: brand loyalty, leadership/satisfaction, personality, and awareness. Targeted truth attitudes and beliefs about social perceptions, acceptability, and industry-related beliefs were regressed on the higher order factor and each of the 4 individual brand equity factors. Ordinary least squares regression models generally showed associations in the expected directions (positive for anti-tobacco and negative for pro-tobacco) between targeted attitudes/beliefs and truth FinishIt brand equity. This study succeeded in developing and validating a new truth FinishIt brand equity scale. The scale may be a valuable metric for future campaign evaluation. Future studies should examine the effects of truth FinishIt brand equity on tobacco use behavioral outcomes over time.

Direct-to-Consumer Marketing of Cigar Productsin the United States

Ganz, O., Teplitskaya, L., Cantrell, J., Hair, E. C., & Vallone, D.

Publication year

2016

Journal title

Nicotine and Tobacco Research

Volume

18

Issue

5

Page(s)

864-868
Abstract
Introduction: Although cigar use and sales have increased in the United States over the past decade,little is known about how these products are promoted. Direct-to-consumer (DTC) advertisingis a common method used to promote tobacco products and may be a potential channel throughwhich cigars are advertised.Methods: Comperemedia (Mintel) was used to acquire opt-in direct mail and email advertising forthe top 10 cigar brands in the United States between January 2013 and July 2014. The advertisementand corresponding data on brand, advertising spend, and mail volume were downloadedand summarized. Promotions such as coupons, giveaways, and sweepstakes were also examined.Results: A total of 92 unique advertisements met the search criteria and included two brands: Black & Mild (n = 77) and Swisher Sweets (n = 15). Expenditures on direct mail advertising during thisperiod totaled $12 809 630. Black & Mild encompassed 80% of total direct mail volume and 78% ofdirect mail advertising expenditures. Almost all advertisements contained at least one promotion(88%) and included a URL to the product website (85%).Conclusions: The results suggest that Black & Mild and Swisher Sweets are the primary cigar brandsusing DTC advertising. Promotional offers were nearly ubiquitous among the advertisements,which may appeal to price-sensitive populations. Future studies should continue to examine cigaradvertising via direct mail and email, in addition to other channels, such as the point-of-sale.Implications: Although cigar use and sales have increased in the United States over the past decade,there is limited data on cigar advertising. This article provides a snapshot of expenditures,volume, and promotional content of DTC cigar advertising in the United States between January2013 and July 2014.

Rapid increase in e-cigarette advertising spending as Altria’s markten enters the marketplace

Cantrell, J., Emelle, B., Ganz, O., Hair, E. C., & Vallone, D.

Publication year

2016

Journal title

Tobacco Control

Volume

25

Page(s)

e16-e18

Contextual Influences and Campaign Awareness among Young Adults: Evidence from the National truth ® Campaign

Vallone, D. M., Ilakkuvan, V., Xiao, H., Cantrell, J., Rath, J., & Hair, E.

Publication year

2015

Journal title

Behavioral Medicine

Volume

41

Issue

3

Page(s)

155-163
Abstract
Mass media campaigns have been found to shape the public's knowledge, attitudes, beliefs, and behavior around tobacco. This study examines the influence of contextual factors with respect to awareness of the national truth ® campaign, a mass media, branded tobacco use prevention campaign, among a sample of young adults (n = 2,804) aged 24-34 years old; these respondents were within the age range for both the primary and secondary targets of the campaign during the period (2000-2007) when the campaign was airing television advertising at consistently high levels. Mulitvariable models reveal lower educational attainment and Hispanic ethnicity as significant contextual factors predictive of lower campaign awareness, controlling for media use. In contrast, gender, state tobacco control policy, sensation-seeking, current smoking status, and community-level SES variables were not significantly associated with campaign awareness. Further research is needed to identify the mechanisms through which public education campaigns operate, particularly among disadvantaged communities.

Exploring smoking cessation attitudes, beliefs, and practices in occupational health nursing

Ganz, O., Fortuna, G., Weinsier, S., Campbell, K., Cantrell, J., & Furmanski, W. L.

Publication year

2015

Journal title

Workplace Health and Safety

Volume

63

Issue

7

Page(s)

288-296
Abstract
The purpose of this study was to explore occupational health nurses' attitudes, beliefs, and practices regarding the delivery of smoking cessation services to workers. The study included 707 members of the American Association of Occupational Health Nurses (AAOHN) who completed a one-time survey during the fall of 2012. Results indicated that occupational health nurses believed that evidence-based treatments are at least somewhat effective and that they should provide smoking cessation services to their workers; however, a majority of occupational health nurses reported that they did not have appropriate smoking cessation training or guidelines in their workplaces. Occupational health nurses would benefit from training in the use of smoking cessation guidelines and evidence-based smoking cessation interventions, which could be used in their clinical practice. Employers should ensure that workplace policies, such as providing coverage for cessation services, facilitate smokers' efforts to quit. Employers can benefit from many of these policies through cost savings via reduced health care costs and absenteeism.

Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels

Villanti, A. C., Pearson, J. L., Cantrell, J., Vallone, D. M., & Rath, J. M.

Publication year

2015

Journal title

Addictive Behaviors

Volume

42

Page(s)

119-125
Abstract
In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34. years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as "smokers" (11%); (4) nondaily, light smokers who self-identify as "social or occasional smokers" (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily "smokers," LCC and hookah users (RRR. =. 2.35) and nonusers closed to smoking (RRR. =. 2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function.

A Multilevel Analysis of Gender, Latino Immigrant Enclaves, and Tobacco Use Behavior

Cantrell, J.

Publication year

2014

Journal title

Journal of Urban Health

Volume

91

Issue

5

Page(s)

928-939
Abstract
Research suggests that immigrant enclaves positively influence health behaviors such as tobacco use through supportive social networks and informal social control mechanisms that promote healthy behavioral norms. Yet, the influence of social cohesion and control on tobacco use may depend on smoking-related norms, which can vary by gender. This study examines the influence of neighborhood Latino immigrant enclave status on smoking and cessation among Hispanic men and women. Data from the Los Angeles Family and Neighborhood Survey was combined with census data to assess the relationship between immigrant enclaves, gender, and smoking using multilevel regression. The effect of the Hispanic enclave environment on smoking differed by gender. Living in an enclave had a harmful effect on tobacco use among Hispanic men, marginally increasing the likelihood of smoking and significantly reducing cessation. This effect was independent of neighborhood socioeconomic status, nativity, and other individual demographics. Neighborhood immigrant concentration was not associated with smoking or cessation for Hispanic women. Research, interventions, and policies aimed at reducing smoking among Hispanics may need to be gender responsive to ensure effectiveness as well as health and gender equity.

Perceptions and perceived impact of graphic cigarette health warning labels on smoking behavior among U.S. young adults

Villanti, A. C., Cantrell, J., Pearson, J. L., Vallone, D. M., & Rath, J. M.

Publication year

2014

Journal title

Nicotine and Tobacco Research

Volume

16

Issue

4

Page(s)

469-477
Abstract
Introduction: In 2011, the Food and Drug Administration published a final rule requiring cigarette packages and advertisements to include graphic health warning labels (HWLs) with new warning statements. Implementation of this rule has been stalled by legal challenge. This study assessed correlates of smoking-related intentions related to graphic HWLs among current cigarette smokers and nonsmokers in a national sample of U.S. young adults aged 18-34. Methods: Data were collected from 4,236 participants aged 18-34 using an online panel in January 2012 for the Legacy Young Adult Cohort Study. Analyses were weighted to provide nationally representative estimates. Our main outcome was assessed with a single item: "Do you think that new warning labels with graphic pictures would make you think about not smoking?" Results: Twenty-two percent of the young adults were current cigarette smokers. Fifty-three percent endorsed that new graphic HWLs would make them think about not smoking (40% among current smokers compared with 56% among nonsmokers). Among nonsmokers, those aged 18-24, females, Hispanics, and those who were aware of graphic cigarette HWLs were more likely to report intention to not smoke related to graphic HWLs. Among current smokers, intending to quit within the next 6 months was correlated with intention resulting from graphic HWLs. Hispanic ethnicity and intention to quit within 30 days were strong correlates of intention in light, nondaily, and self-identified social/occasional smokers. Conclusions: This study supports previous findings that graphic HWLs play an important role in preventing smoking, in addition to encouraging cessation in young adults.

Contact

jmc37@nyu.edu +1 (212) 998-5797 715/719 Broadway New York, NY 10003