Neighborhood Disparities in the Retail Marketing of Menthol Cigarettes Sarah D. Mills, PhD, MPH Cancer Control Education Program UNC Lineberger Comprehensive Cancer Center Carolina Postdoctoral Program for Faculty Diversity University of North Carolina at Chapel Hill 1
Funding Cancer Control Education Program UNC Lineberger Comprehensive Cancer Center NCI award T32 CA057726 Advancing Science and Practice in the Retail Environment NCI award U01 CA15428 No tobacco industry funding
Menthol cigarettes • One third of smokers use menthol cigarettes • Menthol • Chemical compound extracted from the peppermint plant • Provides anesthetic and cooling effects • Minty taste • Easier to start smoking and more difficult to quit (Tobacco Products Scientific Advisory Committee, 2011; Villanti et al., 2016) 3
Current menthol cigarette use among smokers by… Age Household Income 100% 50% 80% 40% 60% 30% 20% 40% 10% 20% 0% 0% < $30,000 $30,000-$74,999 $75,000+ 12-15 16-17 18-21 22-25 26-34 35+ Race/ethnicity 100% 80% 60% 40% 20% 0% Villanti et al., 2016 4 White Black Asian Hispanic > 1 race
Disparities in the Disparities in tobacco retail menthol cigarette environment smoking 5
Tobacco Retail Tobacco retail marketing is Marketing associated with: • Initiation • Brand preference • Cravings • Impulse buys • Relapse Environmental High Tobacco Cues & Use Normalization (Choi et al., 2017; Kirchner et al., 2013; Paynter and Edwards, 2009; Wakefield et al., 2008) 6
Objectives 1) Describe menthol cigarette marketing in a nationally representative sample of tobacco retailers 2) Examine associations between menthol cigarette marketing and neighborhood demographic characteristics 7
Advancing Science and Practice in the Retail Environment (ASPiRE) 8
Outco come me I II: M Menthol c cigarette p price ce p prom omoti otion on Outco come me I I: Ex Exteri erior m r men enthol cigarette adver ertisem ements Outco come me I III: N Newport me menthol p pack p price 9 (Mills, Henriksen, Golden, Kurtzman, Kong, Queen, & Ribisl, Health & Place, 2018)
Independent variables American Community Survey 5-year estimates (2011-2015) • Black • Asian/Pacific Islander • Hispanic • Youth (5 - 17 years) • Median household income 10
N = 2,124 tobacco retailers 69% 69% w with m men enthol c cig pr price pr e promotion 38% w 38% with e exterior m men enthol c cig ad d $6.89, Ne Newport m t menth thol p pack p price 11 (Mills, Henriksen, Golden, Kurtzman, Kong, Queen, & Ribisl, Health & Place, 2018)
Menthol Advertising on the Store Exterior: Percentage of Black Residents * Black: Q2 Black: Q3 * Black: Q4 (Highest) 0.5 Odds Ratio (log scale) 12 (Mills et al., Health & Place, 2018)
Menthol Advertising on the Store Exterior: Median Household Income Income: Q2 * Income: Q3 * Income: Q4 (Lowest) 0.5 Odds Ratio (log scale) 13 (Mills et al., Health & Place, 2018)
Newport Menthol Price Promotion Black: Q2 Black: Q3 * Black: Q4 (Highest ) 0.5 Odds Ratio (log scale) 14 (Mills et al., Health & Place, 2018)
Newport Menthol Pack Price Black: Q2 * * :Q3 * :Q4 Youth : Q2 * :Q3 * :Q4 * Income : Q2 * :Q3 * :Q4 Asian/PI: Q2 :Q3 * :Q4 Hispanic : Q2 :Q3 :Q4 -30 -25 -20 -15 -10 -5 0 5 10 15 20 US Dollars (cents) 15 (Mills et al., Health & Place, 2018)
Retail Marketing for Menthol Cigarettes: Summary of Results Black Asian/ Hispanic Youth Lower Pacific Income Islander Exterior Menthol X X Advertising Newport Menthol X Promotion Newport Green Full X X X Flavor Menthol Pack Price 16 (Mills et al., Health & Place, 2018)
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Thank you Sarah D. Mills, PhD, MPH sarahmills@unc.edu
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