Substance Use and Imagery In Hip Hop, R&B, and Popular YouTube Music Videos

Background: There are over four billion YouTube views per day with “music” the most searched topic. Among US internet users, 8.3 million YouTube users are under 18 years old. Incorporation of substance use imagery in YouTube videos has a considerable potential influence on young viewing audience behavior. This study identifies patterns of substance use portrayal and imagery in YouTube music videos. Methods: The 2014 popular music Billboard R&B/ Hip-hop weekly charts were used to identify the top 25 songs each week which resulted in 112 unique ranked songs; of these, 94 had official videos which were coded. All videos were coded for substance use presence and imagery with an overlap subset tested for reliability by three independent coders. Results: Preliminary results suggest gender differences in types of substance used and imagery. A significant proportion of videos contained blatant product placement of alcohol brands. Of the videos coded, 86% contained at least one substance reference or image. Conclusion: Portrayal of substance use by artists creates social norms that may promote use in youth. Public Health needs to understand in the role of music videos and its influence in uptake of substance use in adolescents. Important gender differences will be discussed

Characterization of Electronic Cigarette Warning Statements Portrayed in YouTube Videos

INTRODUCTION: In 2018, the United States Food and Drug Administration (FDA) required that electronic cigarette (e-cigarette) manufacturers, packagers, importers, distributors, and retailers display an addictive or alternate warning statement on e-cigarette visual advertisements. Few studies have investigated the FDA-mandated and other warnings on social media. This study examined the prevalence and content of warning statements in e-cigarette-related YouTube videos. METHODS: In 2019, The Virginia Commonwealth University Center for the Study of Tobacco Products conducted bi-monthly (February-June) YouTube searches by relevance and view count to identify e-cigarette-related videos. Overall, 178 videos met the inclusion criteria. Staff coded each video for the presence of a visual/verbal warning statement, warning statement type (eg, FDA-mandated, addiction/tobacco, safety/toxic exposure, health effects), sponsorship, and tobacco product characteristics. A data extraction tool collected the video URL, title, upload date, and number of views, likes/dislikes, and comments. RESULTS: Only 5.1% of videos contained FDA-mandated and 21.9% contained non-mandated warnings. All videos with FDA-mandated and 46.2% of non-mandated warnings were represented visually. Only 13.1% of industry-sponsored videos uploaded after the mandate effective date had an FDA-mandated warning statement and videos with FDA-mandated and non-mandated (v. no) warnings had significantly fewer views, likes, dislikes, and comments. Among all non-mandated warnings, 31.3% featured an addiction/tobacco, 18.8% a safety/toxic exposure, and 37.5% a health effects warning. CONCLUSIONS: The prevalence of FDA-mandated warning statements in e-cigarette related YouTube videos was low. FDA enforcement of the warning statement mandate on YouTube could increase the public’s understanding of the addictive nature of nicotine in e-cigarettes. IMPLICATIONS: The FDA has the authority to regulate the advertisement and promotion of e-cigarettes on the Internet. These data can inform future FDA requirements related to the language content and visual representation of addiction/tobacco, safety/exposure, and health effects warning statements that appear in YouTube videos and other visual social media popular among young people. Such data would help consumers make informed decisions about purchasing e-cigarette products, using e-cigarettes, and avoiding unintentional harm related to e-cigarettes. In addition, these data may help social media platforms make decisions on whether they will prohibit advertisements that promote or facilitate the sale of tobacco products

Increases in light and intermittent smoking among Asian Americans and non-Hispanic Whites.

IntroductionAsian Americans are the fastest growing immigrant group in the United States and are more likely to be light and intermittent smokers (LITS) compared with non-Hispanic Whites (NHWs). LITS experience adverse health effects related to smoking. Previous research has aggregated Asian American ethnic groups, masking important differences between groups. We sought to compare LITS rates among Asian American subgroups before and after the 1998 Master Settlement Agreement (MSA) with NHWs in California utilizing data from the California Tobacco Surveys (CTS).MethodsWe combined 1990, 1992, and 1996 CTS (pre-MSA) and the 1999, 2002, 2005, and 2008 CTS (post-MSA) to examine changes in LITS (<10 cigarettes/day or not smoking daily). Chinese, Filipino, Japanese, and Korean ethnic groups were compared with NHWs.ResultsPre-MSA logistic regression models adjusted for age, gender, education level, language spoken at home, and use of other tobacco products found that Chinese (odds ratio [OR] = 3.38, 95% confidence interval [CI] = 2.19, 5.21), Filipinos (OR = 3.55, 95% CI = 2.73, 4.63), Japanese (OR = 1.99, 95% CI = 1.22, 3.27), and Koreans (OR = 3.22, 95% CI = 2.06, 5.03) were significantly more likely to be LITS compared with NHWs. Post-MSA, all Asian American subgroups experienced an increase in LITS (11.7%-37.8%); however, only Chinese (OR = 2.19, 95% CI = 1.16, 4.13) and Filipinos (OR = 3.33, 95% CI = 2.26, 4.91) remained significantly more likely to be LITS compared with NHWs.ConclusionsOur results highlight the need for tobacco control efforts that address the growing group of LITS among Asian Americans and NHWs

Increases in light and intermittent smoking among Asian Americans and non-Hispanic Whites.

IntroductionAsian Americans are the fastest growing immigrant group in the United States and are more likely to be light and intermittent smokers (LITS) compared with non-Hispanic Whites (NHWs). LITS experience adverse health effects related to smoking. Previous research has aggregated Asian American ethnic groups, masking important differences between groups. We sought to compare LITS rates among Asian American subgroups before and after the 1998 Master Settlement Agreement (MSA) with NHWs in California utilizing data from the California Tobacco Surveys (CTS).MethodsWe combined 1990, 1992, and 1996 CTS (pre-MSA) and the 1999, 2002, 2005, and 2008 CTS (post-MSA) to examine changes in LITS (<10 cigarettes/day or not smoking daily). Chinese, Filipino, Japanese, and Korean ethnic groups were compared with NHWs.ResultsPre-MSA logistic regression models adjusted for age, gender, education level, language spoken at home, and use of other tobacco products found that Chinese (odds ratio [OR] = 3.38, 95% confidence interval [CI] = 2.19, 5.21), Filipinos (OR = 3.55, 95% CI = 2.73, 4.63), Japanese (OR = 1.99, 95% CI = 1.22, 3.27), and Koreans (OR = 3.22, 95% CI = 2.06, 5.03) were significantly more likely to be LITS compared with NHWs. Post-MSA, all Asian American subgroups experienced an increase in LITS (11.7%-37.8%); however, only Chinese (OR = 2.19, 95% CI = 1.16, 4.13) and Filipinos (OR = 3.33, 95% CI = 2.26, 4.91) remained significantly more likely to be LITS compared with NHWs.ConclusionsOur results highlight the need for tobacco control efforts that address the growing group of LITS among Asian Americans and NHWs

Disparities in the Population Distribution of African American and Non-Hispanic White Smokers Along the Quitting Continuum

PurposeTo examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites.MethodsSecondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed, population-based surveys designed to assess changes in tobacco use in California. The number of survey respondents ranged from n = 6,744 to n = 12,876 across CTS years. Current smoking behavior (daily or nondaily smoking), number of cigarettes smoked per day, intention to quit in the next 6 months, length of most recent quit attempt among current smokers, and total length of time quit among former smokers were assessed and used to recreate the quitting continuum model.ResultsWhile current smoking rates were significantly higher among African Americans compared with non-Hispanic Whites across all years, cigarette consumption rates were lower among African Americans in all years. There were significant increases in the proportion of former smokers who had been quit for at least 12 months from 1999 (African Americans, 26.8% ± 5.5%; non-Hispanic Whites, 36.8% ± 1.6%) to 2008 (African Americans, 43.6% ± 4.1%; non-Hispanic Whites, 57.4% ± 2.9%). The proportion of African American former smokers in each CTS year was significantly lower than that of non-Hispanic Whites.ConclusionsDespite positive progression along the quitting continuum for both African American and non-Hispanic White smokers, the overall distribution was less favorable for African Americans. The lower smoking consumption levels among African Americans, combined with the lower rates of successful smoking cessation, suggest that cigarette addiction and the quitting process may be different for African American smokers

Why We Must Continue to Investigate Menthol's Role in the African American Smoking Paradox.

BackgroundThe disproportionate burden of tobacco use among African Americans is largely unexplained. The unexplained disparities, referred to as the African American smoking paradox, includes several phenomena. Despite their social disadvantage, African American youth have lower smoking prevalence rates, initiate smoking at older ages, and during adulthood, smoking rates are comparable to whites. Smoking frequency and intensity among African American youth and adults are lower compared to whites and American Indian and Alaska Natives, but tobacco-caused morbidity and mortality rates are disproportionately higher. Disease prediction models have not explained disease causal pathways in African Americans. It has been hypothesized that menthol cigarette smoking, which is disproportionately high among African Americans, may help to explain several components of the African American smoking paradox.PurposeThis article provides an overview of the potential role that menthol plays in the African American smoking paradox. We also discuss the research needed to better understand this unresolved puzzle.MethodsWe examined prior synthesis reports and reviewed the literature in PubMed on the menthol compound and menthol cigarette smoking in African Americans.ResultsThe pharmacological and physiological effects of menthol and their interaction with biological and genetic factors may indirectly contribute to the disproportionate burden of cigarette use and diseases among African Americans.ConclusionsFuture studies that examine taste sensitivity, the menthol compound, and their effects on smoking and chronic disease would provide valuable information on how to reduce the tobacco burden among African Americans.ImplicationsOur study highlights four counterintuitive observations related to the smoking risk profiles and chronic disease outcomes among African Americans. The extant literature provides strong evidence of their existence and shows that long-standing paradoxes have been largely unaffected by changes in the social environment. African Americans smoke menthols disproportionately, and menthol's role in the African American smoking paradox has not been thoroughly explored. We propose discrete hypotheses that will help to explain the phenomena and encourage researchers to empirically test menthol's role in smoking initiation, transitions to regular smoking and chronic disease outcomes in African Americans

Tobacco use disparities by racial/ethnic groups: California compared to the United States.

Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US. Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR=0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR=1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR=1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population

Smoking Among Hispanic/Latino Nationality Groups and Whites, Comparisons Between California and the United States

Introduction Although California is home to the largest Hispanic/Latino population, few studies have compared smoking behavior trends of Hispanic/Latino nationality groups in California to the remaining United States, which may identify the impact of the states antitobacco efforts on these groups. This study compared smoking status, frequency, and intensity among Mexican Americans, Central/South Americans, and non-Hispanic Whites in California to the remaining United States in the 1990s and 2000s. Methods Data were analyzed using the 1992–2011 Current Population Survey Tobacco Use Supplement to report the estimated prevalence of smoking status, frequency, and intensity by decade, race/ethnicity, and state residence. Weighted logistic regression explored sociodemographic factors associated with never and heavy smoking (≥20 cigarettes per day). Results There were absolute overall increases from 6.8% to 9.6% in never smoking across all groups. Compared to the remaining United States, there was a greater decrease in heavy smoking among Mexican American current smokers in California (5.1%) and a greater increase in light and intermittent smokers among Central/South American current smokers in California (9.3%) between decades. Compared to those living in the remaining United States, smokers living in California had lower odds of heavy smoking (1990s: odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.62, 0.66; 2000s: 0.54, 95% CI = 0.52, 0.55). Conclusions California state residence significantly impacted smoking behaviors as indicated by significant differences in smoking intensity between California and the remaining United States among Hispanic/Latino nationality groups. Understanding smoking behaviors across Hispanic/Latino nationality groups in California and the United States can inform tobacco control and smoking prevention strategies for these groups. Implications The present study explored the differences in smoking behaviors between Whites, Mexican Americans, and Central South/Americans living in California versus the rest of the United States in the 1990s and the 2000s. The results contribute to our current knowledge as there have been minimal efforts to provide disaggregated cigarette consumption information among Hispanic/Latino nationality groups. Additionally, by comparing cigarette consumption between those in California and the remaining United States, our data may provide insight into the impact of California’s antitobacco efforts in reaching Hispanic/Latino subpopulations relative to the remaining US states, many of which have had less tobacco control policy implementation

Tobacco use disparities by racial/ethnic groups: California compared to the United States.

Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US. Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR=0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR=1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR=1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population