There is hope and help: Reach and reception of a methamphetamine education campaign in Los Angeles County, California.

Introduction: In the context of increasing rates of methamphetamine (meth) overdose in Los Angeles County, California, USA, in 2021 the Los Angeles County Department of Public Health relaunched Meth Free LA County, a methamphetamine public education campaign built on Rescue Agency's Decision BlocksTM Strategic Framework. Methods: To assess campaign reach and reception, we examined media data and an online cross-sectional post-campaign survey in 2021 with a convenience sample of 750 county residents ages 18-54 who had used meth, were at-risk, or had personal relationships with people at-risk. We assessed campaign awareness, receptivity, and perceived effectiveness. Participants also reported concern about meth use in their community, recall of 10 facts from campaign content, and if they had taken promoted actions such as seeking help. We compared proportions between campaign-aware and unaware participants and explored if recall predicted these measures. Results: Most participants recalled the campaign (84.1%), felt it offered a new way of looking at meth (73.8%), and reported it made them feel that help is available (84.0%) or that it could help reduce their own use (82.4%). Video advertisements received high perceived effectiveness scores. Greater campaign recall was associated with significantly increased odds of being concerned about meth use in the community, recalling facts, and taking promoted actions. Conclusion: In 2021, Meth Free LA County reached its high-risk audiences. Unlike fear-based campaigns its message resonated with high-risk individuals, providing an example of how public education campaigns on meth and similar illicit substances can connect with their audiences.

Young Adult Responses to Peer Crowd-Based Targeting in E-cigarette Advertisements: An Experimental Study.

AIMS: To examine the effects of psychographically targeted e-cigarette advertisements on young adults. METHODS: A total of 2100 young adults (18-29 years old) representing five peer crowds (groups with shared values, interests, and lifestyle: Mainstream, Young Professional, Hip Hop, Hipster, and Partier) were recruited from a nationwide opt-in online panel. Participants were randomly assigned to view e-cigarette advertisements featuring characters that either did or did not match their own peer crowd affiliation and evaluated advertising effectiveness using Likert-type and semantic differential scales. Participants also reported their attitudes toward using e-cigarettes. RESULTS: No significant overall effect of peer crowd matching was observed. However, significant two-way interaction effects emerged where matching advertisements yielded higher evaluations than mismatching advertisements among those who currently do not use tobacco and nicotine products and among Mainstream participants. Advertisements featuring Mainstream characters were in general rated more highly than other advertisements. Additional analyses found significant effects of peer crowd matching among those who viewed advertisements featuring non-Mainstream characters. CONCLUSIONS: Peer crowd-based targeting can increase the effectiveness of e-cigarette advertisements which may impact initiation among current nonusers, requiring stricter marketing regulations. More research is needed to determine if anti-tobacco messaging tailored by peer crowds may effectively counteract targeted e-cigarette marketing. IMPLICATIONS: E-cigarette advertisements often use psychographic targeting strategies, using lifestyles, attitudes, and values. Low-risk young adults (eg, those who currently do not use tobacco and nicotine products) are susceptible to psychographically targeted e-cigarette advertisements. This may result in the initiation of e-cigarette use among young adults who would otherwise be less likely to use tobacco and nicotine products. Stricter marketing regulations for emerging tobacco and nicotine products are required to reduce marketing exposure.

Creating More Effective Vape Education Campaigns: Qualitative Feedback from Teens in Nine U.S. States.

Background: Successful media campaigns to reduce teen cigarette smoking indicate a similar approach may work for vaping, though message testing research is necessary to identify effective topics and approaches. Leveraging data from message testing studies across nine U.S. states, we identify promising topics and approaches and explore how the COVID-19 pandemic affected teens' reactions to vape education commercials. Methods: Teens ages 13-18 (N = 337) who vaped or were susceptible nonusers participated in focus groups and interviews (2018-2021) to review 35 creative concepts and commercials for Behind the Haze (BTH), a vaping education campaign. After viewing each video, participants assessed its perceived effectiveness (PE) and discussed their reactions. We conducted a reflexive thematic analysis of transcripts to identify crosscutting themes and compared PE scores for each video. Results: Key features of effective commercials included detailed facts accompanied by explanatory visuals, metaphors, and empathy. Promising topics included chemicals, physical consequences, and mental health, while addiction and industry deception messages were less impactful. The pandemic drew attention to mental health and immunity messages. Impact of one's vaping on friends emerged as a promising topic. Conclusions: While some tactics from successful cigarette prevention campaigns apply to vaping, others like anti-industry messaging do not. Fact-focused messaging on chemicals, physical consequences, and mental health accompanied by impactful graphics and attention-grabbing twists should be the focus of vape education campaigns. Frequent message testing research such as that conducted to inform BTH is necessary to identify promising and sometimes unexpected messaging approaches for timely and relevant teen vaping education materials.

Psychographic segmentation to identify higher-risk teen peer crowds for health communications: Validation of Virginia's Mindset Lens Survey.

Audience segmentation is necessary in health communications to ensure equitable resource distribution. Peer crowds, which are macro-level teen subcultures, are effective psychographic segments for health communications because each crowd has unique mindsets, values, norms, and health behavior profiles. These mindsets affect behaviors, and can be used to develop targeted health communication campaigns to reach those in greatest need. Though peer crowd research is plentiful, no existing peer crowd measurement tool has been formally validated. As such, we developed and validated Virginia's Mindset Lens Survey (V-MLS), a mindset-based teen peer crowd segmentation survey to support health communication efforts. Using an online convenience sample of teens (N = 1,113), we assessed convergent and discriminant validity by comparing the V-MLS against an existing, widely-used peer crowd survey (I-Base Survey®) utilizing a multi-trait multi-method matrix. We also examined the V-MLS's predictive ability through a series of regressions using peer crowd scores to predict behaviors, experiences, and traits relevant to health communication campaign planning. The V-MLS demonstrated reliability and convergent and discriminant validity. Additionally, the V-MLS effectively distinguished teen peer crowds with unique health behaviors, experiences, and personal traits. When combined with appropriate information processing and campaign development frameworks, this new tool can complement existing instruments to inform message framing, tone, and style for campaigns that target at-risk teens to increase campaign equity and reach.

Join the Commune: A Controlled Study of Social Branding Influencers to Decrease Smoking Among Young Adult Hipsters.

PURPOSE: To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior. DESIGN: Quasi-experimental controlled study. SETTING: Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control). PARTICIPANTS: "Hipster" young adults (age 18-26) attending bars and nightclubs. INTERVENTION: Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media. MEASURES: A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking. ANALYSIS: Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions. RESULTS: Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) (P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking. CONCLUSION: This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.

Peer crowd-based targeting in E-cigarette advertisements: a qualitative study to inform counter-marketing.

BACKGROUND: Cigarette lifestyle marketing with psychographic targeting has been well documented, but few studies address non-cigarette tobacco products. This study examined how young adults respond to e-cigarette advertisements featuring diverse peer crowds - peer groups with shared identities and lifestyles - to inform tobacco counter-marketing design. METHODS: Fifty-nine young adult tobacco users in California participated in interviews and viewed four to five e-cigarette advertisements that featured characters from various peer crowd groups. For each participant, half of the advertisements they viewed showed characters from the same peer crowd as their own, and the other half of the advertisements featured characters from a different peer crowd. Advertisements were presented in random order. Questions probed what types of cues are noticed in the advertisements, and whether and how much participants liked or disliked the advertisements. RESULTS: Results suggest that participants liked and provided richer descriptions of characters and social situations in the advertisements featuring their own peer crowd more than the advertisements featuring a different peer crowd. Mismatching age or device type was also noted: participants reported advertisements showing older adults were not intended for them. Participants who used larger vaporizers tended to dislike cigalike advertisements even if they featured a matching peer crowd. CONCLUSION: Peer crowd and lifestyle cues, age and device type are all salient features of e-cigarette advertising for young adults. Similarly, educational campaigns about e-cigarettes should employ peer crowd-based targeting to engage young adults, though messages should be carefully tested to ensure authentic and realistic portrayals.

Understanding Adversity and Peer Crowds to Prevent Youth Health Risks.

Objectives: Adverse childhood experiences (ACEs) and adolescent peer crowds are associated with similar health risks, and both have been leveraged to inform interventions. In this study, we examined if ACEs and peer crowds are associated with each other, and their combined effect on health risks. Methods: A cross-sectional survey of adolescents (N = 1053) measured ACEs, peer crowd identification (Mainstream, Popular, Hip Hop, Country, Alternative), and risks (current cigarette, alcohol, and marijuana use, obesity, feeling sad/hopeless, making a suicide plan). Logistic regression explored ACEs as a predictor of peer crowd, and ACEs and peer crowds separately as risk predictors. Mediation explored peer crowd as a mediator of the relationship between ACEs and risks. Results: Experiencing 2+ ACEs was associated with increased odds of Alternative (AOR=2.38, 95% CI=1.53, 3.71) and Hip Hop (AOR=2.08, 95% CI=1.24, 3.51) peer crowd identification. ACEs level and peer crowd independently predicted risks. Finally, peer crowd identification was a partial mediator of the effect of ACEs on risks. Conclusions: ACEs and peer crowds are key predictors of adolescent health risks. Peer crowd-targeted interventions may lessen the long-term effects of ACEs by utilizing values-based, trauma-informed messaging to reduce ACEs-related risks.

Differential Associations Between Anti-Tobacco Industry Attitudes and Intention to Quit Smoking Across Young Adult Peer Crowds.

PURPOSE: To compare the relationship between anti-tobacco industry attitudes and intention and attempts to quit smoking across 6 young adult peer crowds. DESIGN: A cross-sectional bar survey in 2015. SETTING: Seven US cities (Albuquerque, Los Angeles, Nashville, Oklahoma City, San Diego, San Francisco, and Tucson). PARTICIPANTS: Two thousand eight hundred seventeen young adult bar patrons who were currently smoking. MEASURES: Intention to quit in the next 6 months and having made a quit attempt in the last 12 months were binary outcomes. Anti-industry attitudes were measured by 3 items indicating support for action against the tobacco industry. Peer crowd affiliation was measured using the I-Base Survey. ANALYSIS: Adjusted multivariable logistic regression models examined the association between anti-industry attitudes and the outcomes for the total sample and for each peer crowd. RESULTS: Overall, anti-industry attitudes were positively associated with both intention to quit (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.24-1.52) and attempt to quit (OR = 1.14, 95% CI = 1.03-1.27). Intriguingly, the relationship between anti-industry attitudes and intention to quit differed by peer crowd affiliation, with significant associations for Homebody, Partier, Hipster, and Hip Hop, but not for Young Professional and Country. CONCLUSIONS: Developing health communication messages that resonate with unique peer crowd values can enhance the relevance of public health campaigns. Tobacco control practitioners should tailor anti-industry messages to promote intention to quit smoking among the highest risk young adults.

Peer Crowd Identification and Adolescent Health Behaviors: Results From a Statewide Representative Study.

PURPOSE: Peer crowds are macro-level subcultures that share similarities across geographic areas. Over the past decade, dozens of studies have explored the association between adolescent peer crowds and risk behaviors, and how they can inform public health efforts. However, despite the interest, researchers have not yet reported on crowd size and risk levels from a representative sample, making it difficult for practitioners to apply peer crowd science to interventions. The current study reports findings from the first statewide representative sample of adolescent peer crowd identification and health behaviors. METHODS: Weighted data were analyzed from the 2015 Virginia Youth Survey of Health Behaviors ( n = 4,367). Peer crowds were measured via the I-Base Survey™, a photo-based peer crowd survey instrument. Frequencies and confidence intervals of select behaviors including tobacco use, substance use, nutrition, physical activity, and violence were examined to identify high- and low-risk crowds. Logistic regression was used to calculate adjusted odds ratios for each crowd and behavior. RESULTS: Risky behaviors clustered in two peer crowds. Hip Hop crowd identification was associated with substance use, violence, and some depression and suicidal behaviors. Alternative crowd identification was associated with increased risk for some substance use behaviors, depression and suicide, bullying, physical inactivity, and obesity. Mainstream and, to a lesser extent, Popular, identities were associated with decreased risk for most behaviors. CONCLUSIONS: Findings from the first representative study of peer crowds and adolescent behavior identify two high-risk groups, providing critical insights for practitioners seeking to maximize public health interventions by targeting high-risk crowds.

Freedom From Chew: Using Social Branding to Reduce Chewing Tobacco Use Among Country Peer Crowd Teens.

BACKGROUND: Peer crowds are macro-level, reputation-based subcultures with shared preferences, values, and behavior. The Country peer crowd has been the focus of tobacco industry research and marketing but has yet to be the primary focus of public health research. The current study explores the utility of Down and Dirty, a Social Branding tobacco education campaign, in changing Virginia Country teens' chewing tobacco-related attitudes and behavior. The relationship between chew use and Country peer crowd identification was also explored. METHOD: To evaluate the campaign, a cross-sectional survey was administered online for 3 years from 2014 to 2016. Responses were collected via social media advertisements targeting 13- to 18-year-old Country youth from Virginia (total n = 1,264). Participants reported peer crowd identification, chew-related attitudes and behavior, and campaign engagement and appeal. RESULTS: Compared with Wave 1, Waves 2 and 3 Country teens who engaged with Down and Dirty had greater odds of holding strong attitudes against chew. Among campaign-engaged Country teens, odds of chew use were lower at Waves 2 and 3, and lower odds were associated with liking the campaign. Related to chew prevalence, Country teens demonstrated greater odds of past 30-day chew use compared to non-Country teens, and higher Country identification was associated with greater odds of chew use. DISCUSSION: Down and Dirty is a promising intervention associated with positive attitudinal and behavioral outcomes for high-risk Country teens. Additionally, this study helps document tobacco-related behavioral patterns of the Country peer crowd, a priority for ongoing tobacco education, especially around chew.

The Hip Hop peer crowd: An opportunity for intervention to reduce tobacco use among at-risk youth.

INTRODUCTION: Peer crowds, peer groups with macro-level connections and shared norms that transcend geography and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop peer crowd identification, which is common among multicultural youth, is associated with increased risk of tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco education campaign tailored for Hip Hop youth aged 12-17 who are multicultural (Hispanic, African American, Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream, Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally recruited sample. METHODS: Youth were recruited via targeted social media advertisements. Participants aged 13-17 (n = 5153) self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific differences. RESULTS: Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country youth, and more likely to be Experimenters than Popular and Mainstream youth. CONCLUSIONS: Representative studies show that Alternative is relatively small compared to other high-risk crowds, such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored to larger at-risk crowds for campaigns like Fresh Empire.

Bars, Nightclubs, and Cancer Prevention: New Approaches to Reduce Young Adult Cigarette Smoking.

INTRODUCTION: Tobacco contributes to multiple cancers, and it is largely preventable. As overall smoking prevalence in California declines, smoking has become concentrated among high-risk groups. Targeting social/cultural groups (i.e., "peer crowds") that share common values, aspirations, and activities in social venues like bars and nightclubs may reach high-risk young adult smokers. Lack of population data on young adult peer crowds limits the ability to assess the potential reach of such interventions. METHODS: This multimodal population-based household survey included young adults residing in San Francisco and Alameda counties. Data were collected in 2014 and analyzed in 2016. Multivariable logistic regressions assessed smoking by sociodemographic factors, attitudes, self-rated health, peer crowd affiliation, and bar/nightclub attendance. RESULTS: Smoking prevalence was 15.1% overall; 35.3% of respondents sometimes or frequently attended bars. In controlled analyses, bar attendance (AOR=2.13, 95% CI=1.00, 4.53) and binge drinking (AOR=3.17, 95% CI=1.59, 6.32) were associated with greater odds of smoking, as was affiliation with "Hip Hop" (AOR=4.32, 95% CI=1.48, 12.67) and "Country" (AOR=3.13, 95% CI=1.21, 8.09) peer crowds. Multivariable models controlling for demographics estimated a high probability of smoking among bar patrons affiliating with Hip Hop (47%) and Country (52%) peer crowds. CONCLUSIONS: Bar attendance and affiliation with certain peer crowds confers significantly higher smoking risk. Interventions targeting Hip Hop and Country peer crowds could efficiently reach smokers, and peer crowd-tailored interventions have been associated with decreased smoking and binge drinking. Targeted interventions in bars and nightclubs may be an efficient way to address these cancer risks.

Why Peer Crowds Matter: Incorporating Youth Subcultures and Values in Health Education Campaigns.

Grounded on research showing that peer crowds vary in risk behavior, several recent health behavior interventions, including the US Food and Drug Administration's Fresh Empire campaign, have targeted high-risk peer crowds. We establish the scientific foundations for using this approach. We introduce peer crowd targeting as a strategy for culturally targeting health behavior interventions to youths. We use social identity and social norms theory to explicate the theoretical underpinnings of this approach. We describe Fresh Empire to demonstrate how peer crowd targeting functions in a campaign and critically evaluate the benefits and limitations of this approach. By replacing unhealthy behavioral norms with desirable, healthy lifestyles, peer crowd-targeted interventions can create a lasting impact that resonates in the target audience's culture.

Peer crowd affiliation as a segmentation tool for young adult tobacco use.

BACKGROUND: In California, young adult tobacco prevention is of prime importance; 63% of smokers start by the age of 18 years, and 97% start by the age of 26 years. We examined social affiliation with 'peer crowd' (eg, Hipsters) as an innovative way to identify high-risk tobacco users. METHODS: Cross-sectional surveys were conducted in 2014 (N=3368) among young adult bar patrons in 3 California cities. We examined use rates of five products (cigarettes, e-cigarettes, hookah, cigars and smokeless tobacco) by five race/ethnicity categories. Peer crowd affiliation was scored based on respondents' selecting pictures of young adults representing those most and least likely to be in their friend group. Respondents were classified into categories based on the highest score; the peer crowd score was also examined as a continuous predictor. Logistic regression models with each tobacco product as the outcome tested the unique contribution of peer crowd affiliation, controlling for race/ethnicity, age, sex, sexual orientation and city. RESULTS: Respondents affiliating with Hip Hop and Hipster peer crowds reported significantly higher rates of tobacco use. As a categorical predictor, peer crowd was related to tobacco use, independent of associations with race/ethnicity. As a continuous predictor, Hip Hop peer crowd affiliation was also associated with tobacco use, and Young Professional affiliation was negatively associated, independent of demographic factors. CONCLUSIONS: Tobacco product use is not the same across racial/ethnic groups or peer crowds, and peer crowd predicts tobacco use independent of race/ethnicity. Antitobacco interventions targeting peer crowds may be an effective way to reach young adult tobacco users. TRIAL REGISTRATION NUMBER: NCT01686178, Pre-results.

Evaluation of Bar and Nightclub Intervention to Decrease Young Adult Smoking in New Mexico.

PURPOSE: Over 20% of young adults in New Mexico currently smoke. We evaluated cigarette smoking prevalence of young adult bar patrons during an anti-tobacco Social Branding intervention. METHODS: The Social Branding intervention used a smoke-free brand, "HAVOC," to compete with tobacco marketing within the "Partier" young adult peer crowd. A series of cross-sectional surveys were collected from adults aged 18-26 in bars and nightclubs in Albuquerque, New Mexico, from 2009 to 2013 using randomized time-location sampling. Multivariable multinomial regression using full information maximum likelihood estimation to account for missing data evaluated differences in daily and nondaily smoking during the intervention, controlling for demographics, other risk behaviors, and tobacco-related attitudes. RESULTS: Data were collected from 1,069 individuals at Time 1, and 720, 1,142, and 1,149 participants at Times 2, 3, and 4, respectively. Current smoking rates decreased from 47.5% at Time 1 to 37.5% at Time 4 (p < .001). Among Partiers, the odds of daily smoking decreased significantly, but nondaily smoking was unchanged. Partiers that recalled, liked, and understood the smoke-free message of HAVOC had lower odds of nondaily (odds ratio: .48, 95% CI: .31-.75) and daily (odds ratio: .31, 95% CI: .14-.68) smoking than those who did not recall HAVOC. HAVOC recall was associated with attitudes that were also associated with smoking behavior. CONCLUSIONS: The significant decrease in daily smoking among young adult Partiers in New Mexico was associated with HAVOC recall and understanding. Social Branding interventions efficiently target and may decrease tobacco use among young adult bar patrons.

The Social Prioritization Index and Tobacco Use Among Young Adult Bar Patrons.

Social benefits likely play a role in young adult tobacco use. The Social Prioritization Index (SPI) was developed to measure the degree to which young adults place a great importance on their social lives. We examined the usefulness of this measure as a potential predictor of tobacco use controlling for demographics and tobacco-related attitudes. Young adults completed cross-sectional surveys between 2012 and 2014 in bars in seven U.S. cities (N = 5,503). The SPI is a 13-item scale that includes personality items and information on how frequently participants attend bars and how late they stay out. Three step-by-step multinomial regression models were run using the SPI as a predictor of smoking status (nondaily and daily smoking vs. nonsmoking): (1) SPI as the sole predictor, (2) SPI and demographics, and (3) SPI, demographics, and tobacco-related attitude variables. Next, we conducted an exploratory factor analysis to examine if the number of items in SPI could be reduced and retain its strong relationship with smoking. Higher scores on the SPI were related to an increased probability of being a Nondaily Smoker (odds ratio = 1.09, 95% confidence interval [1.04, 1.14], p < .001) or Daily Smoker (odds ratio = 1.14, 95% confidence interval [1.07, 1.22], p < .0001) compared to a Nonsmoker, controlling for demographics and other tobacco-related attitudes. The SPI and reduced SPI were independently related to young adult tobacco use. The measure's brevity, ease of use, and strong association with tobacco use may make it useful to tobacco and other prevention researchers.

Social Branding to Decrease Lesbian, Gay, Bisexual, and Transgender Young Adult Smoking.

INTRODUCTION: Lesbian, gay, bisexual, and transgender (LGBT) individuals are more likely to smoke than the general population. This study evaluated a Social Branding intervention, CRUSH, which included an aspirational brand, social events, and targeted media to discourage smoking among LGBT young adults in Las Vegas, NV. METHODS: Cross-sectional surveys (N = 2,395) were collected in Las Vegas LGBT bars at 2 time points 1 year apart. Multivariate logistic regressions examined associations between campaign exposure, message understanding, and current (past 30 days) smoking, controlling for demographics. RESULTS: LGBT individuals were significantly more likely to report current (past 30 day) smoking than heterosexual/straight, gender-conforming participants. Overall, 53% of respondents reported exposure to CRUSH; of those exposed, 60% liked the campaign, 60.3% reported they would attend a CRUSH event on a night when they usually went somewhere else, and 86.3% correctly identified that the campaign was about "partying fresh and smokefree." Current smoking was reported by 47% of respondents at Time 1 and 39.6% at Time 2. There were significant interactions between time and campaign exposure and campaign exposure and understanding the message. Among those who understood the CRUSH smokefree message, the highest level of campaign exposure was significantly associated with 37%-48% lower odds for current smoking. CONCLUSIONS: While longitudinal studies would better assess the impact of this intervention, CRUSH shows promise to reduce tobacco use among LGBT bar patrons.

Wreaking "havoc" on smoking: social branding to reach young adult "partiers" in Oklahoma.

BACKGROUND: More than 25% of young adult Oklahomans smoked cigarettes in 2012. Tobacco marketing campaigns target young adults in social environments like bars/nightclubs. Social Branding interventions are designed to compete directly with this marketing. PURPOSE: To evaluate an intervention to reduce smoking among young adult "Partiers" in Oklahoma. The Partier peer crowd was described as follows: attendance at large nightclubs, fashion consciousness, valuing physical attractiveness, and achieving social status by exuding an image of confidence and financial success. DESIGN: Repeated cross-sectional study with three time points. SETTING/PARTICIPANTS: Randomized time location survey samples of young adult Partier bar and club patrons in Oklahoma City (Time 1 [2010], n=1,383; Time 2 [2011], n=1,292; and Time 3 [2012], n=1,198). Data were analyzed in 2013. INTERVENTION: The "HAVOC" Social Branding intervention was designed to associate a smoke-free lifestyle with Partiers' values, and included events at popular clubs, brand ambassador peer leaders who transmit the anti-tobacco message, social media, and tailored anti-tobacco messaging. MAIN OUTCOME MEASURES: Daily and nondaily smoking rates, and binge drinking rates (secondary). RESULTS: Overall, smoking rates did not change (44.1% at Time 1, 45.0% at Time 2, and 47.4% at Time 3; p=0.17), but there was a significant interaction between intervention duration and brand recall. Partiers reporting intervention recall had lower odds of daily smoking (OR=0.30 [0.10, 0.95]) and no difference in nondaily smoking, whereas Partiers who did not recall the intervention had increased odds of smoking (daily AOR=1.74 [1.04, 2.89]; nondaily AOR=1.97 [1.35, 2.87]). Among non-Partiers, those who recalled HAVOC reported no difference in smoking, and those who did not recall HAVOC reported significantly increased odds of smoking (daily AOR=1.53 [1.02, 2.31]; nondaily AOR=1.72 [1.26, 2.36]). Binge drinking rates were significantly lower (AOR=0.73 [0.59, 0.89]) overall. CONCLUSIONS: HAVOC has the potential to affect smoking behavior among Oklahoma Partiers without increasing binge drinking.

Social branding to decrease smoking among young adults in bars.

OBJECTIVES: We evaluated a Social Branding antitobacco intervention for "hipster" young adults that was implemented between 2008 and 2011 in San Diego, California. METHODS: We conducted repeated cross-sectional surveys of random samples of young adults going to bars at baseline and over a 3-year follow-up. We used multinomial logistic regression to evaluate changes in daily smoking, nondaily smoking, and binge drinking, controlling for demographic characteristics, alcohol use, advertising receptivity, trend sensitivity, and tobacco-related attitudes. RESULTS: During the intervention, current (past 30 day) smoking decreased from 57% (baseline) to 48% (at follow-up 3; P = .002), and daily smoking decreased from 22% to 15% (P < .001). There were significant interactions between hipster affiliation and alcohol use on smoking. Among hipster binge drinkers, the odds of daily smoking (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.30, 0.63) and nondaily smoking (OR = 0.57; 95% CI = 0.42, 0.77) decreased significantly at follow-up 3. Binge drinking also decreased significantly at follow-up 3 (OR = 0.64; 95% CI = 0.53, 0.78). CONCLUSIONS: Social Branding campaigns are a promising strategy to decrease smoking in young adult bar patrons.

Secondhand smoke exposure among young adult sexual minority bar and nightclub patrons.

OBJECTIVES: We compared exposure to secondhand smoke (SHS) and attitudes toward smoke-free bar and nightclub policies among patrons of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT bars and nightclubs. METHODS: We conducted randomized time-location sampling surveys of young adults (aged 21-30 years) in 7 LGBT (n = 1113 patrons) and 12 non-LGBT (n = 1068 patrons) venues in Las Vegas, Nevada, in 2011, as part of a cross-sectional study of a social branding intervention to promote a tobacco-free lifestyle and environment in bars and nightclubs. RESULTS: Compared with non-LGBT bars and nightclubs, patrons of LGBT venues had 38% higher adjusted odds of having been exposed to SHS in a bar or nightclub in the past 7 days but were no less likely to support smoke-free policies and intended to go out at least as frequently if a smoke-free bar and nightclub law was passed. CONCLUSIONS: The policy environment in LGBT bars and nightclubs appears favorable for the enactment of smoke-free policies, which would protect patrons from SHS and promote a smoke-free social norm.