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Effects of pro and anti-smoking cues in stores on craving

Institution: Stanford University
Investigator(s): Lisa Henriksen, Ph.D.
Award Cycle: 2004 (Cycle 13) Grant #: 13RT-0123 Award: $373,894
Subject Area: Public Health, Public Policy, and Economics
Award Type: Research Project Awards

Initial Award Abstract
Stores saturated with tobacco advertising and promotions constitute a significant public health concern. Young adults buy cigarettes in convenience stores at a much higher rate than older shoppers and are sensitive to pricing and brand imagery conveyed at the point-of-sale. High smoking rates among 18- to 24-year-olds and the large proportion who desire to quit provide a compelling rationale for research about young adults’ reactions to retail tobacco marketing and its role in promoting smoking. The focus of this proposal is the widely held belief that retail tobacco marketing stimulates craving and deters quitting. Specifically, two experiments are proposed to examine young adults’ autonomic and subjective responses to pro- and anti-smoking cues in stores. These indicators of craving are important to study because they would provide new evidence about the role of tobacco advertising in perpetuating addiction and the potential for advertising restrictions to deter tobacco use.

Study 1 manipulates young adult smokers’ (n=200) exposure to retail marketing for cigarettes and non-tobacco products and compares the impact of seeing cigarette ads or pack displays. Autonomic response (secondary task reaction time) and subjective reactions (paper-and-pencil measure of craving) will be measured in response to ten point-of-purchase ads or product displays of cigarettes and ten ads or product displays of non-tobacco items, such as sodas, candy, or salty snacks. The primary hypotheses, derived from studies of cue reactivity, predict longer reaction times and higher levels of self-reported craving in response to tobacco than non-tobacco cues. Additionally, we predict longer reaction times and higher levels of craving in response to cigarette pack displays than to cigarette ads.

Study 2 will assess the effect of packaging cigarettes with graphic warning labels on craving. Young adult smokers (n=100) will see 12 non-tobacco products interspersed with either (a) four cigarette packs with graphic Canadian warning labels, or (b) the same four cigarette packs without warning labels, or (c) four more non-tobacco products. Autonomic and subjective responses will be measured as in Study 1. The primary hypothesis predicts lower levels of self-reported craving among smokers exposed to Canadian warning labels than the control group and highest levels among those exposed to packs without warning labels.

Several aspects of this research are innovative. Although considerable research suggests that smokers are responsive to environmental cues that signal the availability of cigarettes, the proposed studies would be the first we are aware of to determine whether exposure to tobacco marketing stimulates craving. Second, the proposed research focuses on young adults – an age group the highest smoking rates in California and whose responses to tobacco marketing are not well understood. Finally, the anticipated study results will help tobacco control advocates understand the implications of various policy options to regulate the packaging and marketing of tobacco in retail outlets.