Use of Brand Engagement Appeals in US Cigarette and E-Cigarettes Ads (2019-2020).

Background: The tobacco industry has historically used brand engagement - communication tactics companies use to increase customer attachment to a brand and brand loyalty - to recruit and retain consumers. Limited information is available to assess the brand engagement tactics used to promote the two most popular tobacco products in the US - cigarettes and electronic cigarettes (e-cigarettes) - across different advertising platforms (e.g., direct-to-consumer (DTC), social media). Material and methods: We acquired 520 cigarette and 5,502 e-cigarette ads that ran in the US January 2019 to December 2020 from market research firms (Kantar, Numerator), Rutger's University ad surveillance website (trinketsandtrash.org), and branded social media accounts. Ads were double-coded for eight types of brand engagement tactics: Price Promotion, Sweepstakes, Mobile App, Email/Mail List, Free Gift, Social Media engagement request, Sponsored Events, and Auto-Ship subscription program. We report presence of brand engagement tactics by product type and advertising platform. Results: Overall, 62.9% of cigarette ads and 49.9% of e-cigarette ads contained at least one brand engagement tactic. For cigarette ads, the most common tactics were Sweepstakes and Mobile App requests, which were most commonly featured in DTC ads. For e-cigarettes, the most common tactic was Price Promotion which was featured in most DTC and online e-cigarette ads. Conclusions: Brand engagement was common in this sample of cigarette and e-cigarette ads. Our findings highlight key differences in the type of brand engagement tactic used to promote each product on different advertising platforms. Results can inform continued advertising surveillance studies and regulatory efforts.

Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial.

Diabetic retinopathy can be prevented with screening and early detection. We hypothesized that autonomous artificial intelligence (AI) diabetic eye exams at the point-of-care would increase diabetic eye exam completion rates in a racially and ethnically diverse youth population. AI for Children's diabetiC Eye ExamS (NCT05131451) is a parallel randomized controlled trial that randomized youth (ages 8-21 years) with type 1 and type 2 diabetes to intervention (autonomous artificial intelligence diabetic eye exam at the point of care), or control (scripted eye care provider referral and education) in an academic pediatric diabetes center. The primary outcome was diabetic eye exam completion rate within 6 months. The secondary outcome was the proportion of participants who completed follow-through with an eye care provider if deemed appropriate. Diabetic eye exam completion rate was significantly higher (100%, 95%CI: 95.5%, 100%) in the intervention group (n = 81) than the control group (n = 83) (22%, 95%CI: 14.2%, 32.4%)(p < 0.001). In the intervention arm, 25/81 participants had an abnormal result, of whom 64% (16/25) completed follow-through with an eye care provider, compared to 22% in the control arm (p < 0.001). Autonomous AI increases diabetic eye exam completion rates in youth with diabetes.