Academic Appointments

Administrative Appointments

  • Pre-Major Advisor, Stanford University (2007 - 2009)
  • Senior Editor, Tobacco Control, BMJ Publishing Group (2010 - Present)

Professional Education

  • PhD, Stanford University, Communication

Current Research and Scholarly Interests

I study environmental influences on adolescent tobacco use, particularly the role of tobacco marketing in smoking initiation and maintenance. Currently funded research projects are a longitudinal school-based study about adolescent smoking and drinking, a geographic information systems (GIS) study about tobacco outlet density and smoking prevalence in California high schools, and laboratory experiments about the impact of tobacco advertising on urge and craving to smoke.

2023-24 Courses

All Publications

  • Causal effects of point-of-sale cigarette promotions and subjective social status on cigarette craving: a randomised within-person experiment. Tobacco control Andrews, M., Cooper, N., Mattan, B. D., Carreras-Tartak, J., Paul, A. M., Strasser, A. A., Henriksen, L., Falk, E. B. 2023


    Cigarette smoking continues to be a leading cause of preventable deaths in the USA, in part because the USA has not adopted the WHO Framework Convention on Tobacco Control. One way the tobacco industry counteracts tobacco control policies is by heavily advertising cigarettes at the point of sale in retailers (eg, at the cash register) and by offering discounts on cigarettes.A within-subject experimental design with adults who smoke cigarettes daily (n=281) investigated whether: (1) exposure to images of cigarette promotions in an online experiment is associated with greater cigarette craving relative to viewing images of non-smoking cues, and (2) if exposure to images of point-of-sale cigarette promotions with a discount (vs without) increases cigarette craving. The study also examined how participants' subjective social status (compared with others in the USA) relates to cigarette craving after exposure to images of cigarette promotions with and without a discount.In an online experiment, exposure to images of smoking cues, including point-of-sale cigarette promotions, elicited greater craving relative to non-smoking cues (all p<0.001). In addition, images of promotions with a discount elicited higher levels of craving compared with those without a discount (b=0.09, p=0.001). Although participants with a higher (vs lower) subjective social status craved cigarettes less overall (b=-0.12, p=0.012), there was no difference in their craving between images of promotions with and without a discount, while craving was higher for images of promotions with a discount than without for participants with higher subjective social status (b=0.06, p=0.021).Viewing images of point-of-sale cigarette promotions can causally increase cravings to smoke, which may also apply to real-world retail settings that display cigarette promotions. Restricting point-of-sale promotions generally, and discounts specifically, could help reduce cigarette smoking and address tobacco use disparities in the USA.

    View details for DOI 10.1136/tc-2023-058069

    View details for PubMedID 37949653

  • Kratom availability in California vape shops. Preventive medicine reports Bowdring, M. A., Leas, E. C., Vishwakarma, M., Schleicher, N. C., Prochaska, J. J., Henriksen, L. 2023; 35: 102380


    Kratom products are derived from trees native to Southeast Asia and have dose-dependent stimulant and opioid-like effects. Despite being on the Drug Enforcement Administration "Drugs and Chemicals of Concern List," kratom is legal for sale in most US states. However, there are scarce data on its availability. The goal of this study was to examine kratom availability in vape shops across the state of California and assess shop compliance with a local kratom sales ban (enacted in 2016) in San Diego City. As part of a larger study about retail tobacco marketing near colleges, availability of kratom was assessed in summer 2019 in a random sample of 614 vape shops that was stratified to compare stores near (≤ 3 miles) and distant (>3 miles) from colleges. Logistic regression examined kratom availability as a function of store type (stores that sold vape products only vs. stores selling other tobacco), nearness to college, and tract-level demographics. Kratom was available in 62.4% of observed stores and more often in vape-and-smoke (81.1%) than vape-only shops (11.5%, AOR = 40.4, 95% CI = 23.3-74.1). Kratom availability did not differ by nearness to colleges. In San Diego City, 46.2% of observed stores (95% CI = 28.8-64.5) sold kratom products. Findings indicate that kratom was available in the majority of vape shops and most commonly in vape-and-smoke shops. Widespread availability in tobacco specialty shops suggests the need for research on dual use with tobacco, kratom advertising and cross-product promotion, and the potential of state and local tobacco retail licensing to prohibit sales.

    View details for DOI 10.1016/j.pmedr.2023.102380

    View details for PubMedID 37680858

    View details for PubMedCentralID PMC10481347

  • Underage Sales of Tobacco in Dollar Stores and Top Grocery Stores, 2015-2020, U.S. American journal of preventive medicine Raskind, I. G., Lee, J. G., Henriksen, L. 2023; 65 (2): 313-316


    INTRODUCTION: Youth access to tobacco in retail settings remains a pressing public health concern and may vary across retail corporations. This study compares underage sales violation rates in tobacco-selling dollar store corporations-a rapidly growing retail segment where cheaper tobacco prices may appeal to youth-with rates in other major grocery corporations.METHODS: In 2021, U.S. Food and Drug Administration data (N=64,059 inspections) from January 2015 to March 2020 were used to compare underage tobacco sales in the two major tobacco-selling dollar store corporations, Dollar General and Family Dollar, with sales in major grocery corporations: Albertsons, Delhaize, Kroger, Publix, and Walmart. Generalized linear mixed models controlled for neighborhood characteristics. Post hoc analyses examined whether the corporation with the highest violation rate was more likely to be in neighborhoods with higher proportions of racially minoritized residents, socioeconomic disadvantage, or rural status.RESULTS: Family Dollar failed 12.1% of underage sales inspections. All other corporations had a significantly lower likelihood of selling tobacco to an underage buyer than Family Dollar. This significant association persisted after controlling for neighborhood characteristics. Family Dollar locations were associated with being in neighborhoods with higher proportions of racially minoritized residents and greater socioeconomic disadvantage.CONCLUSIONS: Regulating corporate behavior is necessary to reduce underage access to tobacco in dollar stores and address place-based inequities in youth tobacco access. Increasing the use of U.S. Food and Drug Administration no-tobacco-sale orders and Assurances of Voluntary Compliance, which provide a mechanism for state attorneys general to engage with tobacco retailers regarding enforcement of minimum legal sales age laws, may help to reduce youth tobacco access in retail settings.

    View details for DOI 10.1016/j.amepre.2023.02.014

    View details for PubMedID 37479422

  • Preemption in State Tobacco Minimum Legal Sales Age Laws in the US, 2022: A Policy Analysis of State Statutes and Case Laws. International journal of environmental research and public health Dobbs, P. D., Chadwick, G., Crosbie, E., Breslin, J., Henriksen, L. 2023; 20 (11)


    Preemptive statutory language within tobacco minimum legal sales age (MLSA) laws has prohibited localities from enacting stricter laws than state statutes. With the recent uptake of state Tobacco 21 laws in the US, the current landscape of preempted MLSA laws is unknown. This study sought to update the status of preemption in MLSA laws enacted in US states between 2015-2022. A public health attorney reviewed state tobacco MLSA laws (n = 50) and state tobacco control codes, searching for language regarding preemption. When statutes were unclear, case law was reviewed by examining local ordinances that were invalidated by state court decisions. Overall, 40 states enacted Tobacco 21 laws, seven of which expanded or introduced preemption when they increased the MLSA; a total of 26 states (52%) included preemption. Six states (12%) retained 'savings clauses' included in the MLSA prior to Tobacco 21, and 18 states (36%) did not mention preemption. Based on the precedent set by state courts, eight of these 18 states may preempt localities from raising their MLSA. Historically, preemption has slowed the diffusion of best practices in tobacco control, and once implemented, the laws are difficult to repeal. The recent expansion of preemption could inhibit the evolution, development, and implementation of effective tobacco control policies.

    View details for DOI 10.3390/ijerph20116016

    View details for PubMedID 37297620

  • Changes in the Point-of-Sale Among Vape Shops in 6 US Metropolitan Areas Over Time, 2018-2021. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Berg, C. J., Romm, K. F., Barker, D. C., Schleicher, N., Johnson, T. O., Wang, Y., Sussman, S., Henriksen, L. 2023


    INTRODUCTION: E-cigarette retail/marketing surveillance is needed during regulatory changes, like the US increasing minimum legal sales age to 21 (T21) and flavor restrictions (2019 and 2020) and certain state/localities increasing related restrictions.METHODS: We examined regulatory compliance (e.g., minimum-age signage), promotional strategies (e.g., health claims), and products at 2 timepoints among vape shops across 6 US metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle). In summer 2018, pairs of trained auditors assessed randomly-selected shops (n=~30/MSA). In fall 2021, audits were conducted among 2018 shops (if open and allowed) and additional randomly-selected shops (n=~20/MSA). Data from 179 shops in 2018 and 119 in 2021 (43 from the 2018 sample) were compared.RESULTS: There were decreases (p<.01) in the proportion of shops with (1) minimum-age signs (90.5% vs. 73.9%); (2) their own e-liquid brand (68.2% vs. 44.5%), onsite vaping (73.2% vs. 46.2%), counter seating (65.2% vs. 34.5%), and e-liquid sampling (90.0% vs. 33.6%); and (3) signs with product/price promotions (89.9% vs. 65.5%), health/cessation claims (29.1% vs. 12.6%), and cartoon imagery (27.4% vs. 11.8%). The proportions selling wet/dry vaporizers (26.4% vs. 39.5%), CBD products (23.3% vs. 71.4%), and pipes/glassware/papers (18.4% vs. 52.9%) increased. In 2021, many sold THC (12.6% e-liquids, 62.2% other products) and kratom (40.3%).CONCLUSIONS: With increasing restrictions (e.g., on flavors, sampling, T21), fewer shops sold their own e-liquid brands or accommodated onsite use/sampling, but fewer also posted minimum-age signage. Notably, more offered cannabis-related products. These changes underscore the need for comprehensive surveillance to assess regulatory impact.IMPLICATIONS: The past 6 years marked increasing e-cigarette sales restrictions in the US, yet limited research has examined the implications for tobacco specialty shops selling e-cigarettes. This study found that, from 2018 to 2021, there were significant decreases in the proportion of vape shops with their own e-liquid, onsite vaping, e-liquid sampling, lounge/counter seating, and price promotions, as well as minimum age signs. There were increases in the proportion selling cannabis-derived products and related paraphernalia. Tobacco control research and regulatory agencies must consider how tobacco specialty stores have evolved alongside legislative changes that impact them and consumers.

    View details for DOI 10.1093/ntr/ntad046

    View details for PubMedID 36951602

  • Rates of age verification for cigarette and e-cigarette purchases as a function of state T21 laws before and after implementation of the federal T21 law in the United States. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Romm, K. F., Wang, Y., Schleicher, N. C., Pannel, A., Williams, R., Berg, C. J., Henriksen, L. 2023


    This study examined the extent to which having a 21 minimum legal sales age for tobacco (T21) at the state level impacted age verification of cigarette and e-cigarette purchases among US young adults (ages 18-26) before and after federal T21 implementation.We analyzed data from cigarette and/or e-cigarette users (n=618 and n=864) in 6 metropolitan areas in 6 states. Participants reported frequency of being age verified ("almost always" vs. less frequently) for cigarette and/or e-cigarette purchases across 3 timepoints (i.e., Wave 1 [W1]: Sept-Dec 2018; W2: Sept-Dec 2019; W3: Sept-Dec 2020). Multilevel modeling examined time-varying state T21 status and time (reflecting federal T21 implementation) in relation to age verification of cigarette and e-cigarette purchases, respectively.The proportions almost always age verified for cigarette purchases in states with T21 versus without were: W1: 38.5% versus 37.7%; W2: 33.0% versus 39.1%; and W3: 45.4% versus 30.6%. For e-cigarettes, the proportions were: W1: 30.6% versus 40.3%; W2: 42.3% versus 50.5%; and W3: 56.0% versus 58.3%. In multilevel modeling, state T21 status was associated with greater likelihood of age verification for e-cigarettes (aOR=1.67, CI=1.13-2.45), but not for cigarettes. Age verification increased over time for e-cigarettes - both accounting for and not accounting for state T21 status. There were no changes for cigarettes.State T21 status and time correlated with age verification for e-cigarettes, but not cigarettes. These self-reported age verification data contribute to evidence from compliance checks, indicating that retailers require additional prompts and enforcement to enhance compliance with T21 laws.Current findings suggest that variations in regulations and gaps in enforcement may hinder the potential impact of increasing the minimum legal sales age, which ultimately may undermine the promise of such policies, specifically with regard to preventing tobacco use among the underage. Therefore, it is crucial to monitor retailer compliance with T21 laws and evaluate their efficacy to increase/improve ID checks, minimize illegal sales, and curb underage use of tobacco. Relatedly, particular attention to enforcement efforts that may promote compliance is warranted.

    View details for DOI 10.1093/ntr/ntad044

    View details for PubMedID 36943250

  • Rapid-response surveillance of the first US test market for VLN cigarettes. Tobacco control Henriksen, L., Johnson, T. O., Mahoney, M., Schleicher, N. C., Ali, A., Prochaska, J. J. 2023


    VLN King menthol and non-menthol are the first combustible cigarettes to receive US Food and Drug Administration (FDA) authorisation as modified risk tobacco products. Focusing on the first retail test market, this study characterised VLN advertising, product placement, discounts and price.All Chicago-area Circle K stores (n=133) were telephoned to assess whether they sold VLN. Single-pack price of non-menthol was obtained in 57 of 100 stores that sold VLN. In fall 2022, trained data collectors visited those 57 stores to assess VLN product placement, advertising, discounts and prices. Paired t-tests compared observed VLN price with telephone price and to price of other cigarette brands.Nearly all stores (91.1%) displayed exterior advertisements for VLN, and 41.1% displayed interior advertising, with 8.9% of stores advertising VLN in the power wall but never in the header row. VLN cigarettes were displayed in the power wall exclusively and among high-nicotine cigarettes. Some VLN marketing claims were not FDA-authorised. VLN advertised a sweepstakes offer and rewards programme. Most stores (85.7%) offered VLN discounts. VLN was priced like a premium brand (mean=$10.90, SD=$1.53), and prices obtained by telephone did not differ from observed prices several months later.Retail marketing strategies for VLN mimic those for high-nicotine cigarettes. Deviations from FDA-authorised marketing claims were evident. Surveillance in future test markets is recommended to assess compliance with marketing claims and examine relative price and discount offers. Of interest is how premium-priced, low-nicotine cigarettes stand to compete in a market dominated by cheaper high-nicotine cigarettes.

    View details for DOI 10.1136/tc-2022-057888

    View details for PubMedID 36927515

  • New policy of people-first language to replace 'smoker', 'vaper' 'tobacco user' and other behaviour-based labels. Tobacco control Hefler, M., Durkin, S. J., Cohen, J. E., Henriksen, L., O'Connor, R., Barnoya, J., Hill, S. E., Malone, R. E. 2023; 32 (2): 133-134

    View details for DOI 10.1136/tc-2023-057950

    View details for PubMedID 36806099

  • The association between local tobacco retail licensing and adult cigarette smoking by race/ethnicity, income, and education in California (2012-2019). Preventive medicine reports Usidame, B., Xie, Y., Colston, D., Titus, A. R., Henriksen, L., Kelly, B. C., Fleischer, N. L. 2023; 31: 102064


    This study investigates the association between the strength of TRL ordinances and adult cigarette use, and differences in the relationship by sociodemographic characteristics, using California as a case study. We merged geocoded data from the California Health Interview Survey with the State of Tobacco Control Reports from the American Lung Association from 2012 to 2019. Each jurisdiction was graded (A-strongest to F-weakest) based on the strength of their TRL ordinance while current cigarette use was defined as respondents who had smoked 100 or more cigarettes in their lifetime and currently smoke cigarettes every day or some days. We estimated multilevel logistic regression models to test the relationship between the strength of the TRL ordinance and current cigarette use and tested for effect modification by including interaction terms for race/ethnicity, income, and education in separate models. 11.6 % of sample participants from all years (n = 132,209) were current cigarette smokers. Adults in jurisdictions with stronger grades (A-D) had lower odds of current cigarette use (OR = 0.89, 95 % CI: 0.79-1.01) compared to adults in jurisdictions with the weakest grade (F), but the association was not statistically significant (p < 0.07). We found no evidence of effect modification by race/ethnicity, income, or education. We found limited evidence that stronger TRL ordinances were associated with lower adult cigarette smoking in California. However, future studies testing the relationship between TRL ordinances and adult smoking outcomes should examine the role of TRL fees across jurisdictions and adult cigarette use.

    View details for DOI 10.1016/j.pmedr.2022.102064

    View details for PubMedID 36467543

    View details for PubMedCentralID PMC9713321

  • Retail-focused tobacco control: equity and endgame implications. Tobacco control Henriksen, L. 2022; 31 (e2): e96-e98

    View details for DOI 10.1136/tc-2022-057771

    View details for PubMedID 36450610

  • State T21, Restrictions on Flavored E-Cigarette Products, and Non-Medical Cannabis Sales Legalization in Relation to Young Adult Reports of Vape Shop Age Verification and Product Offerings: A Multilevel Analysis. International journal of environmental research and public health Duan, Z., Wang, Y., Romm, K. F., Henriksen, L., Schleicher, N. C., Berg, C. J. 2022; 19 (22)


    Vape shop practices related to age verification and product offerings (e.g., other tobacco, cannabis), which may affect young-adult tobacco/substance use, are likely impacted by state-level policies (i.e., Tobacco 21 [T21], flavored e-cigarette restrictions, non-medical cannabis legalization). Using data from young adults (18-34 years) in 6 US states representing variability in whether/when they implemented the aforementioned policies, this study focused on past 6-month e-cigarette users who visited vape shops (Wave 1 [W1]: September-December 2018, n = 1127; W2: September-December 2019, n = 702; W3: September-December 2020, n = 549). Multilevel modeling examined T21 in relation to participants' reports of age verification at last vape shop visit (among those < 27), and flavor restrictions and cannabis legalization in relation to noticing other tobacco or cannabis products at last visit. At W1-W3, 69.7%, 78.7%, and 75.8% of participants < 27 reported age verification, and participants increasingly noticed other tobacco (W2: 36.9%; W3: 48.6%) and cannabis products (W1: 25.8%; W2: 41.3%; W3: 58.3%). State T21 was unrelated to age verification (aOR = 1.19, 95%CI = 0.80-1.79); flavored e-cigarette restrictions correlated with noticing other tobacco products (aOR = 1.96, 95%CI = 1.10-3.51); flavored e-cigarette restrictions (aOR = 2.26, 95%CI = 1.57-3.24) and cannabis legalization (aOR = 2.84, 95%CI = 1.78-4.51) correlated with noticing cannabis products. Regulatory efforts must be informed by ongoing surveillance of such policies and their impact.

    View details for DOI 10.3390/ijerph192215079

    View details for PubMedID 36429798

  • Relapse to problem drinking or trading up to spirits? Using U.S. national cross-sectional survey data to highlight possible negative impacts of potential tobacco retail changes. Substance abuse treatment, prevention, and policy Karriker-Jaffe, K. J., Henriksen, L., Smith, E. A., McDaniel, P. A., Malone, R. E., Kerr, W. C. 2022; 17 (1): 72


    BACKGROUND: According to the National Alcohol Beverage Control Association, twelve states in the United States (U.S.) have government retail monopolies on spirits/liquor sales. With a new federal minimum legal sales age for tobacco (raised from 18 to 21, the minimum legal sales age for alcohol), we examine possible unintended consequences of a hypothetical policy change restricting retail tobacco sales to state-run spirits/liquor stores in alcohol control states, which has been proposed as a tobacco endgame strategy.METHODS: We used cross-sectional survey data from 14,821 randomly-selected adults ages 21 and older who responded to the 2015 or 2020 U.S. National Alcohol Survey (51.8% female; 65.8% identified as non-Hispanic White, 12.4% as Black or African American, 14.2% as Hispanic or Latinx; 34.0% had a low level of education), including 2,274 respondents (18.9%) residing in one of the alcohol control states (representing 42.2million (M) adults ages 21+). We estimated associations between tobacco measures (lifetime smoking status, lifetime daily smoking, past-year daily smoking) and alcohol measures (drinking status, beverage choices, lifetime alcohol use disorder (AUD) status, recovery status) overall and for specific subgroups.RESULTS: In control states, 55.1% of people who smoked daily in the past year also reported lifetime AUD, including an estimated 3.56M adults ages 21+who reported prior (but not current) AUD. The association of daily smoking with lifetime AUD was stronger among those with low education compared to those with higher education. Further, 58.8% of people in recovery from an alcohol and/or drug problem (1.49M adults ages 21+) smoked daily, and this was more marked among women than men in control states.CONCLUSION: There could be negative consequences of an endgame strategy to restructure tobacco retail sales, including increased risk for relapse to drinking among people who smoke daily, especially among women and people with low levels of education. Strategies to mitigate unintended harms would be needed if such a policy were implemented.

    View details for DOI 10.1186/s13011-022-00498-8

    View details for PubMedID 36320048

  • Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas. Preventive medicine reports Romm, K. F., Henriksen, L., Huang, J., Le, D., Clausen, M., Duan, Z., Fuss, C., Bennett, B., Berg, C. J. 2022; 28: 101901


    Given the 2020 federal restrictions on flavored cartridge-based e-cigarettes and increasing state/local flavored e-cigarette sales restrictions, this mixed-methods study examined US young adult e-cigarette users' responses to flavored e-cigarette sales restrictions (e.g., changes in use, products used, access). We descriptively analyzed Fall 2020 survey data from 726 past 6-month e-cigarette users (Mage=24.15, 51.1% female, 4.4% Black, 10.2% Asian, 12.1% Hispanic, 35.5% sexual minority), and qualitatively analyzed Spring 2021 semi-structured interview data among 40 participants (Mage=26.30, 35.0% female, 5.0% Black, 22.5% Asian, 12.5% Hispanic, 45.0% sexual minority). Across all participants (i.e., survey and interview participants), ≥80% most commonly used non-tobacco flavors; ≥40% used tank-based devices. Survey participants most commonly reported that the federal restrictions did not impact their use: 35.8% used available flavors (i.e., tobacco, menthol), 30.4% continued to use tank-based e-cigarettes, and 10.1% switched to tank-based e-cigarettes. Only 8.4% reduced their e-cigarette use. Among interview participants, some indicated no impact on their e-cigarette use because they stocked up or obtained flavors from alternative sources (e.g., online). Some filled their own pods with e-liquids, switched to menthol/tobacco flavors, switched e-cigarette devices or brands, and/or reduced use. Regarding the anticipated impact of comprehensive flavor restrictions, some participants reported that they would: 1) quit vaping; 2) switch to cigarettes; or 3) not change their use (e.g., stock up on flavors). The potential unintended reactions to flavored e-cigarette sales restrictions (e.g., continued use of flavored cartridge-based e-cigarettes) underscore the need for ongoing surveillance of retail and consumer behavior to inform policy and compliance/enforcement efforts.

    View details for DOI 10.1016/j.pmedr.2022.101901

    View details for PubMedID 35855926

  • Cannabidiol Knowledge, Perceptions, and Use Among Young Adults in 6 U.S. Metropolitan Areas. Cannabis and cannabinoid research Wysota, C. N., Henriksen, L., Romm, K. F., Duan, Z., Wang, Y., Huang, J., Berg, C. J. 2022


    Background: Cannabidiol (CBD) has gained popularity in the United States, particularly among certain populations, including young adults. Thus, we examined (1) CBD product knowledge, perceptions, use, and use intentions among young adults and (2) correlates of use and use intentions. Methods: We analyzed data from a Fall 2020 survey regarding tobacco and other substance use among 2464 young adults in 6 U.S. cities (Mage=24.67; 57.4% female; 28.7% racial/ethnic minority). We used multinomial regression to identify correlates of use status (i.e., former [ever but no past 6 months] use vs. current [past 6 months] and never use, respectively), and linear regression to examine use intentions among never users. Results: Around 51.4% reported ever use, and 32.0% reported current use. On average, participants perceived CBD as safe and effective for addressing pain, anxiety, and sleep (also prominent use motives: 40% to 60%, respectively). Use intentions were relatively high, particularly for edibles and topicals (also the most common use modes). Roughly one-fourth mistakenly believed that CBD products were required to be approved by U.S. Food and Drug Administration (24.9%), tested/proven safe (28.8%), and proven effective to be marketed for pain, anxiety, sleep, and so on. (27.2%). Compared to former users, never users perceived greater CBD-related risk (p<0.001), less social acceptability (p<0.001), and greater difficulty accessing CBD (p=0.004); current users perceived more health benefits (p<0.001). Among never users, greater use intentions were associated with greater perceived social acceptability (p<0.001), health benefits (p<0.001), and difficulty accessing CBD (p=0.005). Conclusions: Given misperceptions about CBD, surveillance of young adults' knowledge, perceptions, and use of CBD is critical as its market expands.

    View details for DOI 10.1089/can.2022.0029

    View details for PubMedID 35878060

  • The Reshaping of the E-Cigarette Retail Environment: Its Evolution and Public Health Concerns. International journal of environmental research and public health Berg, C. J., Melena, A., Wittman, F. D., Robles, T., Henriksen, L. 2022; 19 (14)


    E-cigarette use represents a public health controversy in the US and globally. Despite the potential of e-cigarettes to support cigarette cessation, their use increases health risks and risk for addiction, particularly in young people. Various federal, state, and local laws have impacted tobacco retail in general and e-cigarettes in particular. In the US, 2019-2020 federal laws increased in the minimum legal sales age for tobacco to 21 and banned flavored cartridge-based e-cigarettes. Many states and localities were early adopters of Tobacco 21 and implemented more comprehensive flavor restrictions than the federal ban. Meanwhile, cannabis retail is increasingly being legalized in the US-while cannabis-based product regulation has notable gaps at the federal, state, and local levels. These regulatory complexities have impacted specialized retailers selling e-cigarettes, including "vape shops" that exclusively sell e-cigarettes, "smoke shops" that sell e-cigarettes and other tobacco (and potentially CBD/THC and other un- or under-regulated products), and online retail. This commentary outlines public health concerns related to: (1) youth access; (2) consumer exposure to a broader range of tobacco products and marketing in retail settings where they may seek products to aid in cigarette cessation (i.e., such broad product exposure could hinder cessation attempts); (3) consumer exposure to un-/under-regulated products (e.g., delta-8-THC, kratom); and (4) federal, state, and local regulations being undermined by consumer access to prohibited products online and via the mail. These concerns underscore the need for ongoing surveillance of how retailers and consumers respond to regulations.

    View details for DOI 10.3390/ijerph19148518

    View details for PubMedID 35886373

  • Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo. Tobacco control Duan, Z., Henriksen, L., Vallone, D., Rath, J. M., Evans, W. D., Romm, K. F., Wysota, C., Berg, C. J. 2022


    Nicotine pouches are gaining popularity, yet their marketing is understudied.Using Numerator advertising data from January 2019 to September 2021 regarding three popular brands of nicotine pouch in the USA-Zyn (by Swedish Match, introduced in the USA in July 2016), On! (Altria, August 2016) and Velo (RJ Reynolds, July 2019)-we examined (1) general advertising characteristics (eg, media type, year); (2) ad content (ie, headlines and imagery themes); (3) prominent media channels (ie, specific websites, magazines, etc); and (4) ad expenditures.There were 286 unique ads (Zyn: 44.4%; On!: 2.8%; Velo: 52.8%), 119 143 occurrences (Zyn: 3.5%; On!: 0.5%; Velo: 96.0%) and $24 774 650 total expenditures (Zyn: 4.7%; On!: 0.6%; Velo: 94.7%). The greatest proportion of ad occurrences and expenditures were accounted for by radio (75.9% and 28.2%, respectively) and television (16.2% and 56.5%), followed by mobile (0.5% and 7.2%) and online display (6.7% and 3.6%). Across ad occurrences and expenditures, prominent headline themes included 'freedom' (26.0% and 17.1%, respectively), 'brand' (9.6% and 18.6%) and 'flavour' (16.4% and 7.6%); images mainly featured the product alone (61.4% and 56.1%), text (16.2% and 24.6%) or men (8.7% and 8.6%); and prominent channel themes were entertainment (34.7% and 37.3%), news/weather (14.3% and 21.7%), business/finance (12.9% and 9.0%) and sports (9.5% and 1.0%). Zyn and On! prioritised online display and print; Velo prioritised radio and television. Zyn's and Velo's headlines focused on 'freedom', with Zyn also emphasising 'brand' and Velo 'innovation'; On!'s headlines emphasised 'flavour'.Regulatory efforts must be informed by surveillance of nicotine pouch marketing and impacts on consumer subgroups (eg, young people).

    View details for DOI 10.1136/tc-2022-057360

    View details for PubMedID 35817549

  • Draining the tobacco swamps: Shaping the built environment to reduce tobacco retailer proximity to residents in 30 big US cities. Health & place Combs, T. B., Ornstein, J. T., Chaitan, V. L., Golden, S. D., Henriksen, L., Luke, D. A. 2022; 75: 102815


    Combining geospatial data on residential and tobacco retailer density in 30 big US cities, we find that a large majority of urban residents live in tobacco swamps - neighborhoods where there is a glut of tobacco retailers. In this study, we simulate the effects of tobacco retail reduction policies and compare probable changes in resident-to-retailer proximity and retailer density for each city. While measures of proximity and density at baseline are highly correlated, the results differ both between effects on proximity and density and across the 30 cities. Context, particularly baseline proximity of residents to retailers, is important to consider when designing policies to reduce retailer concentration.

    View details for DOI 10.1016/j.healthplace.2022.102815

    View details for PubMedID 35598345

  • The Impact of Recent Tobacco Regulations and COVID-19 Restrictions and Implications for Future E-Cigarette Retail: Perspectives from Vape and Vape-and-Smoke Shop Merchants. International journal of environmental research and public health Duan, Z., Romm, K. F., Henriksen, L., Schleicher, N. C., Johnson, T. O., Wagener, T. L., Sussman, S. Y., Schillo, B. A., Huang, J., Berg, C. J. 2022; 19 (7)


    BACKGROUND: Tobacco regulations and COVID-19 state orders have substantially impacted vape retail. This study assessed vape retailers' perspectives regarding regulations and future retail activities.METHODS: In March-June 2021, 60 owners or managers of vape or vape-and-smoke shops (n = 34 vs. n = 26) in six US metropolitan areas completed an online survey assessing: (1) current and future promotional strategies and product offerings; and (2) experiences with federal minimum legal sales age (T21) policies, the federal flavored e-cigarette ban, and COVID-19-related orders. Quantitative data were analyzed descriptively; qualitative responses to open-ended questions were thematically analyzed.RESULTS: Most participants had websites (65.0%), used social media for promotion (71.7%), offered curbside pickup (51.7%), and sold CBD (e.g., 73.3% vape products, 80.0% other); many also sold other tobacco products. Knowledge varied regarding state/local policies in effect before federal policies. Participants perceived tobacco regulations and COVID-19 orders as somewhat easy to understand/implement and perceived noncompliance consequences as somewhat severe. Qualitative themes indicated concerns regarding regulations' negative impacts (e.g., sales/customer loss, customers switching to combustibles), insufficient evidence base, challenges explaining regulations to customers, and concerns about future regulatory actions.CONCLUSIONS: Surveillance of tobacco retail, consumer behavior, and regulatory compliance is warranted as policies regarding nicotine and cannabis continue evolving.

    View details for DOI 10.3390/ijerph19073855

    View details for PubMedID 35409539

  • Retail endgame strategies: reduce tobacco availability and visibility and promote health equity. Tobacco control Kong, A. Y., Henriksen, L. 2022; 31 (2): 243-249


    An increasing number of countries have set tobacco endgame goals that target dramatic reductions in smoking prevalence. To achieve those targets and promote health equity, policies are needed to reduce the retail supply and visibility of tobacco products. Focusing on retailer reduction strategies and tobacco display bans, this special communication reviews solution-oriented research about the retail environment. It highlights examples of policy implementation and identifies data needs and research gaps for designing and evaluating retail policies to promote population health equitably.

    View details for DOI 10.1136/tobaccocontrol-2021-056555

    View details for PubMedID 35241596

  • Follow the money: a closer look at US tobacco industry marketing expenditures. Tobacco control Levy, D. T., Liber, A. C., Cadham, C., Sanchez-Romero, L. M., Hyland, A., Cummings, M., Douglas, C., Meza, R., Henriksen, L. 1800


    INTRODUCTION: While much of the concern with tobacco industry marketing has focused on direct media advertising, a less explored form of marketing strategy is to discount prices. Price discounting is important because it keeps the purchase price low and can undermine the impact of tax increases.METHODS: We examine annual US marketing expenditures from 1975 to 2019 by the largest cigarette and smokeless tobacco companies as reported to the Federal Trade Commission. We consider three categories: direct advertising, promotional allowances and price discounting. In addition to considering trends in these expenditures, we examine how price discounting expenditures relate to changes in product prices and excise taxes.RESULTS: US direct advertising expenditures for cigarettes fell from 80% of total industry marketing expenditures in 1975 to less than 3% in 2019, while falling from 39% in 1985 to 6% in 2019 for smokeless tobacco. Price discounting expenditures for cigarettes became prominent after the Master Settlement Agreement and related tax increases in 2002. By 2019, 87% of cigarette marketing expenditures were for price discounts and 7% for promotional allowances. Smokeless marketing expenditures were similar: 72% for price promotions and 13% for promotional allowances. Price discounting increased with prices and taxes until reaching their currently high levels.CONCLUSIONS: Between 1975 and 2019, direct advertising dramatically fell while price discounting and promotional expenditures increased. Local, state and federal policies are needed that apply non-tax mechanisms to increase tobacco prices and restrict industry contracts to offset industry marketing strategies. Further study is needed to better understand industry decisions about marketing expenditures.

    View details for DOI 10.1136/tobaccocontrol-2021-056971

    View details for PubMedID 35074930

  • Spatial clustering of hookah lounges, vape shops and all tobacco retailers near colleges. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Sun, D. L., Schleicher, N. C., Recinos, A., Henriksen, L. 1800


    BACKGROUND: US college students smoke hookah and vape nicotine at higher rates than other young adults. Density/proximity of hookah lounges and vape shops near colleges has been described, but this study is the first to test whether tobacco retailers spatially cluster near college campuses.METHODS: We created and linked spatial shapefiles for community colleges and 4-year universities/colleges in California with lists of hookah lounges, vape shops and licensed tobacco retailers. We simulated 100 data sets, placing hookah lounges, vape shops and tobacco retailers randomly in census tracts in proportion to population density. A modified version of Ripley's K-function was computed using the radius (r) from each retailer within retail category.RESULTS: In 2018/2019, 50.5% of hookah lounges (n=479), 42.5% of vape shops (n=2,467) and 42.0% of all tobacco retailers (n=31,100) were located within 3 miles of a community college. Spatial clustering was significant (p<0.05) from at least 0.4 miles for hookah lounges, 0.1 mile for vape shops, and 0.3 miles for all tobacco retailers. For 4-year universities/colleges, approximately 46.8% of hookah lounges, 31.3% of vape shops and 31.6% of all tobacco retailers were located within 3 miles. Clustering was significant from 0.2 miles for hookah lounges and 1.3 miles for all tobacco retailers but was not significant for vape shops.CONCLUSION: Evidence that some types of tobacco retailers cluster near community colleges and 4-year universities/colleges implies greater accessibility and exposure to advertising for students. It is also concerning because a higher probability of underage tobacco sales presumably exists near colleges.IMPLICATIONS: Prior studies infer that hookah lounges and vape shops cluster near colleges from the density and closer proximity to campuses. This study modified a traditional test of spatial clustering and considered community colleges separately from 4-year universities. Spatial clustering of hookah lounges and all licensed tobacco retailers was evident near both types of campuses, but vape shops clustered only near community colleges. Place-based strategies to limit tobacco retail density could expand state/local laws that prohibit tobacco sales near schools to include retailers near college campuses. In addition, college environments should be a target for reducing hookah smoking and nicotine vaping.

    View details for DOI 10.1093/ntr/ntac007

    View details for PubMedID 35022769

  • Tobacco Couponing: A Systematic Review of Exposures and Effects on Tobacco Initiation and Cessation. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Liber, A. C., Sánchez-Romero, L. M., Cadham, C. J., Yuan, Z., Li, Y., Oh, H., Cook, S., Warner, K. E., Henriksen, L., Mistry, R., Meza, R., Fleischer, N. L., Levy, D. T. 2022


    Tobacco couponing continues to be part of contemporary tobacco marketing in the US. We performed a systematic review of the evidence of tobacco product coupon receipt and redemption to inform regulation.We searched EMBASE OVID and Medline databases for observational (cross-sectional and longitudinal) studies that examined the prevalence of tobacco coupon receipt and coupon redemption across different subpopulations, as well as studies of the association between coupon receipt and redemption with tobacco initiation and cessation at follow-up. We extracted unadjusted and adjusted odds ratios for the associations between coupon exposure (receipt, redemption) and tobacco use outcomes (initiation, cessation) and assessed each studies' potential risk of bias.27 studies met the criteria for inclusion. Of 60 observations extracted, 37 measured coupon receipt, nine measured coupon redemption, eight assessed tobacco use initiation, and six assessed cessation. Tobacco product coupon receipt and redemption tended to be more prevalent among younger adults, women, lower education individuals, members of sexual and gender minorities, and more frequent tobacco users. Coupon receipt at baseline was associated with greater initiation. Coupon receipt and redemption at baseline were associated with lower cessation at follow-up among tobacco users. Results in high-quality studies did not generally differ from all studies.Tobacco product coupon receipt and redemption are often more prevalent among price-sensitive subpopulations. Most concerning, our results suggest coupon receipt may be associated with higher tobacco initiation and lower tobacco cessation. Couponing thereby increases the toll of tobacco use and could prove to be a viable public health policy intervention point.A systematic review was conducted of the scientific literature about the receipt, redemption, and effects on tobacco initiation and cessation of tobacco product couponing. This review found that tobacco coupons are more often received by price-sensitive persons and these coupons serve to increase tobacco initiation and decrease tobacco cessation. Policy efforts to address these consequences may help curb tobacco's harms and address health inequities.

    View details for DOI 10.1093/ntr/ntac037

    View details for PubMedID 35143678

  • Using place-based characteristics to inform FDA tobacco sales inspections: results from a multilevel propensity score model. Tobacco control Dai, H., Henriksen, L., Xu, Z., Rathnayake, N. 2021


    BACKGROUND: Conducting routine inspections for compliance with age-of-sale laws is essential to reducing underage access to tobacco. We seek to develop a multilevel propensity score model (PSM) to predict retail violation of sales to minors (RVSM).METHODS: The Food and Drug Administration compliance check of tobacco retailers with minor-involved inspections from 2015 to 2019 (n=683741) was linked with multilevel data for demographics and policies. Generalised estimating equation was used to develop the PSM using 2015-2016 data to predict the 2017 RVSM. The prediction accuracy of the PSM was validated by contrasting PSM deciles against 2018-2019 actual violation data.RESULTS: In 2017, 44.3% of 26150 zip codes with ≥1 tobacco retailer had 0 FDA underage sales inspections, 11.0% had 1 inspection, 13.5% had 2-3, 15.3% had 4-9, and 15.9% had 10 or more. The likelihood of having an RVSM in 2017 was higher in zip codes with a lower number of inspections (adjusted OR (aOR)=0.988, 95%CI (0.987 to 0.990)) and penalties (aOR=0.97, 95%CI (0.95 to 0.99)) and a higher number of violations (aOR=1.07, 95%CI (1.06 to 1.08)) in the previous 2years. Urbanicity, socioeconomic status, smoking prevalence and tobacco control policies at multilevels also predicted retail violations. Prediction accuracy was validated with zip codes with the highest 10% of the PSM 3.4 times more likely to have retail violations in 2019 than zip codes in the bottom decile.CONCLUSION: The multilevel PSM predicts the RVSM with a good rank order of retail violations. The model-based approach can be used to identify hot spots of retail violations and improve the sampling plan for future inspections.

    View details for DOI 10.1136/tobaccocontrol-2021-056742

    View details for PubMedID 34697089

  • Are California's Local Flavored Tobacco Sales Restrictions Effective in Reducing the Retail Availability of Flavored Tobacco Products? A Multicomponent Evaluation. Evaluation review Andersen-Rodgers, E., Zhang, X., Vuong, T. D., Hendrix, L., Edora, C., Williams, R. J., Groves, L., Roeseler, A., Rogers, T., Voelker, D. H., Schleicher, N. C., Johnson, T. O., Henriksen, L. 2021: 193841X211051873


    INTRODUCTION: Flavored tobacco appeals to new users. This paper describes evaluation results of California's early ordinances restricting flavored tobacco sales.METHODS: A multicomponent evaluation of proximal policy outcomes involved the following: (a) tracking the reach of local ordinances; (b) a retail observation survey; and (c) a statewide opinion poll of tobacco retailers. Change in the population covered by local ordinances was computed. Retail observations compared availability of flavored tobacco at retailers in jurisdictions with and without an ordinance. Mixed models compared ordinance and matched no-ordinance jurisdictions and adjusted for store type. An opinion poll assessed retailers' awareness and ease of compliance with local ordinances, comparing respondents in ordinance jurisdictions with the rest of California.RESULTS: The proportion of Californians living in a jurisdiction with an ordinance increased from 0.6% in April 2015 to 5.82% by January 1, 2019. Flavored tobacco availability was significantly lower in ordinance jurisdictions than in matched jurisdictions: menthol cigarettes (40.6% vs. 95.0%), cigarillos/cigar wraps with explicit flavor descriptors (56.4% vs. 85.0%), and vaping products with explicit flavor descriptors (6.1% vs. 56.9%). Over half of retailers felt compliance was easy; however, retailers in ordinance jurisdictions expressed lower support for flavor sales restrictions.CONCLUSIONS: The proportion of California's population covered by a flavor ordinance increased nine-fold between April 2015 and January 2019. Fewer retailers in ordinance jurisdictions had flavored tobacco products available compared to matched jurisdictions without an ordinance, but many still advertised flavored products they could not sell. Comprehensive ordinances and retailer outreach may facilitate sales-restriction support and compliance.

    View details for DOI 10.1177/0193841X211051873

    View details for PubMedID 34693773

  • Young people's e-cigarette risk perceptions, policy attitudes, and past-month nicotine vaping in 30 U.S. cities. Drug and alcohol dependence Vogel, E. A., Henriksen, L., Schleicher, N. C., Prochaska, J. J. 2021; 229 (Pt A): 109122


    BACKGROUND: This study examined young people's e-cigarette risk perceptions, policy attitudes, and past-month nicotine vaping in 30 US cities in relation to city e-cigarette retail policy.METHODS: Participants ages 13-20 were recruited online September-November 2020 (N=900, approximately 30 per city). Cities (median population=688,531) were in 23 states. Ever e-cigarette users were oversampled. A multilevel generalized estimating equations (GEE) model compared past-month nicotine vaping as a function of local e-cigarette retail policy. Among ever-users, multilevel bivariate GEE models examined associations of participant characteristics with past-month vaping (yes/no) and, among past-month nicotine vapers, purchase of vaping products at a retail location (yes/no).RESULTS: The sample (age M=17.7 [SD=1.8]) was 60.2% female and 29.3% Black. Minimal city-level variation was observed in e-cigarette risk perceptions or policy attitudes (ICCs<0.001). Nearly half the sample (44.6%) reported ever e-cigarette use; 11.8% reported past-month nicotine vaping. Past-month nicotine vaping was associated with older age, being non-Hispanic white, living with someone who vapes, having friends who vape, greater exposure to retail e-cigarette ads, lower e-cigarette risk perceptions, and lower perceived efficacy of flavored tobacco policy. Among ever-users, past-month nicotine vaping was not significantly associated with city e-cigarette flavor policy (p=.784). Most participants reporting past-month nicotine vaping purchased products in-store (58.5%).CONCLUSIONS: Among young people surveyed in US cities, e-cigarette risk perceptions and policy attitudes showed minimal between-city variation. Past-month vaping among ever-users did not differ significantly by local flavor policies. A majority of past-month users, regardless of city policies, reported underage access to flavored products in retail locations.

    View details for DOI 10.1016/j.drugalcdep.2021.109122

    View details for PubMedID 34695673

  • The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations. Tobacco control Raskind, I. G., Vishwakarma, M., Schleicher, N. C., Andersen-Rodgers, E., Henriksen, L. 2021


    INTRODUCTION: Dollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers.METHODS: Data were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics.RESULTS: Census tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as 'other'.CONCLUSIONS: Dollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores' rapid expansion.

    View details for DOI 10.1136/tobaccocontrol-2020-056389

    View details for PubMedID 34607887

  • Associations of tobacco retailer density and proximity with adult tobacco use behaviours and health outcomes: a meta-analysis. Tobacco control Lee, J. G., Kong, A. Y., Sewell, K. B., Golden, S. D., Combs, T. B., Ribisl, K. M., Henriksen, L. 2021


    OBJECTIVE: We sought to conduct a systematic review and meta-analysis of evidence to inform policies that reduce density and proximity of tobacco retailers.DATA SOURCES: Ten databases were searched on 16 October 2020: MEDLINE via PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus, plus grey literature searches using Google and the RAND Publication Database.STUDY SELECTION: Included studies used inferential statistics about adult participants to examine associations between tobacco retailer density/proximity and tobacco use behaviours and health outcomes. Of 7373 studies reviewed by independent coders, 37 (0.5%) met inclusion criteria.DATA EXTRACTION: Effect sizes were converted to a relative risk reduction (RRR) metric, indicating the presumed reduction in tobacco use outcomes based on reducing tobacco retailer density and decreasing proximity.DATA SYNTHESIS: We conducted a random effects meta-analysis and examined heterogeneity across 27 studies through subgroup analyses and meta-regression. Tobacco retailer density (RRR=2.55, 95% CI 1.91 to 3.19, k=155) and proximity (RRR=2.38, 95% CI 1.39 to 3.37, k=100) were associated with tobacco use behaviours. Pooled results including both density and proximity found an estimated 2.48% reduction in risk of tobacco use from reductions in tobacco retailer density and proximity (RRR=2.48, 95% CI 1.95 to 3.02, k=255). Results for health outcomes came from just two studies and were not significant. Considerable heterogeneity existed.CONCLUSIONS: Across studies, lower levels of tobacco retailer density and decreased proximity are associated with lower tobacco use. Reducing tobacco supply by limiting retailer density and proximity may lead to reductions in tobacco use. Policy evaluations are needed.

    View details for DOI 10.1136/tobaccocontrol-2021-056717

    View details for PubMedID 34479990

  • JUUL and other e-cigarettes: Socio-demographic factors associated with use and susceptibility in California. Preventive medicine reports Mathur Gaiha, S., Halpern-Felsher, B., Feld, A. L., Gaber, J., Rogers, T., Henriksen, L. 2021; 23: 101457


    This study examined which socio-demographic factors are associated with susceptibility (lack of commitment to avoid future use), past-12-month and past-30-day use of JUUL and other e-cigarettes, and reasons for and against using JUUL. An online survey of 3,075 Californians ages 15-29, including 24.3% who identified as LGBTQ, were recruited via social media in January-March 2019. Multi-level weighted logistic regression models suggest that LGBTQ participants were more likely to be susceptible to JUUL [AOR=2.11 (1.60, 2.79) (parentheses include 95% Confidence Intervals)] and other e-cigarettes [AOR=2.31 (1.75, 3.05)], and more likely to use JUUL [AOR=1.27 (1.02, 1.58)] and other e-cigarettes [AOR=1.66 (1.35, 2.05)] in the past 12months. Susceptibility to using JUUL was more likely among adolescents (ages 15-17) [AOR=1.72 (1.30, 2.28)] and young adults (ages 18-20) [AOR=1.26 (1.00,1.58)] than adults (ages 21-29). At the community level, living in jurisdictions with higher median household income was associated with a higher likelihood of being susceptible to using JUUL and other e-cigarettes. Compared to non-Hispanic Whites, Asian/Pacific Islanders were less likely to use JUUL [AOR=0.68 (0.54, 0.86)] and other e-cigarettes [AOR=0.60 (0.48, 0.76)] in the past 12months. Past-30-day JUUL use was more likely among males than females [AOR=1.44 (1.11, 1.88)]. Common reasons for using JUUL were: friends' use, flavors, "safer" than cigarettes, no one will notice, and nicotine rush is greater than other devices. Common reasons against using JUUL were: harmful to self/others, contains nicotine and is addictive. E-cigarette prevention and cessation efforts should include tailored messaging for people who identify as LGBTQ and reinforce reasons for not vaping nicotine.

    View details for DOI 10.1016/j.pmedr.2021.101457

    View details for PubMedID 34194963

  • Turning over a new leaf: Vape shop closings, openings and transitions in six U.S. Metropolitan statistical areas. Preventive medicine reports Barker, D. C., Henriksen, L., Voelker, D. H., Ali, A., Raskind, I. G., Schleicher, N. C., Johnson, T. O., Berg, C. J. 2021; 23: 101428


    This study characterizes vape shop closings, openings, and changes in product mix in six U.S. metropolitan statistical areas with different tobacco and marijuana policies. With concern for higher rates of marijuana use among those who vape nicotine, the presence of marijuana-related terms in store names was also assessed. A census of stores that were classified online as vape shops/stores or vaporizer stores were telephoned in April-May 2018 (n=739) and July-September 2019 (n=919) to verify whether vape products and other tobacco products (OTP) were sold. We computed the percent of stores that closed, opened, and started/stopped selling OTP. Multilevel models tested whether these events varied by store type and by neighborhood demographics. Within 16months, 11.5% of 739 stores had closed and 29.8% of 919 stores at follow-up had opened. Closings were more likely among vape-only than vape+OTP stores (AOR=2.51, 95% CI=1.47,4.29); vape-only stores were less likely to open (AOR=0.46, 95% CI=0.34,0.62). Regardless of store type, the odds of a store opening increased as the proportion of non-Hispanic/Latino White residents in the census tract increased (AOR=1.47, 95% CI=1.18,1.85). Overall, 2.0% of stores (vape-only and vape+OTP) had marijuana-related names at baseline and 3.5% at follow-up. The observed change (1.6% to 5.8%) was greatest in Oklahoma City, where the state legalized medical marijuana between baseline and follow-up. More stores were opening than closing in six U.S. metropolitan statistical areas before statewide sales restrictions on flavored tobacco and COVID-19. Uniform licensing is recommended to define vape shops and track their location and sales practices.

    View details for DOI 10.1016/j.pmedr.2021.101428

    View details for PubMedID 34159050

  • Plant-based menthol cigarettes? Food industry trends and farm-to-pack cigarette advertising. Tobacco control Raskind, I. G., Prochaska, J. J., Epperson, A. E., Henriksen, L. 2021

    View details for DOI 10.1136/tobaccocontrol-2021-056534

    View details for PubMedID 34400569

  • Impact of Local Flavored Tobacco Sales Restrictions on Policy-Related Attitudes and Tobacco Product Access. Health education & behavior : the official publication of the Society for Public Health Education Feld, A. L., Rogers, T., Gaber, J., Pikowski, J., Farrelly, M. C., Henriksen, L., Johnson, T. O., Halpern-Felsher, B., Andersen-Rodgers, E., Zhang, X. 2021: 10901981211027520


    BACKGROUND: As of September 2020, more than 300 state and local jurisdictions restrict the sales of flavored tobacco, with some including menthol.AIMS: o evaluate the impact of local ordinances restricting the sale of flavored tobacco, we surveyed Californians regarding policy support and perceived access to flavored tobacco.METHODS: In 2019, we conducted an online survey of 3,075 California youth and young adults recruited via social media, about half of whom lived in a policy jurisdiction. Logistic regressions assessed differences on propensity score-weighted outcomes, policy support, and perceived access.RESULTS: Most respondents indicated agreement with almost all policy support statements. Although policy respondents were less likely than rest-of-California respondents to report perceived difficulty in buying flavored cigars, flavored vape users in policy jurisdictions were more likely than those in the rest of California to report perceived difficulty in buying flavored e-liquid. Regardless of jurisdiction, certain priority subgroups were significantly more likely to report perceived difficulty in accessing flavored cigars, flavored vaping products, flavored e-liquid, and menthol cigarettes.DISCUSSION: With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products.CONCLUSIONS: Findings might be an early indication of shifts in social norms about flavored tobacco products in California, which could gain traction as local sales restriction ordinances proliferate throughout the state and a statewide flavored-tobacco sales restriction goes into effect.

    View details for DOI 10.1177/10901981211027520

    View details for PubMedID 34399591

  • Menthol cigarettes in black neighbourhoods: still cheaper after all these years. Tobacco control Henriksen, L., Schleicher, N. C., Fortmann, S. P. 2021

    View details for DOI 10.1136/tobaccocontrol-2021-056758

    View details for PubMedID 34385403

  • Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Posner, H., Romm, K., Henriksen, L., Bernat, D., Berg, C. J. 2021


    SIGNIFICANCE: Despite increases in e-cigarette sales restrictions, support for sales restrictions and perceived impact on young adult use are unclear.METHODS: We analyzed Feb-May 2020 data from a longitudinal study of 2,159 young adults (ages 18-34; Mage=24.75±4.71; n=550 past 30-day e-cigarette users) in 6 metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle). We examined support for e-cigarette sales restrictions and - among e-cigarette users - perceived impact of flavored vape product and all vape product sales restrictions on e-cigarette and cigarette use (and potential correlates; i.e., e-cigarette/tobacco use, use-related symptoms/health concerns).RESULTS: 24.2% of e-cigarette users (and 57.6% of non-users) supported (strongly/somewhat) sales restrictions on flavored vape products; 15.1% of e-cigarette users (45.1% of non-users) supported complete vape product sales restrictions. If restricted to tobacco flavors, 39.1% of e-cigarette users reported being likely (very/somewhat) to continue using e-cigarettes (30.5% not at all likely); 33.2% were likely to switch to cigarettes (45.5% not at all). Considering complete vape product sales restrictions, equal numbers (~39%) were likely vs. not at all likely to switch to cigarettes. Greater policy support correlated with being e-cigarette non-users (aR 2=.210); among users, correlates included fewer days of use and greater symptoms and health concerns (aR 2=.393). If such restrictions were implemented, those less likely to report continuing to vape or switching to cigarettes used e-cigarettes on fewer days, were never-smokers, and indicated greater health concern (aR 2=.361).CONCLUSIONS: While lower-risk users may be more positively impacted by such policies, other young adult user subgroups may not experience benefit.IMPLICATIONS: Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%). Those most likely to report positive impact of such policies being implemented were less frequent users, never-smokers, and those with greater e-cigarette-related health concerns. This research should be considered in future tobacco control initiatives.

    View details for DOI 10.1093/ntr/ntab154

    View details for PubMedID 34331447

  • Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review. Tobacco control Travis, N., Levy, D. T., McDaniel, P. A., Henriksen, L. 2021


    OBJECTIVE: States and localities are formulating strategies to reduce the widespread retail availability of tobacco products. Evidence of associations between retailer density/proximity and tobacco use outcomes can help inform those strategies. We conducted a scoping review on tobacco retail availability and cigarette/e-cigarette use in adults and youth, and considered variations in spatial units, measures of retailer exposure and outcomes across studies.METHODS: A systematic search for studies examining the association between retailer density/proximity and youth and adult cigarette/e-cigarette use was conducted across MEDLINE (PubMed), Web of Science and Google Scholar through 27 August 2020 with no restrictions.RESULTS: Thirty-five studies were included in our qualitative synthesis. While there were differences in neighbourhood definitions (eg, egocentric vs administrative), there is evidence for a positive association between higher retailer density in egocentric neighbourhoods around homes and current smoking in adults and adolescents. Administrative unit measures in some studies showed associations with adult current smoking, and adolescent lifetime and current smoking. Studies on tobacco outlet proximity to homes obtained mixed results. Density/proximity of tobacco outlets around schools showed no or inverse association with adolescent smoking, but suggests higher susceptibility to smoking. Evidence of an association between e-cigarette retail availability and e-cigarette use is limited due to a small number of studies.CONCLUSION: The current literature provides limited empirical evidence of the association between tobacco retailer availability and smoking or e-cigarette use. More research with uniform measures of environmental exposure to tobacco retailers is needed to allow for greater comparability between studies.

    View details for DOI 10.1136/tobaccocontrol-2020-056376

    View details for PubMedID 34301839

  • Perceived Susceptibility to and Seriousness of COVID-19: Associations of Risk Perceptions with Changes in Smoking Behavior. International journal of environmental research and public health Vogel, E. A., Henriksen, L., Schleicher, N. C., Prochaska, J. J. 2021; 18 (14)


    During the COVID-19 pandemic, studies have documented increased and decreased cigarette smoking among adults. Individual differences in the perceived susceptibility and seriousness of the virus, for people who smoke in general and for oneself personally, may relate to changes in smoking. Using the Health Belief Model (HBM) as a theoretical framework, we examined associations with self-reported increasing and decreasing smoking a lot during the COVID-19 stay-at-home period. Adults in 30 large U.S. cities who smoked cigarettes daily completed an online survey between 14 July and 30 November 2020. The analytic sample (N = 2768) was 54.0% male and 68.3% white with 23.7% reporting increasing and 11.3% decreasing smoking (6% reported both). Younger age, a diagnosis of COVID-19, and greater pandemic-related stress were associated with greater odds of both increased and decreased smoking. Increased smoking also was associated with heavier nicotine dependence, greater desire to quit, and greater perceived susceptibility and lower perceived seriousness of COVID-19 for people who smoke, while pandemic-related job-loss, lower nicotine dependence, and greater self-efficacy were associated with decreased smoking. Among respondents who had not contracted COVID-19 (n = 2418), correlates were similar with the addition of greater perceived personal susceptibility to COVID-19 associated with both increased and decreased smoking, while greater perceived personal seriousness of COVID-19 was associated with increased smoking. Findings for risk perceptions were largely in directions that contradict the HBM. Circumstances surrounding behavior change during the pandemic are complex and may be especially complex for nicotine addiction.

    View details for DOI 10.3390/ijerph18147621

    View details for PubMedID 34300072

  • Flavors And Implied Reduced-Risk Descriptors In Cigar Ads At Stores Near Schools. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Sterling, K., Vishwakarma, M., Ababseh, K., Henriksen, L. 2021


    INTRODUCTION: Although the FDA prohibits using inaccurate, reduced-risk descriptors on tobacco product advertising, descriptors that imply reduced-risk or an enhanced user experience may be present on cigar product advertising in retail outlets near schools. Therefore, to inform the development of federal labeling and advertising requirements that reduce youth appeal of cigars, we conducted a content analysis of cigar ads in retailers near schools to document the presence of implied health claims and other selling propositions that may convey enhanced smoking experience.METHODS: Up to four interior and exterior LCC advertisements were photographed in a random sample of licensed tobacco retailers (n=530) near California middle and high schools. Unique ads (n= 234) were coded for brand, flavor, and presence of implicit health claims, premium branding descriptors, and sensory descriptors. Logistic regressions assessed the association among flavored ads and presence of implicit health claims, premium branding, or sensory descriptors.RESULTS: Seventeen cigar brands were advertised near schools; Black & Mild (20.1%) and Swisher Sweets (20.1%) were most common. Flavor was featured in 64.5% of ads, with explicit flavor names (e.g., grape) being more prevalent than ambiguous names (e.g., Jazz) (49.6% vs. 34.2%). Compared to ads without flavors, ads with ambiguous flavors were more likely to feature implicit health claims (OR=1.83, 95%CI=1.06, 3.19) and sensory descriptors (OR=2.64, 95%CI=1.39, 5.04); ads with explicit flavors were more likely to feature premium branding (OR=2.84, 95%CI=1.53, 5.41).CONCLUSIONS: Cigar ads that featured implicit health claims and premium branding, and sensory selling propositions are present at retailer stores near schools.

    View details for DOI 10.1093/ntr/ntab136

    View details for PubMedID 34214176

  • Thoughts on neologisms and pleonasm in scientific discourse and tobacco control TOBACCO CONTROL O'Connor, R., Durkin, S. J., Cohen, J. E., Barnoya, J., Henriksen, L., Hill, S. E., Malone, R. E. 2021; 30 (4): 359-360
  • Implementation of a comprehensive flavoured tobacco product sales restriction and retail tobacco sales. Tobacco control Gammon, D. G., Rogers, T., Gaber, J., Nonnemaker, J. M., Feld, A. L., Henriksen, L., Johnson, T. O., Kelley, T., Andersen-Rodgers, E. 2021


    OBJECTIVE: San Francisco's comprehensive restriction on flavoured tobacco sales applies to all flavours (including menthol), all products and all retailers (without exemptions). This study evaluates associations of policy implementation with changes in tobacco sales in San Francisco and in two California cities without any sales restriction.METHODS: Using weekly retail sales data (July 2015 through December 2019), we computed sales volume in equivalent units within product categories and the proportion of flavoured tobacco. An interrupted time series analysis estimated within-city changes associated with the policy's effective and enforcement dates, separately by product category for San Francisco and comparison cities, San Jose and San Diego.RESULTS: Predicted average weekly flavoured tobacco sales decreased by 96% from before the policy to after enforcement (p<0.05), and to very low levels across all products, including cigars with concept-flavour names (eg, Jazz). Average weekly flavoured tobacco sales did not change in San Jose and decreased by 10% in San Diego (p<0.05). Total tobacco sales decreased by 25% in San Francisco, 8% in San Jose and 17% in San Diego (each, p<0.05).CONCLUSIONS: San Francisco's comprehensive restriction virtually eliminated flavoured tobacco sales and decreased total tobacco sales in mainstream retailers. Unlike other US flavoured tobacco policy evaluations, there was no evidence of substitution to concept-flavour named products. Results may be attributed to San Francisco Department of Health's self-education and rigorous retailer education, as well as the law's rebuttable presumption of a product as flavoured based on manufacturer communication.

    View details for DOI 10.1136/tobaccocontrol-2021-056494

    View details for PubMedID 34088881

  • Sources of flavoured e-cigarettes among California youth and young adults: associations with local flavoured tobacco sales restrictions. Tobacco control Gaiha, S. M., Henriksen, L., Halpern-Felsher, B., Rogers, T., Feld, A. L., Gaber, J., Andersen-Rodgers, E. 2021


    PURPOSE: This study compares access to flavoured JUUL and other e-cigarettes from retail, online and social sources among underage and young adult e-cigarette users who live in California jurisdictions that restrict sales of flavoured tobacco with the rest of the state.METHODS: An online survey used social media advertisements to recruit participants (n=3075, ages 15-29) who lived in one of nine jurisdictions that restrict sales (n=1539) or in the rest of state, and oversampled flavoured tobacco users. Focusing on past-month e-cigarette users (n=908), multilevel models tested whether access to flavoured JUUL and other e-cigarettes from retail, online and social sources differed by local law (yes/no) and age group (15-20 or older), controlling for other individual characteristics.RESULTS: The percent of underage users who obtained flavoured JUUL and other e-cigarettes in the past month was 33.6% and 31.2% from retail, 11.6% and 12.7% online, and 76.0% and 70.9% from social sources, respectively. Compared with underage and young adult users in the rest of California, those in localities that restrict the sales of flavoured tobacco were less likely to obtain flavoured JUUL from retail sources (Adjusted OR=0.54, 95% CI 0.36 to 0.80), but more likely to obtain it from social sources (Adjusted OR=1.55, 95% CI 1.02 to 2.35). The same pattern was observed for other brands of flavoured e-cigarettes.CONCLUSION: Although local laws may reduce access to flavoured e-cigarettes from retail sources, more comprehensive state or federal restrictions are recommended to close the loopholes for online sources. Dedicated efforts to curtail access from social sources are needed.

    View details for DOI 10.1136/tobaccocontrol-2020-056455

    View details for PubMedID 33850007

  • Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies. Health & place Marsh, L., Vaneckova, P., Robertson, L., Johnson, T. O., Doscher, C., Raskind, I. G., Schleicher, N. C., Henriksen, L. 2021; 67: 102275


    BACKGROUND: Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.METHODS: We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.FINDINGS: Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.CONCLUSIONS: The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.

    View details for DOI 10.1016/j.healthplace.2019.102275

    View details for PubMedID 33526204

  • Underage sales signage in vape shops: Comparison of stores near and far from California colleges. Journal of American college health : J of ACH Ali, A., Barker, D. C., Vishwakarma, M., Schleicher PhDa, N. C., Johnson, T. O., Henriksen, L. 2021: 1-4


    Two-thirds of U.S. colleges are near vape shops, where higher rates of underage sales exist. This study examined vape shop compliance with state-mandated age-of-sale signs, the presence of age-of-entry signs and the tobacco industry's "We Card" sign. Participants: Random sample of 614 California vape shops, stratified by distance to community colleges or 4-year universities/colleges; visited June-August, 2019. Methods: Logistic regressions examined whether signage varied by distance to colleges and whether stores sold other tobacco products (OTP). Results: Compliance with the state-mandated age-of-sale sign was 69.4%; vape-only stores were less compliant than vape + OTP (AOR = 0.39, 95% CI = 0.22,0.70). Age-of-entry signs were more common in vape-only (AOR = 1.87, 95% CI = 1.07,3.28) than vape + OTP stores. However, this difference was greater for vape-only stores near community colleges and attenuated for vape-only stores near 4-year universities/colleges. Conclusion: Improved enforcement and retailer education regarding age-of-sale signage are needed, particularly near colleges where greater potential for underage sales presumably exists.

    View details for DOI 10.1080/07448481.2021.1978457

    View details for PubMedID 34788557

  • Cigarette Promotions in U.S. Pharmacies. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Seidenberg, A. B., Henriksen, L., Ribisl, K. M. 2021


    The sale of tobacco products within American pharmacies has generated controversy for several decades, leading two US states and 45 municipalities to adopt tobacco-free pharmacy policies. While previous research has reported cheaper cigarette prices in pharmacies, compared to other retailers, little is known about cigarette promotions in pharmacies, which are associated with increased youth smoking and unplanned cigarette purchases among adults.Between May and August 2015, trained data collectors conducted store audits at 2128 tobacco retailers located within 97 US counties in 40 states. Observations were made for three types of cigarette promotions: special price (e.g., $0.30 off/pack), multi-pack promotions (e.g., buy one pack, get one free), and cross-product promotions (e.g., buy a pack of cigarettes and a get free can of snus). We calculated weighted estimates of the proportion of pharmacies and other retailer types with cigarette promotions and used weighted multivariable logistic regression to compare cigarette promotions by tobacco retailer type, accounting for clustering at the county level and controlling for county-level demographic characteristics.Cigarette promotions were observed in 94.0% of pharmacies, more than any other retailer type (e.g., convenience stores: 82.0%, tobacco stores: 77.0%). All retailer types had lower odds of promotions for Marlboro, Newport, Camel, menthol, or any interior cigarette promotion, compared to pharmacies.Nearly all pharmacies offered in-store cigarette promotions and pharmacies had greater odds of offering cigarette promotions than all other retailer types. Whether voluntarily or legislatively, tobacco-free pharmacies would eliminate a prevalent retail source of cigarette promotions.This is the first known national study to examine prevalence of cigarette promotions in US pharmacies compared to other retailer types. Nearly all pharmacies offered in-store cigarette promotions and pharmacies had greater odds of offering cigarette promotions than all other retailer types. These findings underscore the inherent contradiction of pharmacies serving both as an important component of the healthcare system, but also as purveyors and promotors of addictive and lethal tobacco products. Whether voluntarily or legislatively, tobacco-free pharmacy policies would eliminate a prevalent retail source of cigarette promotions.

    View details for DOI 10.1093/ntr/ntab204

    View details for PubMedID 34624896

  • Young adults' vaping, readiness to quit, and recent quit attempts: The role of co-use with cigarettes and marijuana. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Berg, C. J., Duan, X., Romm, K., Pulvers, K., Le, D., Ma, Y., Krishnan, N., Abroms, L. C., Getachew, B., Henriksen, L. 2020


    INTRODUCTION: E-cigarette cessation intervention research is limited. Young adult e-cigarette use and cessation is particularly nuanced, given various user profiles (i.e., polytobacco use, co-use with marijuana) warranting different intervention approaches.METHODS: The current study is an analysis of baseline survey data (collected September-December, 2018) among 1,133 young adult (ages 18-34) e-cigarette users in a 2-year longitudinal study. We examined: 1) e-cigarette user profiles (i.e., e-cigarette only; e-cigarette/other tobacco; e-cigarette/marijuana; e-cigarette/other tobacco/marijuana); and 2) correlates of readiness to quit e-cigarette use in the next 6 months and past-year e-cigarette quit attempts.RESULTS: In this sample (Mage=23.91, 47.3% male, 35.5% sexual minority, 75.2% White, 13.7% Hispanic), e-cigarette user profiles were: 16.8% e-cigarettes-only, 23.4% e-cigarette/other tobacco, 18.0% e-cigarette/marijuana, and 41.8% e-cigarette/other tobacco/marijuana. Multinomial logistic regression (referent: e-cigarette-only use) indicated that all polyuse groups were more likely to use high-nicotine e-liquids (containing ≥9mg of nicotine). Other predictors included: e-cigarettes/other tobacco users being older and male; e-cigarettes/marijuana users using closed systems; and e-cigarettes/other tobacco/marijuana users being sexual minority (p's<.01). Readiness to quit e-cigarettes and past-year quit attempts were reported by 20.8% and 32.3%, respectively. Per multilevel regression, readiness to quit and quit attempts correlated with using fewer days, high-nicotine e-liquids, and closed systems, but not marijuana, as well as being heterosexual and Black (vs. White); readiness to quit also correlated with being single; past-year quit attempts correlated with other tobacco use and being Hispanic.CONCLUSIONS: Young adult e-cigarette users demonstrate distinct user profiles and cessation-related experiences that should be considered in developing cessation interventions.IMPLICATIONS: The vast majority of young adult e-cigarette users use other tobacco products and marijuana. Unfortunately, few reported readiness to quit or attempting quit. Moreover, certain subgroups (e.g., sexual/racial/ethnic minorities) are more likely to be ready or attempt to quit, but may not be successful. Vaping cessation interventions must attend to these nuances.

    View details for DOI 10.1093/ntr/ntaa265

    View details for PubMedID 33331889

  • Vape shop and consumer activity during COVID-19 non-essential business closures in the USA. Tobacco control Berg, C. J., Callanan, R., Johnson, T. O., Schliecher, N. C., Sussman, S., Wagener, T. L., Meaney, M., Henriksen, L. 2020


    INTRODUCTION: Vaping and vape shops pose risk for COVID-19 and its transmission.OBJECTIVES: We examined vape shop non-compliance with state-ordered business closures during COVID-19, changes in their marketing and experiences among consumers.METHODS: As part of a longitudinal study of vape retail in six metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego and Seattle), we conducted: (1) legal research to determine whether statewide COVID-19 orders required vape shops to close; (2) phone-based and web-based surveillance to assess vape shop activity in March-June 2020 during shelter-in-place periods; and (3) a concurrent online survey of e-cigarette users about their experiences with vape retail.RESULTS: Non-essential business closure varied in timing/duration across states and applied to vape shops in California, Massachusetts, Minnesota, Oklahoma (for a brief period) and Washington (Georgia's orders were ambiguous). Surveillance analysis focused on the five MSAs in these states. Of 156 vape shops, 53.2% were open as usual, 11.5% permanently closed and 3.8% temporarily closed; 31.4% offered pick-up/delivery services. Among survey respondents (n=354, M age =23.9±4.6; 46.9% male, 71.8% white, 13.0% Hispanic), 27.4% worried their vape shop would close/go out of business during COVID-19; 7.3% said their vape shop did so. Few noticed increases in vape product delivery options (7.3%), discounts/price promotions (9.9%) and/or prices (9.3%). While 20.3% stockpiled vape products, 20.3% tried to reduce use and 15.8% tried to quit.CONCLUSIONS: Many vape shops were non-compliant with state COVID-19 orders. E-cigarette users were as likely to stockpile vape products as to attempt to reduce or quit using e-cigarettes.

    View details for DOI 10.1136/tobaccocontrol-2020-056171

    View details for PubMedID 33077506

  • Vape shop identification, density and place characteristics in six metropolitan areas across the US. Preventive medicine reports Berg, C. J., Schleicher, N. C., Johnson, T. O., Barker, D. C., Getachew, B., Weber, A., Park, A. J., Patterson, A., Dorvil, S., Fairman, R. T., Meyers, C., Henriksen, L. 2020; 19: 101137


    Vaping is increasingly prevalent and controversial. Vape shops and convenience stores are common but distinct sources of vaping products, and where they locate may reflect likely target markets. This study examined the density and neighborhood demographics of vape shops and convenience stores in six metropolitan statistical areas (MSAs): Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle. We identified 459 vape shops using Yelp and Google application programming interfaces and 10,777 convenience stores using ReferenceUSA and Dun & Bradstreet. Retailers were geocoded to census tracts (n=4,442), and logistic regressions were conducted using as predictors percent non-White, percent youth (5-17years or 5-20years), and median household income from the American Community Survey, 2013-2017. Per 10,000 young adults, vape shop density ranged from 0.6 (Boston, San Diego) to 1.7 (Oklahoma City), and convenience store density ranged from 12.6 (San Diego) to 26.3 (Oklahoma City). Logistic regressions indicated that vape shops more likely resided in tracts with lower percentages of youth in Boston, but higher percentages of youth in Atlanta, as well as with lower incomes in Boston and Seattle. Convenience stores more likely resided in tracts with lower percentages of non-Whites in Atlanta and Boston; lower incomes in Atlanta, Boston, San Diego, and Seattle; and higher percentages of youth in Atlanta, Boston, and Minneapolis. These common retail sources of vaping products differentially locate in relation to neighborhood sociodemographics across MSAs. Findings suggest that, in some MSAs, vape shops and convenience stores may target youth and lower income populations.

    View details for DOI 10.1016/j.pmedr.2020.101137

    View details for PubMedID 32566458

  • Vape shop owners/managers' opinions about FDA regulation of e-cigarettes. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Berg, C. J., Barker, D. C., Sussman, S., Getachew, B., Pulvers, K., Wagener, T. L., Hayes, R. B., Henriksen, L. 2020


    INTRODUCTION: In the US, prominent sources of vaping products are specialty vape shops, which are subject to Food and Drug Administration (FDA) regulation. This study interviewed vape shop owners/managers to assess: 1) reasons for entering into or engaging in vape shop retail; 2) personnel training, particularly with regard to FDA and state regulations; and 3) how existing regulations are perceived and the anticipated impact of future regulation.METHODS: The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018 as FDA regulations regarding minimum age verification, bans on product sampling, and health warnings (among others) were first being implemented.RESULTS: Vape shop owners/managers reported: 1) entering the industry with positive intentions for their customers; 2) training their personnel to adhere to regulations and provide good customer service; and 3) significant concerns about the impact of FDA regulations. With regard to the latter, participants reported mistrust of the intentions of the FDA regulations, financial implications of the regulations (particularly for small businesses), difficulty understanding and interpreting the regulations, insufficient evidence to support the regulations, negative impact on customer service, negative impact on product offerings and product innovation/advancement, and negative implications of flavor bans and/or restrictions on sale of flavors.CONCLUSIONS: These findings indicate the complexities in implementing tobacco regulations, particularly from the perspective of the vape shop industry. Current findings should inform future regulatory actions and efforts to assess compliance with regulations.IMPLICATIONS: Current and impending FDA regulation of vaping products presents a critical period for examining regulatory impact on the vape shop industry. Current results indicated that many vape shop owners/managers reporting positive intentions for engaging in the vaping product industry and in training vape shop personnel to adhere to regulations. However, the majority reported concerns about FDA regulation and other state/local regulations that could have negative implications for their industry. Particular concerns include difficulty understanding the regulations due to complexity, vagueness, and changes in language and/or interpretation over time. These issues have implications for compliance that must be addressed.

    View details for DOI 10.1093/ntr/ntaa138

    View details for PubMedID 32722808

  • Adolescents' Health Perceptions of Natural American Spirit's On-the-Pack Eco-Friendly Campaign. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Epperson, A. E., Wong, S., Lambin, E. F., Henriksen, L., Baiocchi, M., Flora, J. A., Prochaska, J. J. 2020


    PURPOSE: Natural American Spirit (NAS) cigarettes, which have recently grown in popularity, are marketed as eco-friendly and natural. The present study examined whether NAS's on-the-pack messaging influences adolescents' health perceptions of the brand.METHODS: In a mixed-factor design, adolescent participants (N= 1,003, ages 13-17, 75% female) were randomized to one of the six exposure conditions. All viewed images of an NAS and a Pall Mall (comparison brand) cigarette pack, but differed in pack color (blue, green, or gold/orange) and brand viewed first. Perceptions of pack logos, addictiveness, harms to the smoker, others, and the environment were assessed directly after viewing pack images for each brand.RESULTS: Adolescents who perceived NAS as more pro-environment tended to perceive NAS cigarettes to be less addictive, r=-.19, p < .01. NAS cigarettes also were perceived as less addictive and better for the environment than Pall Mall. Most (90%) participants provided nature-friendly words (e.g., environment, recycle) when asked to describe logos on the NAS packs. In adjusted models, relative to Pall Mall, NAS was perceived as healthier for smokers, healthier for smokers' family and friends, and safer for the environment. Findings did not differ by pack color and ever tobacco use.CONCLUSIONS: Adolescents perceived a health advantage for NAS cigarettes with its on-the-pack, eco-friendly and pro-health marketing. The findings are consistent with prior research with adults. Given the accumulating evidence of consumer misperceptions, eco-friendly messaging on cigarettes is a public health concern that warrants further consideration for regulatory intervention.

    View details for DOI 10.1016/j.jadohealth.2020.06.033

    View details for PubMedID 32713741

  • Popularity of natural American Spirit cigarettes is greater in U.S. cities with lower smoking prevalence. Addictive behaviors Vogel, E. A., Henriksen, L., Johnson, T. O., Schleicher, N. C., Prochaska, J. J. 2020; 111: 106558


    BACKGROUND: Often perceived as a safer smoke, Natural American Spirit (NAS) may find particular appeal in communities with strong non-smoking norms. We hypothesized NAS would be more popular in cities with lower smoking prevalence, with the pattern unique to NAS. We tested household income, cigarette taxes, and young adult population as alternative correlates and examined brand specificity, relative to Marlboro and Pall Mall.METHODS: Using proprietary, city-specific sales estimates obtained from Nielsen for 30 U.S. cities over one year (9/7/18-9/9/19), we computed cigarette sales volume as standard pack units per 10,000 adult smokers for NAS and Marlboro and Pall Mall. Linear regression models examined associations between city-level sales volume and adult smoking prevalence, median household income, the sum of state/local cigarette excise taxes, and young adult population.RESULTS: NAS sales volume averaged 44,785 packs per 10,000 adult smokers (SD=47,676). Across 30 cities, adult smoking prevalence averaged 18.0% (SD=4.5%), median household income averaged $53,677 (SD=$14,825), cigarette excise tax averaged $2.55 (SD=$1.63), and young adult population averaged 10.6% (SD=2.2%). NAS sales volume was greater in cities with lower adult smoking prevalence (beta=-0.39, 95% CI[-0.74, -0.03], p=0.034), a pattern that was not observed for Marlboro or Pall Mall (ps>0.356). Marlboro (beta=-0.40, 95% CI[-0.76, -0.05], p=0.027) and Pall Mall (beta=-0.48, 95% CI[-0.82, -0.14], p=0.008) sales volumes were higher in cities where cigarette excise taxes were lower, a pattern not observed for NAS (p=0.224).CONCLUSION: NAS appears to be more popular in cities with lower smoking prevalence and may deter efforts to further decrease prevalence.

    View details for DOI 10.1016/j.addbeh.2020.106558

    View details for PubMedID 32745944

  • State and regional gaps in coverage of 'Tobacco 21' policies TOBACCO CONTROL Leas, E., Schliecher, N., Recinos, A., Mahoney, M., Henriksen, L. 2020; 29 (2): 226–27
  • County-level associations between tobacco retailer density and smoking prevalence in the USA, 2012. Preventive medicine reports Golden, S. D., Kuo, T., Kong, A. Y., Baggett, C. D., Henriksen, L., Ribisl, K. M. 2020; 17: 101005


    We examine whether county-level tobacco retailer density and adult smoking prevalence are positively associated in the United States and determine whether associations differ in metropolitan vs. nonmetropolitan counties. We merged a list of likely tobacco retailers from the 2012 National Establishment Time-Series with smoking prevalence data from the Behavioral Risk Factor Surveillance System for 2828 US counties, as well as state tobacco policy information and county-level demographic data for the same year. We modeled adult smoking prevalence as a function of tobacco retailer density, accounting for clustering of counties within states. Average density in US counties was 1.25 retailers per 1000 people (range = 0.3-4.5). Smoking prevalence was 0.86 percentage points higher in the most retailer-dense counties, compared to the least. This association, however, was only significant for metropolitan counties. Metropolitan counties in the highest tobacco retailer density quartile had smoking prevalence levels that were 1.9 percentage points higher than metropolitan counties in the lowest density quartile. Research should examine whether policies limiting the quantity, type and location of tobacco retailers could reduce smoking prevalence.

    View details for DOI 10.1016/j.pmedr.2019.101005

    View details for PubMedID 31934535

  • Exploring the Point-of-Sale Among Vape Shops Across the US: Audits Integrating a Mystery Shopper Approach. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Berg, C. J., Barker, D. C., Meyers, C., Weber, A., Park, A. J., Patterson, A., Dorvil, S., Fairman, R. T., Huang, J., Sussman, S., Livingston, M. D., Wagener, T. L., Hayes, R. B., Pulvers, K., Getachew, B., Schleicher, N., Henriksen, L. 2020


    INTRODUCTION: Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the US. This study assessed compliance of US vape shop retail marketing strategies with new regulations (e.g., required age verification, prohibited free samples) and pre-implementation conditions for other regulations (e.g., health warning labels on all nicotine products, required disclosures of e-liquid contents).METHODS: In May-July 2018, trained research assistants (ages 23-25) conducted mystery shopper (alone, n=174) and point-of-sale audits (in pairs, n=179) on different occasions in 30 randomly-selected vape shops in each of six US metropolitan areas (Atlanta, Boston, Minneapolis-St. Paul, Oklahoma City, San Diego, and Seattle).RESULTS: 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol (CBD), 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions.CONCLUSIONS: Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and CBD product offerings, which call for further FDA and state regulatory/enforcement efforts.IMPLICATIONS: Current and impending FDA regulation of vaping products presents a critical period for examining regulatory impact on vape shop marketing and point-of-sale practices. Findings from the current study indicate that vape shops are complying with several regulations (e.g., minimum-age signage, FDA health warnings, free sampling bans). However, results also highlight the utility of mystery shoppers in identifying noncompliance (e.g., age verification, health claims, sampling, CBD product offerings). This study provides baseline data for comparison with future surveillance efforts in order to document the impact of full implementation of the FDA regulations on vape shop practices and marketing.

    View details for DOI 10.1093/ntr/ntaa041

    View details for PubMedID 32149340

  • Inequity in California's Smokefree Workplace Laws: A Legal Epidemiologic Analysis of Loophole Closures. American journal of preventive medicine Prochaska, J. J., Watts, M. H., Zellers, L., Huang, D., Daza, E. J., Rigdon, J., Peters, M. J., Henriksen, L. 2020


    INTRODUCTION: California's landmark 1994 Smokefree Workplace Act contained numerous exemptions, or loopholes, believed to contribute to inequities in smokefree air protections among low-income communities and communities of color (e.g., permitting smoking in warehouses, hotel common areas). Cities/counties were not prevented from adopting stronger laws. This study coded municipal laws and state law changes (in 2015-2016) for loophole closures and determined their effects in reducing inequities in smokefree workplace protections.METHODS: Public health attorneys reviewed current laws for 536 of California's 539 cities and counties from January 2017 to May 2018 and coded for 19 loophole closures identified from legislative actions (inter-rater reliability, 87%). The local policy data were linked with population demographics from intercensal estimates (2012-2016) and adult smoking prevalence (2014). The analyses were cross-sectional and conducted in February-June 2019.RESULTS: Between 1994 and 2018, jurisdictions closed 6.09 loopholes on average (SD=5.28). Urban jurisdictions closed more loopholes than rural jurisdictions (mean=6.40 vs 3.94, p<0.001), and loophole closure scores correlated positively with population size, median household income, and percentage white, non-Hispanic residents (p<0.001 for all). Population demographics and the loophole closure score explained 43% of the variance in jurisdictions' adult smoking prevalence. State law changes in 2015-2016 increased loophole closure scores and decreased jurisdiction variation (mean=9.74, SD=3.56); closed more loopholes in rural versus urban jurisdictions (meangain=4.44 vs 3.72, p=0.002); and in less populated, less affluent jurisdictions, with greater racial/ethnic diversity, and higher smoking prevalence (p<0.001 for all).CONCLUSIONS: Although jurisdictions made important progress in closing loopholes in smokefree air law, state law changes achieved greater reductions in inequities in policy coverage.

    View details for DOI 10.1016/j.amepre.2019.10.011

    View details for PubMedID 31952942

  • PhenX: Vector measures for tobacco regulatory research. Tobacco control Ribisl, K. M., Chaloupka, F. J., Kirchner, T. R., Henriksen, L., Nettles, D. S., Geisler, R. C., Hendershot, T. P., Swan, G. E., PhenX TRR Vector Working Group, Chaloupka, F. J., Ribisl, K., Henriksen, L., Kirchner, T. R., Malone, R., Mayne, R. G., Hyland, A., Wanke, K. L., Hendershot, T., Nettles, D. S., Geisler, R. 2020; 29 (Suppl 1): s27–s34


    The PhenX (Phenotypes and eXposures) Toolkit provides researchers with recommended standard consensus measures for use in epidemiological, biomedical, clinical and translational studies. To expand the depth and breadth of measures in the PhenX Toolkit, the National Institutes of Health and U.S. Food and Drug Administration have launched a project to identify 'Core' and 'Specialty' collections of measures recommended for human subjects studies in tobacco regulatory research (TRR). The current paper addresses the PhenX Toolkit TRR Vector specialty area and describes the 6-month process to identify high-priority, low-burden, scientifically supported consensus measures. Self-reported, interviewer-administered and observational measurements were considered, and input from the research community assisted in justifying the inclusion of 13 tobacco industry-relevant measures (mainly interviewer-administered or self-reported measures) in the PhenX Toolkit. Compared with measures of addiction or the use of tobacco products, assessments of many Vector factors are much newer and at an earlier stage of development. More work is needed to refine and validate measures of the spatial distribution of tobacco retailers, retail environment, price promotions and corporate social responsibility.

    View details for DOI 10.1136/tobaccocontrol-2019-054977

    View details for PubMedID 31992661

  • Moving From Metrics to Mechanisms to Evaluate Tobacco Retailer Policies: Importance of Retail Policy in Tobacco Control. American journal of public health Luke, D. A., Ornstein, J. T., Combs, T. B., Henriksen, L. n., Mahoney, M. n. 2020; 110 (4): 431–33

    View details for DOI 10.2105/AJPH.2020.305578

    View details for PubMedID 32159978

  • Vape shop owners'/managers' attitudes about CBD, THC, and marijuana legal markets. Preventive medicine reports Berg, C. J., Getachew, B. n., Pulvers, K. n., Sussman, S. n., Wagener, T. L., Meyers, C. n., Park, A. n., Dorvil, S. n., Patterson, A. n., Weber, A. n., Hayes, R. B., Barker, D. C., Henriksen, L. n. 2020; 20: 101208


    Over the past decade in the US there have been marked pivotal changes in the policy and retail environment regarding cannabinoids, particularly cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). Many vape shops may carry products relevant to these two markets. This study interviewed vape shop owners/managers to assess their perceptions of consumer interests/behaviors regarding CBD and THC and of the impact of legalized marijuana retail on vape shops. The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018. Overall, 82.2% of participants were male, 77.8% were non-Hispanic White, 64.4% were managers, 8.9% reported past 30-day smoking, and 95.6% reported past 30-day vaping. Overall, 44.4% sold e-liquids containing CBD. Vape shop owners/managers indicated minimal perceived risk and some beliefs in therapeutic benefits of CBD products; however, there was a broader range of perspectives regarding marijuana retail and selling marijuana for recreational use. Some chose to distance themselves from marijuana products, their use, and the possibility of entering marijuana retail if it were to evolve in their state, while some indicated high levels of enthusiasm for the growing retail marijuana market. Future research should examine how vape shops and other retailers of CBD and marijuana communicate with consumers about products and modes of using such products, as well as how various industry sectors (e.g., vape shops) adapt or evolve with increasing regulation of nicotine and increasing legalization of marijuana retail.

    View details for DOI 10.1016/j.pmedr.2020.101208

    View details for PubMedID 32995147

    View details for PubMedCentralID PMC7516178

  • Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices. Health promotion practice Henriksen, L., Schleicher, N. C., Johnson, T. O., Roeseler, A., Zhu, S. 2020; 21 (1_suppl): 27S–36S


    Objectives. To assess tobacco product availability, advertised discounts, and prices in rural and nonrural stores, comparing results for two definitions of rural. Method. This geospatial study linked data from marketing surveillance in a representative sample of licensed tobacco retailers in California (n = 1,276) and categorized rural/nonrural stores at the county and tract levels. Data were collected from January to March, 2017, and mixed-models analyses tested for differences by location (rural vs. nonrural). Results. Compared to nonrural stores, rural-county stores were 2.1 (95% confidence interval [CI; 1.2, 3.6]) times more likely to sell chewing tobacco and 2.5 (95% CI [1.4, 4.2]) times more likely to sell roll-your-own. Rural-county stores sold larger packs of cigarillos for less than $1 (coefficient = 0.22, 95% CI [0.05, 0.39]) and charged less for the cheapest cigarette pack regardless of brand (estimated mean difference = $-0.21, 95% CI [-0.39, -0.03]). Contrary to expectation, a popular brand of chewing tobacco cost more in rural-county stores. A tract-level definition of rural reclassified only 1 in 10 stores, and did not substantially alter the results. Overall, 32.9% of stores advertised discounts on chewing tobacco, but this was more common in rural than nonrural census tracts (adjusted odds ratio = 1.81, 95% CI [1.14, 2.88]). Discussion. Evidence that $1 buys more cigarillos in rural-county stores than elsewhere adds to health equity concerns that the prevalence of cheap, flavored tobacco is not limited to neighborhoods characterized by socioeconomic disadvantage, higher proportions of African Americans, and higher proportions of school-age youth. Policies that focus on the retail environment for tobacco are needed to make tobacco less attractive and more costly everywhere, including rural areas.

    View details for DOI 10.1177/1524839919888652

    View details for PubMedID 31908200

  • PMI reduced-risk claims and upselling of IQOS via Reviti life insurance. Tobacco control Prochaska, J. J., Henriksen, L. 2019

    View details for DOI 10.1136/tobaccocontrol-2019-055145

    View details for PubMedID 31366704

  • Neighbourhood disparities in the price of the cheapest cigarettes in the USA. Journal of epidemiology and community health Mills, S. D., Golden, S. D., Henriksen, L., Kong, A. Y., Queen, T. L., Ribisl, K. M. 2019


    BACKGROUND: There is evidence that the cheapest cigarettes cost even less in neighbourhoods with higher proportions of youth, racial/ethnic minorities and low-income residents. This study examined the relationship between the price of the cheapest cigarette pack and neighbourhood demographics in a representative sample of tobacco retailers in the USA.METHODS: Data collectors recorded the price of the cheapest cigarette pack (regardless of brand) in 2069 retailers in 2015. Multilevel linear modelling examined the relationship between price and store neighbourhood (census tract) characteristics, specifically median household income and percentage of youth, Black, Asian/Pacific Islander and Hispanic residents.RESULTS: Average price for the cheapest pack was $5.17 (SD=1.73) and it was discounted in 19.7% of stores. The price was $0.04 less for each SD increase in the percentage of youth and $0.22 less in neighbourhoods with the lowest as compared with the highest median household incomes. Excluding excise taxes, the average price was $2.48 (SD=0.85), and associations with neighbourhood demographics were similar.CONCLUSION: The cheapest cigarettes cost significantly less in neighbourhoods with a greater percentage of youth and lower median household income. Non-tax mechanisms to increase price, such as minimum price laws and restrictions on discounts/coupons, may increase cheap cigarette prices.

    View details for DOI 10.1136/jech-2018-210998

    View details for PubMedID 31122944

  • State and regional gaps in coverage of 'Tobacco 21' policies. Tobacco control Leas, E. C., Schliecher, N., Recinos, A., Mahoney, M., Henriksen, L. 2019

    View details for PubMedID 31004006

  • The price of Natural American Spirit relative to other cigarette brands. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Epperson, A. E., Johnson, T. O., Schleicher, N. C., Henriksen, L. 2019


    Introduction: American Spirit cigarettes feature American Indian/Alaska Native (AI/AN) imagery in the branding, are marketed as environmentally friendly, without additives, and four varieties contain organic tobacco. This study is the first to examine retail price of American Spirit relative to other cigarette brands and to assess how its price varies by neighborhood demography.Methods: In a random sample of licensed tobacco retailers (n=1277), trained data collectors recorded availability and price of American Spirit, Pall Mall, Newport, Marlboro and the cheapest cigarettes regardless of brand. Data were collected in January-March 2017 in California, the state with the largest AI/AN population. Paired t-tests assessed prices (before sales tax) of American Spirit relative to others. Ordinary least squares regressions modeled prices as a function of neighborhood demography, adjusting for store type.Results: American Spirit was sold in 77% of stores at an average price of $7.03 (SD=0.66), which was $0.75 to $1.78 (12.0% to 34.4%) higher than Pall Mall, Newport, and Marlboro in the same stores. American Spirit cost significantly less in neighborhoods with a higher proportion of school-age residents, however this pattern was not unique to that brand. Contrary to expectation, American Spirit did not cost less in neighborhoods with a higher proportion of AI/ANs.Conclusion: This study is the first to document lower prices for American Spirit in neighborhoods with a higher proportion of school-age youth. Future research should consider whether the ultra-premium price of American Spirit contributes to misperceptions that the brand is organic and less harmful than other cigarettes.Implications: In a large random sample of licensed tobacco retailers in California, American Spirit cost significantly more than other brands,12.0% to 34.4% more than Pall Mall, Newport, and Marlboro in the same stores.After controlling for store type, American Spirit price was significantly lower in neighborhoods with a higher proportion of school-age residents. Research about how an ultra-premium price contributes to misperceptions that all American Spirit varieties are organic and the brand is less harmful, less addictive than other cigarette brands would be informative for ongoing litigation and product regulation.

    View details for PubMedID 30759248

  • Place-Based Inequity in Smoking Prevalence in the Largest Cities in the United States. JAMA internal medicine Leas, E. C., Schleicher, N. C., Prochaska, J. J., Henriksen, L. 2019

    View details for PubMedID 30615029

  • What to do when tobacco advertisers exploit antitobacco social media campaigns to sell tobacco. Tobacco control Leas, E. C., Prochaska, J. J., Ayers, J. n., Nobles, A. L., Henriksen, L. n. 2019

    View details for DOI 10.1136/tobaccocontrol-2019-054993

    View details for PubMedID 31249102

  • Local Retail Tobacco Environment Regulation: Early Adoption in the United States. Tobacco regulatory science Combs, T. B., Brosi, D., Chaitan, V., He, E., Luke, D. A., Henriksen, L. A. 2019; 5 (1): 76-86


    To identify sociodemographic and policy environment characteristics of early adopters of retail tobacco control policies in U.S. localities.We interviewed a sample of local tobacco control programs on policy progress for 33 specific policies, along with other program characteristics. We combine these results with secondary data in logistic regression analysis.Eighty (82% of 97) county tobacco control programs from 24 states were interviewed. Localities with lower smoking rates (OR: 0.7; 95%: 0.6-0.9) or higher excise taxes (OR: 6.0; 95%: 1.4-26.0) were more likely to have adopted a retail policy by late 2015. Early adopters were less likely to have voted majority Republican in the 2012 election (OR: 0.03; 95%: 0.00-0.34) or to have higher percentages of African American population (OR: 0.9; 95%: 0.8-0.99).While localities with more resources, eg, program capacity, political will or policy options, were more likely to adopt policies by 2015, those with higher smoking rates and proportions of priority populations were less likely to do so. As local retail policy work becomes more commonplace, only time will tell if this "rich-get-richer" trend continues, or if the contexts in which retail policies are adopted diversify.

    View details for DOI 10.2105/AJPH.2016.303077

    View details for PubMedID 38222289

    View details for PubMedCentralID PMC10786621

  • Association of Number of Indoor Tanning Salons With Neighborhoods With Higher Concentrations of Male-Male Partnered Households. JAMA network open Chen, R. n., Hipp, J. A., Morrison, L. n., Henriksen, L. n., Swetter, S. M., Linos, E. n. 2019; 2 (10): e1912443


    Both indoor tanning and skin cancer are more common among sexual-minority men, defined as gay and bisexual men, than among heterosexual men. Convenient access to indoor tanning salons may influence use patterns.To investigate whether indoor tanning salons are disproportionately located in areas with higher concentrations of gay men.This cross-sectional study used geographic information systems to integrate census data and business location data obtained from ArcGIS and Google Maps for the 10 US cities with the largest lesbian, gay, bisexual, and transgender populations in 2010, ie, Los Angeles, California; Chicago, Illinois; San Francisco, California; Seattle, Washington; San Diego, California; Dallas, Texas; Phoenix, Arizona; Washington, DC; Portland, Oregon; and Denver, Colorado. The association of indoor tanning salon locations with proportions of gay men, using the concentration of male-male partnered households as a proxy measure for the latter, was examined. Data analysis was performed in October 2018.Census tracts with at least 1%, 5%, or 10% male-male partnered households, adjusting for median household income, percentage young women, and percentage non-Hispanic white residents.Presence of 1 or more indoor tanning salons within census tracts.Across the 10 cities and 4091 census tracts in this study, there were 482 823 unmarried partnered households, of which 35 164 (7.3%) were male-male. The median (interquartile range) percentage of male-male partnered households per census tract was 0% (0%-10.6%). Odds of indoor tanning salon presence in areas with at least 10% male-male households were more than twice those of areas with less than 10% male-male households (odds ratio, 2.17; 95% CI, 1.59-2.97). When sensitivity analyses using a 1-mile euclidian buffer around each tanning salon were conducted, this association remained significant (odds ratio, 2.48; 95% CI, 2.14-2.88). After adjusting for median household income, percentage young women, and percentage non-Hispanic white residents, the odds of an indoor tanning salon being within 1 mile of a census tract with at least 10% male-male households remained twice that of census tracts with less than 10% male-male households (odds ratio, 2.00; 95% CI, 1.71-2.35).In this study, indoor tanning salons were more likely to be located near neighborhoods with higher concentrations of male-male partnered households, possibly contributing to the disproportionate use of indoor tanning by sexual-minority men.

    View details for DOI 10.1001/jamanetworkopen.2019.12443

    View details for PubMedID 31584678

  • Assessment of Underage Sales Violations in Tobacco Stores and Vape Shops. JAMA pediatrics Roeseler, A. n., Vuong, T. D., Henriksen, L. n., Zhang, X. n. 2019

    View details for DOI 10.1001/jamapediatrics.2019.1571

    View details for PubMedID 31233124

  • Social Capital and Tobacco Retail Outlet Density: An Empirical Test of the Relationship. American journal of health promotion : AJHP Gonzalez, M. n., Sanders-Jackson, A. n., Henriksen, L. n. 2019: 890117119853716


    To examine the relationship between tobacco outlet density and social capital.Parents of at least one teen (N = 2734) in a representative sample of US households with teens (ages 13-16).Population-based, cross-sectional survey of a web panel of adolescent-parent pairs matched with spatial data for address to characterize household neighborhoods.US households identified by latitude and longitude with a 50-ft random shift.Perceived social capital (trust and informal social control as reported by parents), tobacco outlet density (retailers per land area in 1/2-mile buffer around each household), neighborhood demographics (derived from American Community Survey), and parent demographics.Multivariable regression examined the relationship between tobacco outlet density and social capital controlling for household buffer and individual-level covariates, including correlates of social capital.Tobacco outlet density was inversely correlated with perceived trust in neighbors (B = -1.12, P = .0004), but not social control (B = 0.11, P = .731).This study is the first we are aware of to find that social capital is related to tobacco outlet density. The results imply that individuals with low social capital may benefit from policies regulating tobacco outlet density and may benefit from policies that address neighborhood inequality by increasing social capital and reducing poverty.

    View details for DOI 10.1177/0890117119853716

    View details for PubMedID 31195802

  • Tobacco Retail Density and Initiation of Alternative Tobacco Product Use Among Teens. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Abdel Magid, H. S., Halpern-Felsher, B. n., Ling, P. M., Bradshaw, P. T., Mujahid, M. S., Henriksen, L. n. 2019


    The rise of noncigarette, alternative tobacco product (ATP) use among adolescents may be due in part to an increase in retail availability of ATPs. We examined whether proximity and density of tobacco retailers near students' homes are associated with a higher likelihood of initiating ATP use over time.Using data from 728 adolescents (aged 13-19 years at baseline) residing in 191 different neighborhoods and attending 10 different California high schools, longitudinal multilevel and cross-classified random effect models evaluated individual-level, neighborhood-level, and school-level risk factors for ATP initiation after 1 year. Covariates were obtained from the American Community Survey and the California Department of Education.The sample was predominantly female (63.5%) and was racially and ethnically diverse. Approximately one third of participants (32.5%) reported ever ATP use at baseline, with 106 (14.5%) initiating ATP use within 1 year. The mean number of tobacco retailers per square mile within a tract was 5.66 (standard deviation = 6.3), and the average distance from each participant's residence to the nearest tobacco retailer was .61 miles (standard deviation = .4). Living in neighborhoods with greater tobacco retailer density at baseline was associated with higher odds of ATP initiation (odds ratio = 1.22, 95% confidence interval = 1.07-2.12), controlling for individual and school factors.Tobacco retailers clustered in students' home neighborhood may be an environmental influence on adolescents' ATP use. Policy efforts to reduce adolescent ATP use should aim to reduce the density of tobacco retailers and limit the proximity of tobacco retailers near adolescents' homes and schools.

    View details for DOI 10.1016/j.jadohealth.2019.09.004

    View details for PubMedID 31784411

  • Little filtered cigars: US sales, flavours, package sizes and prices. Tobacco control Gammon, D. G., Rogers, T. n., Coats, E. M., Nonnemaker, J. M., Henriksen, L. n. 2019; 28 (3): 346–49


    At least four varieties of little filtered cigars (LFCs) violate the US prohibition on flavoured cigarettes other than menthol. This study characterises the sales of prohibited products and other LFCs by flavour category and pack size, as well as the price of LFCs relative to cigarettes.Using retail sales data for 2016, we computed the sales volume in dollars and equivalent units and the percentage of total sales by flavour and pack size for the USA by region and state. Paired t-tests compared the prices for LFCs and cigarettes sold in same-sized packs and cartons.LFC sales totalled 24 033 equivalent units per 100 000 persons in 2016. Flavoured LFC varieties accounted for almost half (47.5%) of the total sales. LFCs were sold in 12 different pack sizes, but 79.7% of sales were packs of 20. The price of 20-packs averaged $2.41 (SD=$1.49), which was significantly less than cigarettes (M=$5.90, SD=$0.85). Regional differences suggest a greater proportion of menthol/mint LFCs and lower prices in the South than in other regions.Classifying all LFCs as cigarettes would require that they be offered in a minimum package of 20, eliminate flavoured varieties other than menthol and increase prices through applicable state and local cigarette taxes.

    View details for PubMedID 30021869

  • Assurances of Voluntary Compliance: A Regulatory Mechanism to Reduce Youth Access to E-Cigarettes and Limit Retail Tobacco Marketing. American journal of public health Henriksen, L. n., Schleicher, N. C., Johnson, T. O., Lee, J. G. 2019: e1–e7


    Objectives. To evaluate assurances of voluntary compliance (AVCs) between state attorneys general and retail chains by assessing e-cigarette sales to underage decoys and tobacco marketing violations in corporate-owned stores (that sign AVCs) and franchise stores (that do not sign AVCs).Methods. Decoys 18 to 19 years of age attempted to purchase e-cigarettes without presenting ID in California convenience stores (n = 540). Auditors characterized the presence and content of age-of-sale signage and advertising for tobacco products. Data were collected and analyzed in 2018.Results. Corporate-owned stores were less likely than were franchise stores to violate ID requests (adjusted odds ratio [AOR] = 0.29; 95% confidence interval [CI] = 0.12, 0.71) and to sell e-cigarettes illegally (AOR = 0.37; 95% CI = 0.15, 0.88). Regardless of AVC category, advertising violations were common in stores (vaping products, 26.3%; other tobacco products, 74.3%).Conclusions. The differences in violation rates found in corporate and franchise stores imply that AVCs could reduce youth access to e-cigarettes. However, merchant education and routine enforcement are needed to better leverage restrictions on retail tobacco marketing in AVCs.Public Health Implications. Strengthening compliance with existing AVCs and establishing new agreements with retailers shown to be in violation through federal or state inspections could reduce youth access to e-cigarettes and exposure to tobacco marketing. (Am J Public Health. Published online ahead of print December 19, 2019: e1-e7. doi:10.2105/AJPH.2019.305436).

    View details for DOI 10.2105/AJPH.2019.305436

    View details for PubMedID 31855484

  • Natural American Spirit's pro-environment packaging and perceptions of reduced-harm cigarettes. Preventive medicine Epperson, A. E., Lambin, E. F., Henriksen, L. n., Baiocchi, M. n., Flora, J. A., Prochaska, J. J. 2019: 105782


    Natural American Spirit (NAS) cigarettes feature a pro-environment marketing campaign on the packs. The NAS "Respect for the Earth" campaign is the first example of on-the-pack corporate social responsibility advertising. In a randomized survey design, we tested perceptions of NAS relative to other cigarette brands on harms to self, others, and the environment. Never (n = 421), former (n = 135), and current (n = 358) US adult smokers were recruited for an online survey from January through March 2018. All participants viewed packs of both NAS and Pall Mall. Participants were randomized to view NAS vs. Pall Mall and to pack color (blue, green, or yellow/orange), which was matched between brands. Survey items assessed perceptions of health risk of the cigarette brand to self, others, and the environment and perceptions of the manufacturer. Consistently on all measures, NAS cigarettes were rated as less harmful for oneself, others, and the environment relative to Pall Mall (p's < .001). Though Reynolds American manufactures both brands, participants rated the company behind NAS as more socially responsible than the company behind Pall Mall, F[1, 909] = 110.25, p < .001. The NAS advantage was significant irrespective of smoking status, pack color, and brand order, with findings stronger for current than never smokers. Pro-environmental marketing on NAS cigarette packs contributes to misperceptions that the product is safer for people and the environment than other cigarettes and made by a company that is more socially responsible. Stricter government regulations on the use of pro-environment terms in marketing that imply modified risk is needed.

    View details for DOI 10.1016/j.ypmed.2019.105782

    View details for PubMedID 31325524

  • US Food and Drug Administration Inspection of Tobacco Sales to Minors at Top Pharmacies, 2012-2017 JAMA PEDIATRICS Lee, J. L., Schleicher, N. C., Leas, E. C., Henriksen, L. 2018; 172 (11): 1089–90

    View details for PubMedID 30193340

  • ENDS retailers and marketing near university campuses with and without tobacco-free policies TOBACCO INDUCED DISEASES Barker, D. C., Schleicher, N. C., Ababseh, K., Johnson, T. O., Henriksen, L. 2018; 16

    View details for DOI 10.18332/tid/94600

    View details for Web of Science ID 000447345500001

  • Point-of-sale marketing and context of marijuana retailers: Assessing reliability and generalizability of the marijuana retail surveillance tool. Preventive medicine reports Berg, C. J., Henriksen, L., Cavazos-Rehg, P., Schauer, G. L., Freisthler, B. 2018; 11: 37-41


    As recreational marijuana expands, standardized surveillance measures examining the retail environment are critical for informing policy and enforcement. We conducted a reliability and generalizability study using a previously developed tool involving assessment of a sample of 25 randomly selected Seattle recreational marijuana retailers (20 recreational; 5 recreational/medical) in 2017. The tool assessed: 1) contextual/neighborhood features (i.e., facilities nearby); 2) compliance/security (e.g., age-of-sale signage, age verification); and 3) marketing (i.e., promotions, product availability, price). We found that retailers were commonly within two blocks of restaurants (n = 23), grocery stores (n = 17), liquor stores (n = 13), and bars/clubs (n = 11). Additionally, two were within two blocks of schools, and four were within two blocks of parks. Almost all (n = 23) had exterior signage indicating the minimum age requirement, and 23 verified age. Two retailers had exterior ads for marijuana, and 24 had interior ads. Overall, there were 76 interior ads (M = 3.04; SD = 1.84), most commonly for edibles (n = 28). At least one price promotion/discount was recorded in 17 retailers, most commonly in the form of loyalty membership programs (n = 10) or daily/weekly deals (n = 10). One retailer displayed potential health harms/warnings, while three posted some health claim. Products available across product categories were similar; we also noted instances of selling retailer-branded apparel/ paraphernalia (which is prohibited). Lowest price/unit across product categories demonstrated low variability across retailers. This study documented high inter-rater reliability of the surveillance tool (Kappas = 0.73 to 1.00). In conclusion, this tool can be used in future research and practice aimed at examining retailers marketing practices and regulatory compliance.

    View details for DOI 10.1016/j.pmedr.2018.05.010

    View details for PubMedID 29984136

    View details for PubMedCentralID PMC6030680

  • Disparities in retail marketing for menthol cigarettes in the United States, 2015 HEALTH & PLACE Mills, S. D., Henriksen, L., Golden, S. D., Kurtzman, R., Kong, A. Y., Queen, T. L., Ribisl, K. M. 2018; 53: 62–70


    This study describes retail marketing for menthol cigarettes and its relationship with neighborhood demographics in a national sample of tobacco retailers in the United States. Mixed-effects models were used to examine three outcomes: menthol cigarette exterior advertising, menthol cigarette price promotions, and the pack price of menthol and non-menthol cigarettes. Thirty-eight percent of retailers displayed at least one menthol advertisement on the store exterior and 69% advertised price promotions. Retail advertising was more common in neighborhoods in the second (OR = 1.5 [1.1, 2.0]) and fourth (OR = 1.9 [1.3, 2.7]) quartiles of Black residents as compared to the lowest quartile. Menthol advertising was more prevalent in the third (OR = 1.4 [1.0, 1.9]) and lowest (OR = 1.6 [1.2, 2.2]) income quartiles as compared to the highest quartile. Price promotions for Newport were more common in neighborhoods with the highest quartile of Black residents (OR = 1.8 [1.2, 2.7]). Prices of Newport were cheaper in neighborhoods with the highest quartiles of youth, Black residents, and lower-income households. Policies that restrict the sales and marketing of menthol cigarettes are needed to address disparities.

    View details for PubMedID 30055469

  • The emerging marijuana retail environment: Key lessons learned from tobacco and alcohol retail research ADDICTIVE BEHAVIORS Berg, C. J., Henriksen, L., Cavazos-Rehg, P. A., Haardoerfer, R., Freisthler, B. 2018; 81: 26–31


    The emerging retail market for recreational marijuana use warrants research and surveillance as such markets are established in more US states. This research can be informed by the existing literature regarding tobacco and alcohol, which highlights the impact of spatial access to tobacco and alcohol retailers and exposure to tobacco and alcohol marketing on smoking and drinking among youth and young adults. Prior research indicates that tobacco and alcohol retailers, as well as medical marijuana dispensaries, are disproportionately located in neighborhoods characterized by socioeconomic disadvantage and by higher proportions of racial/ethnic minorities and young adults. Moreover, retail marketing or point-of-sale practices may differentially target subpopulations and differ by neighborhood demography and local policy. This literature and the methods employed for studying the tobacco and alcohol market could inform research on the retail environment for marijuana, as current gaps exist. In particular, much of the existing literature involves cross-sectional research designs; longitudinal studies are needed. Moreover, standardized measures are needed for systematic monitoring of industry marketing practices and to conduct research examining neighborhood differences in exposure to retail marketing for marijuana and its contribution to use modality and frequency, alone and in combination with nicotine and alcohol. The use of standardized measures for tobacco and alcohol marketing have been critical to develop an evidence base from cross-sectional and longitudinal studies that document the impact of retail marketing on substance use by adolescents and adults. Similar research is needed to establish an evidence base to inform federal, state, and local regulations of marijuana.

    View details for PubMedID 29421347

    View details for PubMedCentralID PMC5845833

  • Concordance of Advertised Cigarette Prices with Purchase Receipts in the United States. Tobacco regulatory science Schleicher, N. C., Johnson, T. O., D'Angelo, H., Luke, D. A., Ribisl, K. M., Henriksen, L. 2018; 4 (3): 3-9


    Researchers and regulators study the advertised price of tobacco products to evaluate compliance with minimum price policies, tax increases, and geodemographic marketing. However, few studies report reliability of advertised price and none address its concordance with receipt price.In a sample of US tobacco retailers (N=1972), data collectors purchased the leading brand of non-menthol or menthol cigarettes, recorded advertised prices, whether sales tax was included and price was discounted. Intraclass correlation coefficients (ICCs) were computed for the same measures by different observers (reliability), and for receipt and advertised pack price (validity). Discrepancy between receipt and advertised price was modeled as a function of store type and presence of a discount.Advertised price was assessed reliably (ICCs = 0.74 to 0.87) and concordance with receipt price was near perfect (ICCs = 0.96 to 1.00). Prices were identical in 77.7% of stores for Marlboro and 78.1% for Newport. Differences between receipt and advertised price were related to store type and presence of a discount for Marlboro, but not for Newport.Findings validate a common measure of cigarette price in research on minimum price compliance, effects of tax increase and industry marketing.

    View details for DOI 10.18001/TRS.4.3.1

    View details for PubMedID 30746427

    View details for PubMedCentralID PMC6368404

  • Reasons for Marijuana and Tobacco Co-use Among Young Adults: A Mixed Methods Scale Development Study SUBSTANCE USE & MISUSE Berg, C. J., Payne, J., Henriksen, L., Cavazos-Rehg, P., Getachew, B., Schauer, G. L., Haardorfer, R. 2018; 53 (3): 357–69


    Marijuana-tobacco co-use has increased recently, particularly in young adults.We conducted a mixed-methods study to: (1) examine reasons for co-use; and (2) develop a scale assessing reasons for co-use among participants in a longitudinal cohort study of 3,418 students aged 18-25 from 7 Georgia colleges and universities.Phone-based semi-structured interviews were conducted in Summer 2015 among 46 current (past 30-day, n = 26) or lifetime (n = 20) marijuana users. Subsequently, scale items were developed and included at Wave 3. Participants reporting past 4-month tobacco and marijuana use (n = 328) completed the Reasons for Marijuana-Tobacco Co-use section.Per qualitative data, reasons for marijuana-tobacco co-use included synergistic effects, one triggering or preceding the other's use, using one to reduce the other's use, co-administration, social context, and experimentation. The survey subsample included 37.1% who used cigarettes, 30.4% LCCs, 9.4% smokeless, 23.7% e-cigarettes, and 30.4% hookah. Four subscale factors emerged: (1) Instrumentality, indicating synergistic effects; (2) Displacement, indicating using one product to reduce/quit the other; (3) Social context, indicating use in different settings/social situations; and (4) Experimentation, indicating experimentation with both but no specific reasons for co-use. These subscales demonstrated distinct associations with tobacco type used; nicotine dependence; marijuana and alcohol use frequency; tobacco and marijuana use motives, respectively; perceptions of tobacco and marijuana; and parental and friend use. Including these subscales in regressions predicting nicotine dependence and days of marijuana use significantly contributed to each model.These findings might inform theoretical frameworks upon which marijuana-tobacco co-use occurs and direct future intervention studies.

    View details for PubMedID 28792283

    View details for PubMedCentralID PMC5890801

  • The development and pilot testing of the marijuana retail surveillance tool (MRST): assessing marketing and point-of-sale practices among recreational marijuana retailers HEALTH EDUCATION RESEARCH Berg, C. J., Henriksen, L., Cavazos-Rehg, P., Schauer, G. L., Freisthler, B. 2017; 32 (6): 465–72


    As recreational marijuana expands, it is critical to develop standardized surveillance measures to study the retail environment. To this end, our research team developed and piloted a tool assessing recreational marijuana retailers in a convenience sample of 20 Denver retailers in 2016. The tool assesses: (i) compliance and security (e.g. age-of-sale signage, ID checks, security cameras); (ii) marketing (i.e. promotions, product availability and price) and (iii) contextual and neighborhood features (i.e. retailer type, facilities nearby). Most shops (90.0%) indicated the minimum age requirement, all verified age. All shops posted interior ads (M = 2.6/retailer, SD = 3.4), primarily to promote edibles and other non-smoked products. Price promotions were common in shops (73.7%), 57.9% used social media promotions and 31.6% had take-away materials (e.g. menus, party promotions). Nearly half of the shops (42.1%) advertised health claims. All shops offered bud, joints, honey oil, tinctures, kief, beverages, edibles and topicals; fewer sold clones and seeds. Six shops (31.6%) sold shop-branded apparel and/or paraphernalia. Prices for bud varied within and between stores ($20-$45/'eighth', ∼3.5 g). Twelve were recreational only, and eight were both recreational and medicinal. Liquor stores were commonly proximal. Reliability assessments with larger, representative samples are needed to create a standardized marijuana retail surveillance tool.

    View details for PubMedID 29237032

    View details for PubMedCentralID PMC5914449

  • Marijuana as a 'concept' flavour for cigar products: availability and price near California schools. Tobacco control Henriksen, L., Schleicher, N. C., Ababseh, K., Johnson, T. O., Fortmann, S. P. 2017


    OBJECTIVES: To assess the retail availability of cigar products that refer to marijuana and the largest package size of cigarillos available for ≤$1.METHODS: Trained data collectors conducted marketing surveillance in a random sample of licensed tobacco retailers that sold little cigars/cigarillos (LCCs) (n=530) near a statewide sample of middle and high schools (n=132) in California. Multilevel models examined the presence of marijuana co-marketing and cigarillo pack size as a function of school/neighbourhood characteristics and adjusted for store type.RESULTS: Of stores that sold LCCs, approximately 62% contained at least one form of marijuana co-marketing: 53.2% sold cigar wraps marketed as blunt wraps, 27.2% sold cigarillos marketed as blunts and 26.0% sold at least one LCC with a marijuana-related 'concept' flavour. Controlling for store type, marijuana co-marketing was more prevalent in school neighbourhoods with a higher proportion of young residents (ages 5-17 years) and with lower median household income. Nearly all stores that sold LCCs (87.9%) offered the products for ≤$1. However, significantly larger packs at similarly low prices were available near schools in lower-income neighbourhoods and with a lower percentage of Hispanic students.CONCLUSIONS: Understanding how the tobacco industry manipulates cigar products and marketing to capitalise on the appeal of marijuana to youth and other priority populations is important to inform regulation, particularly for flavoured tobacco products. In addition, the retail availability of five and six packs of LCCs for ≤$1 near California schools underscores policy recommendations to establish minimum prices for multipacks.

    View details for PubMedID 29025999

  • Taking Stock of Tobacco Control Program and Policy Science and Impact in the United States. Journal of addictive behaviors and therapy Farrelly, M. C., Chaloupka, F. J., Berg, C. J., Emery, S. L., Henriksen, L., Ling, P., Leischow, S. J., Luke, D. A., Kegler, M. C., Zhu, S. H., Ginexi, E. M. 2017; 1 (2)


    The 60% decline in the prevalence of cigarette smoking among U.S. adults over the past 50 years represents a significant public health achievement. This decline was steered in part by national, state, and local tobacco control programs and policies, such as public education campaigns; widespread smoke-free air laws; higher cigarette prices that have been driven by large increases in federal, state, and local cigarette excise taxes; and other tobacco control policy and systems-level changes that discourage smoking. Using the MPOWER framework informed by the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health and the World Health Organization (WHO), this paper reviews these accomplishments and identifies gaps in tobacco control policy implementation and additional research needed to extend these historic successes.

    View details for PubMedID 30198028

    View details for PubMedCentralID PMC6124688

  • Natural American Spirit Brand Marketing Casts Health Halo Around Smoking. American journal of public health Epperson, A. E., Henriksen, L., Prochaska, J. J. 2017; 107 (5): 668-670

    View details for DOI 10.2105/AJPH.2017.303719

    View details for PubMedID 28398789

  • Tobacco Town: Computational Modeling of Policy Options to Reduce Tobacco Retailer Density. American journal of public health Luke, D. A., Hammond, R. A., Combs, T., Sorg, A., Kasman, M., Mack-Crane, A., Ribisl, K. M., Henriksen, L. 2017; 107 (5): 740-746


    To identify the behavioral mechanisms and effects of tobacco control policies designed to reduce tobacco retailer density.We developed the Tobacco Town agent-based simulation model to examine 4 types of retailer reduction policies: (1) random retailer reduction, (2) restriction by type of retailer, (3) limiting proximity of retailers to schools, and (4) limiting proximity of retailers to each other. The model examined the effects of these policies alone and in combination across 4 different types of towns, defined by 2 levels of population density (urban vs suburban) and 2 levels of income (higher vs lower).Model results indicated that reduction of retailer density has the potential to decrease accessibility of tobacco products by driving up search and purchase costs. Policy effects varied by town type: proximity policies worked better in dense, urban towns whereas retailer type and random retailer reduction worked better in less-dense, suburban settings.Comprehensive retailer density reduction policies have excellent potential to reduce the public health burden of tobacco use in communities.

    View details for DOI 10.2105/AJPH.2017.303685

    View details for PubMedID 28398792

  • Neighborhood variation in the price of cheap tobacco products in California: Results from Healthy Stores for a Healthy Community. Nicotine & tobacco research Henriksen, L., Andersen-Rodgers, E., Zhang, X., Roeseler, A., Sun, D. L., Johnson, T. O., Schleicher, N. C. 2017


    Retail marketing surveillance research highlights concerns about lower-priced cigarettes in neighborhoods with a higher proportion of racial/ethnic minorities, but focuses almost exclusively on premium brands. To remedy this gap in the literature, the current study examines neighborhood variation in prices for the cheapest cigarettes and a popular brand of cigarillos in a large statewide sample of licensed tobacco retailers in a low-tax state.All 61 local health departments in California trained data collectors to conduct observations in a census of eligible licensed tobacco retailers in randomly selected zip codes (n=7,393 stores, completion rate=91%). Data were collected in 2013, when California had a low and stagnant tobacco tax. Two prices were requested: the cheapest cigarette pack regardless of brand and a single, flavored Swisher Sweets cigarillo. Multilevel models (stores clustered in tracts) examined prices (before sales tax) as a function of neighborhood race/ethnicity and proportion of school-age youth (ages 5-17). Models adjusted for store type and median household income.Approximately 84% of stores sold cigarettes for less than $5 and a Swisher Sweets cigarillo was available for less than $1 in 74% of stores that sold the brand. The cheapest cigarettes cost even less in neighborhoods with a higher proportion of school-age residents and Asian/Pacific Islanders.Neighborhood disparities in the price of the cheapest combustible tobacco products are a public health threat. Policy changes that make all tobacco products, especially combustible products, less available and more costly may reduce disparities in their use and protect public health.Much of what is known about neighborhood variation in the price of combustible tobacco products focuses on premium brand cigarettes. The current study extends this literature in two ways, by studying prices for the cheapest cigarette pack regardless of brand and a popular brand of flavored cigarillos, and by reporting data from the largest statewide sample of licensed tobacco retailers. Significantly lower prices in neighborhoods with a higher proportion of youth and of racial/ethnic groups with higher smoking prevalence are a cause of concern. The study results underscore the need for policies that reduce availability and increase price of combustible tobacco products, particularly in states with low, stagnant tobacco taxes.

    View details for DOI 10.1093/ntr/ntx089

    View details for PubMedID 28444233

  • Disparities in tobacco marketing and product availability at the point of sale: Results of a national study. Preventive medicine Ribisl, K. M., D'Angelo, H., Feld, A. L., Schleicher, N. C., Golden, S., Luke, D. A., Henriksen, L. 2017


    Neighborhood socioeconomic and racial/ethnic disparities exist in the amount and type of tobacco marketing at retail, but most studies are limited to a single city or state, and few have examined flavored little cigars. Our purpose is to describe tobacco product availability, marketing, and promotions in a national sample of retail stores and to examine associations with neighborhood characteristics.At a national sample of 2230 tobacco retailers in the contiguous US, we collected in-person store audit data on: Availability of products (e.g., flavored cigars), quantity of interior and exterior tobacco marketing, presence of price promotions, and marketing with youth appeal. Observational data were matched to census tract demographics.Over 95% of stores displayed tobacco marketing; the average store featured 29.5 marketing materials. 75.1% of stores displayed at least one tobacco product price promotion, including 87.2% of gas/convenience stores and 85.5% of pharmacies. 16.8% of stores featured marketing below three feet, and 81.3% of stores sold flavored cigars, both of which appeal to youth. Stores in neighborhoods with the highest (vs. lowest) concentration of African-American residents had more than two times greater odds of displaying a price promotion (OR=2.1) and selling flavored cigars (OR=2.6). Price promotions were also more common in stores located in neighborhoods with more residents under age 18.Tobacco companies use retail marketing extensively to promote their products to current customers and youth, with disproportionate targeting of African Americans. Local, state, and federal policies are needed to counteract this unhealthy retail environment.

    View details for DOI 10.1016/j.ypmed.2017.04.010

    View details for PubMedID 28392252

  • Tobacco industry's T.O.T.A.L. interference. Tobacco control Henriksen, L., Mahoney, M. 2017

    View details for DOI 10.1136/tobaccocontrol-2016-053530

    View details for PubMedID 28274990

  • Inequalities in tobacco outlet density by race, ethnicity and socioeconomic status, 2012, USA: results from the ASPiRE Study. Journal of epidemiology and community health Lee, J. G., Sun, D. L., Schleicher, N. M., Ribisl, K. M., Luke, D. A., Henriksen, L. 2017


    Evidence of racial/ethnic inequalities in tobacco outlet density is limited by: (1) reliance on studies from single counties or states, (2) limited attention to spatial dependence, and (3) an unclear theory-based relationship between neighbourhood composition and tobacco outlet density.In 97 counties from the contiguous USA, we calculated the 2012 density of likely tobacco outlets (N=90 407), defined as tobacco outlets per 1000 population in census tracts (n=17 667). We used 2 spatial regression techniques, (1) a spatial errors approach in GeoDa software and (2) fitting a covariance function to the errors using a distance matrix of all tract centroids. We examined density as a function of race, ethnicity, income and 2 indicators identified from city planning literature to indicate neighbourhood stability (vacant housing, renter-occupied housing).The average density was 1.3 tobacco outlets per 1000 persons. Both spatial regression approaches yielded similar results. In unadjusted models, tobacco outlet density was positively associated with the proportion of black residents and negatively associated with the proportion of Asian residents, white residents and median household income. There was no association with the proportion of Hispanic residents. Indicators of neighbourhood stability explained the disproportionate density associated with black residential composition, but inequalities by income persisted in multivariable models.Data from a large sample of US counties and results from 2 techniques to address spatial dependence strengthen evidence of inequalities in tobacco outlet density by race and income. Further research is needed to understand the underlying mechanisms in order to strengthen interventions.

    View details for DOI 10.1136/jech-2016-208475

    View details for PubMedID 28249990

  • Blog fog? Using rapid response to advance science and promote debate. Tobacco control O'Connor, R., Gartner, C., Henriksen, L., Hill, S., Barnoya, J., Cohen, J., Malone, R. E. 2017; 26 (2): 121

    View details for DOI 10.1136/tobaccocontrol-2017-053632

    View details for PubMedID 28220026

  • The flip side of Natural American Spirit: corporate social responsibility advertising. Tobacco control Epperson, A. E., Prochaska, J. J., Henriksen, L. 2017

    View details for DOI 10.1136/tobaccocontrol-2016-053576

    View details for PubMedID 28237942

  • The Case for a Concerted Push to Reduce Place-Based Disparities in Smoking-Related Cancers. JAMA internal medicine Ribisl, K. M., Luke, D. A., Henriksen, L. 2016

    View details for DOI 10.1001/jamainternmed.2016.6865

    View details for PubMedID 27775767

  • Prices for Tobacco and Nontobacco Products in Pharmacies Versus Other Stores: Results From Retail Marketing Surveillance in California and in the United States. American journal of public health Henriksen, L., Schleicher, N. C., Barker, D. C., Liu, Y., Chaloupka, F. J. 2016; 106 (10): 1858-1864


    To examine disparities in the price of tobacco and nontobacco products in pharmacies compared with other types of stores.We recorded the prices of Marlboro, Newport, the cheapest cigarettes, and bottled water in a random sample of licensed tobacco retailers (n = 579) in California in 2014. We collected comparable data from retailers (n = 2603) in school enrollment zones for representative samples of US 8th, 10th, and 12th graders in 2012. Ordinary least squares regressions modeled pretax prices as a function of store type and neighborhood demographics.In both studies, the cheapest cigarettes cost significantly less in pharmacies than other stores; the average estimated difference was $0.47 to $1.19 less in California. We observed similar patterns for premium-brand cigarettes. Conversely, bottled water cost significantly more in pharmacies than elsewhere. Newport cost less in areas with higher proportions of African Americans; other cigarette prices were related to neighborhood income and age. Neighborhood demographics were not related to water prices.Compared with other stores, pharmacies charged customers less for cigarettes and more for bottled water. State and local policies to promote tobacco-free pharmacies would eliminate an important source of discounted cigarettes.

    View details for DOI 10.2105/AJPH.2016.303306

    View details for PubMedID 27552272

    View details for PubMedCentralID PMC5024371

  • Standardized Tobacco Assessment for Retail Settings (STARS): dissemination and implementation research. Tobacco control Henriksen, L., Ribisl, K. M., Rogers, T., Moreland-Russell, S., Barker, D. M., Sarris Esquivel, N., Loomis, B., Crew, E., Combs, T. 2016; 25: i67-i74


    The Standardized Tobacco Assessment for Retail Settings (STARS) was designed to characterise the availability, placement, promotion and price of tobacco products, with items chosen for relevance to regulating the retail tobacco environment. This study describes the process to develop the STARS instrument and protocol employed by a collaboration of US government agencies, US state tobacco control programmes (TCPs), advocacy organisations, public health attorneys and researchers from the National Cancer Institute's State and Community Tobacco Control (SCTC) Research Initiative.To evaluate dissemination and early implementation experiences, we conducted telephone surveys with state TCP leaders (n=50, response rate=100%), and with individuals recruited via a STARS download registry on the SCTC website. Website registrants were surveyed within 6 months of the STARS release (n=105, response rate=66%) and again after ∼5 months (retention rate=62%).Among the state TCPs, 42 reported conducting any retail marketing surveillance, with actual or planned STARS use in 34 of these states and in 12 of the 17 states where marketing surveillance was not previously reported. Within 6 months of the STARS release, 21% of surveyed registrants reported using STARS and 35% were likely/very likely to use it in the next 6 months. To investigate implementation fidelity, we compared data collected by self-trained volunteers and by trained professionals, the latter method being more typically in retail marketing surveillance studies. Results suggest high or moderate reliability for most STARS measures.The study concludes with examples of states that used STARS to inform policy change.

    View details for DOI 10.1136/tobaccocontrol-2016-053076

    View details for PubMedID 27697950

    View details for PubMedCentralID PMC5099212

  • Tobacco outlet density near home and school: Associations with smoking and norms among US teens. Preventive medicine Schleicher, N. C., Johnson, T. O., Fortmann, S. P., Henriksen, L. 2016; 91: 287-293


    This study examined whether living or going to school in neighborhoods with higher tobacco outlet density is associated with higher odds of cigarette smoking among teens, and with perceptions of greater smoking prevalence and peer approval. Using an Internet panel that is representative of US households, we matched data from teen-parent pairs (n=2771, surveyed June 2011-December 2012) with environmental data about home and school neighborhoods. Density was measured as the number of tobacco outlets per square mile for a ½-mile roadway service area around each participant's home and school. Logistic regressions tested relationships between tobacco outlet density near home and schools with ever smoking. Linear regressions tested relationships between density, perceived prevalence and peer approval. Models were adjusted for teen, parent/household and neighborhood characteristics. In total, 41.0% of US teens (ages 13-16) lived within ½ mile of a tobacco outlet, and 44.4% attended school within 1000ft of a tobacco outlet. Higher tobacco outlet density near home was associated with higher odds of ever smoking, although the relationship was small, OR=1.01, 95% CI (1.00, 1.02). Higher tobacco outlet density near home was also associated with perceptions that more adults smoked, coef.=0.09, 95% CI (0.01, 0.17). Higher tobacco outlet density near schools was not associated with any outcomes. Living in neighborhoods with higher tobacco outlet density may contribute to teen smoking by increasing access to tobacco products and by cultivating perceptions that smoking is more prevalent. Policy interventions to restrict tobacco outlet density should not be limited to school environments.

    View details for DOI 10.1016/j.ypmed.2016.08.027

    View details for PubMedID 27569829

    View details for PubMedCentralID PMC5065244

  • Tobacco retail policy landscape: a longitudinal survey of US states. Tobacco control Luke, D. A., Sorg, A. A., Combs, T., Robichaux, C. B., Moreland-Russell, S., Ribisl, K. M., Henriksen, L. 2016; 25: i44-i51


    There are ∼380 000 tobacco retailers in the USA, where the largest tobacco companies spend almost $9 billion a year to promote their products. No systematic survey has been conducted of state-level activities to regulate the retail environment, thus little is known about what policies are being planned, proposed or implemented.This longitudinal study is the first US survey of state tobacco control programmes (TCPs) about retail policy activities. Surveyed in 2012 and 2014, programme managers (n=46) reported activities in multiple domains: e-cigarettes, retailer density and licensing, non-tax price increases, product placement, advertising and promotion, health warnings and other approaches. Policy activities were reported in one of five levels: no formal activity, planning or advocating, policy was proposed, policy was enacted or policy was implemented. Overall and domain-specific activity scores were calculated for each state.The average retail policy activity almost doubled between 2012 and 2014. States with the largest increase in scores included: Minnesota, which established a fee-based tobacco retail licensing system and banned self-service for e-cigarettes and all other tobacco products (OTP); Oregon, Kansas and Maine, all of which banned self-service for OTP; and West Virginia, which banned some types of flavoured OTP.Retail policy activities in US states increased dramatically in a short time. Given what is known about the impact of the retail environment on tobacco use by youth and adults, state and local TCPs may want diversify policy priorities by implementing retail policies alongside tax and smoke-free air laws.

    View details for DOI 10.1136/tobaccocontrol-2016-053075

    View details for PubMedID 27697947

  • Is There a Relationship Between the Concentration of Same-Sex Couples and Tobacco Retailer Density? Nicotine & tobacco research Lee, J. G., Pan, W. K., Henriksen, L., Goldstein, A. O., Ribisl, K. M. 2016; 18 (2): 147-155


    Tobacco use is markedly higher among lesbian, gay, and bisexual populations than heterosexuals. Higher density of tobacco retailers is found in neighborhoods with lower income and more racial/ethnic minorities. Same-sex couples tend to live in similar neighborhoods, but the association of this demographic with tobacco retailer density has not been examined.For a national sample of 97 US counties, we calculated the number of tobacco retailers per 1000 persons and rates of same-sex couples per 1000 households in each census tract (n = 17 941). Using spatial regression, we examined the association of these variables in sex-stratified models, including neighborhood demographics and other environmental characteristics to examine confounding.Results from spatial regression show that higher rates of both female and male same-sex couples were associated with a higher density of tobacco retailers. However the magnitude of this association was small. For female couples, the association was not significant after controlling for area-level characteristics, such as percent black, percent Hispanic, median household income, the presence of interstate highways, and urbanicity, which are neighborhood correlates of higher tobacco retailer density. For male couples, the association persisted after control for these characteristics.Same-sex couples reside in areas with higher tobacco retailer density, and for men, this association was not explained by neighborhood confounders, such as racial/ethnic composition and income. While lesbian, gay, and bisexual disparities in tobacco use may be influenced by neighborhood environment, the magnitude of the association suggests other explanations of these disparities remain important areas of research.

    View details for DOI 10.1093/ntr/ntv046

    View details for PubMedID 25744959

    View details for PubMedCentralID PMC4723672

  • Retrospective analysis of changing characteristics of treatment-seeking smokers: implications for further reducing smoking prevalence. BMJ open Leyro, T. M., Crew, E. E., Bryson, S. W., Lembke, A., Bailey, S. R., Prochaska, J. J., Henriksen, L., Fortmann, S. P., Killen, J. D., Killen, D. T., Hall, S. M., David, S. P. 2016; 6 (6)


    The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades.Retrospective treatment cohort comparison.Data were collected from 9 randomised clinical trials conducted at Stanford University and the University of California, San Francisco, between 1990 and 2013.Data from a total of 2083 participants were included (Stanford, n=1356; University of California San Francisco, n=727).One-way analysis of variance and covariance, χ(2) and logistic regression analyses were used to examine relations between nicotine dependence, cigarettes per day, depressive symptoms and demographic characteristics among study cohorts.Similar trends were observed at both settings. When compared to earlier trials, participants in more recent trials smoked fewer cigarettes, were less nicotine-dependent, reported more depressive symptoms, were more likely to be male and more likely to be from a minority ethnic/racial group, than those enrolled in initial trials (all p's<0.05). Analysis of covariances revealed that cigarettes per day, nicotine dependence and current depressive symptom scores were each significantly related to trial (all p's<0.001).Our findings suggest that more recent smoking cessation treatment-seeking cohorts in a low prevalence region were characterised by less smoking severity, more severe symptoms of depression and were more likely to be male and from a minority racial/ethnic group.

    View details for DOI 10.1136/bmjopen-2015-010960

    View details for PubMedID 27357195

  • Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States ADDICTION Sanders-Jackson, A., Schleicher, N. C., Fortmann, S. P., Henriksen, L. 2015; 110 (12): 2015-2024

    View details for DOI 10.1111/add.12838

    View details for PubMedID 25557128

  • Knowledge About E-Cigarette Constituents and Regulation: Results From a National Survey of U.S. Young Adults. Nicotine & tobacco research Sanders-jackson, A. N., Tan, A. S., Bigman, C. A., Henriksen, L. 2015; 17 (10): 1247-1254

    View details for DOI 10.1093/ntr/ntu276

    View details for PubMedID 25542915

  • A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing. American journal of public health Lee, J. G., Henriksen, L., Rose, S. W., Moreland-Russell, S., Ribisl, K. M. 2015; 105 (9): e8-18


    We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.

    View details for DOI 10.2105/AJPH.2015.302777

    View details for PubMedID 26180986

  • Convenience store visits by US adolescents: Rationale for healthier retail environments HEALTH & PLACE Sanders-Jackson, A., Parikh, N. M., Schleicher, N. C., Fortmann, S. P., Henriksen, L. 2015; 34: 63-66


    Given interest in the public health impact of convenience stores, it is surprising that so little is known about the popularity of these destinations for youth. We surveyed 2772 adolescents (age 13-16) from a nationally representative web panel of US households. Nearly half (47.5%) of adolescents reported visiting convenience stores at least weekly. Significant risk factors for frequent visits were age, being African-American, living in rural areas and in areas with higher levels of neighborhood deprivation. With approximately 4.1 million US adolescents visiting convenience stores at least weekly, new policies and other interventions are needed to promote a healthier retail environment for youth.

    View details for DOI 10.1016/j.healthplace.2015.03.011

    View details for Web of Science ID 000357475600008

    View details for PubMedID 25955537

    View details for PubMedCentralID PMC4497830

  • Tobacco retailer proximity and density and nicotine dependence among smokers with serious mental illness. American journal of public health Young-Wolff, K. C., Henriksen, L., Delucchi, K., Prochaska, J. J. 2014; 104 (8): 1454-1463


    Objectives. We examined the density and proximity of tobacco retailers and associations with smoking behavior and mental health in a diverse sample of 1061 smokers with serious mental illness (SMI) residing in the San Francisco Bay Area of California. Methods. Participants' addresses were geocoded and linked with retailer licensing data to determine the distance between participants' residence and the nearest retailer (proximity) and the number of retailers within 500-meter and 1-kilometer service areas (density). Results. More than half of the sample lived within 250 meters of a tobacco retailer. A median of 3 retailers were within 500 meters of participants' residences, and a median of 12 were within 1 kilometer. Among smokers with SMI, tobacco retailer densities were 2-fold greater than for the general population and were associated with poorer mental health, greater nicotine dependence, and lower self-efficacy for quitting. Conclusions. Our findings provide further evidence of the tobacco retail environment as a potential vector contributing to tobacco-related disparities among individuals with SMI and suggest that this group may benefit from progressive environmental protections that restrict tobacco retail licenses and reduce aggressive point-of-sale marketing.

    View details for DOI 10.2105/AJPH.2014.301917

    View details for PubMedID 24922145

  • A systematic review of store audit methods for assessing tobacco marketing and products at the point of sale TOBACCO CONTROL Lee, J. G., Henriksen, L., Myers, A. E., Dauphinee, A. L., Ribisl, K. M. 2014; 23 (2): 98-106


    Over four-fifths of reported expenditures for marketing tobacco products occur at the retail point of sale (POS). To date, no systematic review has synthesised the methods used for surveillance of POS marketing. This review sought to describe the audit objectives, methods and measures used to study retail tobacco environments.We systematically searched 11 academic databases for papers indexed on or before 14 March 2012, identifying 2906 papers. Two coders independently reviewed each abstract or full text to identify papers with the following criteria: (1) data collectors visited and assessed (2) retail environments using (3) a data collection instrument for (4) tobacco products or marketing. We excluded papers where limited measures of products and/or marketing were incidental. Two abstractors independently coded included papers for research aims, locale, methods, measures used and measurement properties. We calculated descriptive statistics regarding the use of four P's of marketing (product, price, placement, promotion) and for measures of study design, sampling strategy and sample size.We identified 88 store audit studies. Most studies focus on enumerating the number of signs or other promotions. Several strengths, particularly in sampling, are noted, but substantial improvements are indicated in the reporting of reliability, validity and audit procedures.Audits of POS tobacco marketing have made important contributions to understanding industry behaviour, the uses of marketing and resulting health behaviours. Increased emphasis on standardisation and the use of theory are needed in the field. We propose key components of audit methodology that should be routinely reported.

    View details for DOI 10.1136/tobaccocontrol-2012-050807

    View details for Web of Science ID 000332200800013

    View details for PubMedID 23322313

    View details for PubMedCentralID PMC3849332

  • Endgame: engaging the tobacco industry in its own elimination. European journal of clinical investigation Ioannidis, J. P., Henriksen, L., Prochaska, J. J. 2013; 43 (12): 1366-1370


    A billion deaths from tobacco are expected by 2100. Many policy interventions such as increased taxation, restrictions on advertisement, smoking bans, as well as behavioral interventions, such as pharmacological and psychological treatments for smoking cessation, decrease tobacco use, but they reach their limits. Endgame scenarios focusing on tobacco supply rather than demand are increasingly discussed, but meet with resistance by the industry and even by many tobacco control experts. A main stumbling block that requires more attention is what to do with the tobacco industry in endgame scenarios. This industry has employed notoriously talented experts in law, business, organization, marketing, advertising, strategy, policy, and statistics and has tremendous lobbying power. Performance-based regulatory approaches can pose a legal obligation on manufacturers to decrease - and eventually - eliminate tobacco products according to specified schedules. Penalties and rewards can make such plans both beneficial for public health and attractive to the companies that do the job well. We discuss caveats and reality checks of engaging the tobacco industry to eliminate its current market and change focus. Brainstorming is warranted to entice the industry to abandon tobacco for other profit goals. To get the dialogue started, we propose the wild possibility of hiring former tobacco companies to reduce the costs of healthcare, thereby addressing concurrently two major challenges to public health.

    View details for DOI 10.1111/eci.12172

    View details for PubMedID 24117211

  • Racial differences in cigarette brand recognition and impact on youth smoking. BMC public health Dauphinee, A. L., Doxey, J. R., Schleicher, N. C., Fortmann, S. P., Henriksen, L. 2013; 13: 170-?


    African Americans are disproportionately exposed to cigarette advertisements, particularly for menthol brands. Tobacco industry documents outline strategic efforts to promote menthol cigarettes to African Americans at the point of sale, and studies have observed more outdoor and retail menthol advertisements in neighborhoods with more African-American residents. Little research has been conducted to examine the effect of this target marketing on adolescents' recognition of cigarette brand advertising and on smoking uptake. To our knowledge, this is the first study to examine racial differences in brand recognition and to assess the prospective relationship between brand recognition and smoking uptake.School-based surveys assessing tobacco use and environmental and social influences to smoke were administered to 6th through 9th graders (ages 11 to 15) in an urban and racially diverse California school district. The primary outcome for the cross-sectional analysis (n = 2,589) was brand recognition, measured by students' identification of masked tobacco advertisements from the point of sale. The primary outcome for the longitudinal analysis (n = 1,179) was progression from never to ever smoking within 12 months.At baseline, 52% of students recognized the Camel brand, 36% Marlboro, and 32% Newport. African-American students were three times more likely than others to recognize Newport (OR = 3.03, CI = 2.45, 3.74, p < 0.01) and less likely than others to recognize Marlboro (OR = 0.60, CI = 0.48, 0.73, p < 0.01). At follow-up, 17% of never smokers reported trying smoking. In this racially diverse sample, brand recognition of Camel and Marlboro did not predict smoking initiation. Regardless of race, students who recognized the Newport brand at baseline were more likely to initiate smoking at follow-up (OR = 1.49, CI = 1.04, 2.15, p < 0.05) after adjusting for shopping frequency and other risk factors.The study findings illustrate that African-American youth are better able to recognize Newport cigarette advertisements, even after adjustment for exposure to smoking by parents and peers. In addition, recognition of Newport cigarette advertising predicted smoking initiation, regardless of race. This longitudinal study contributes to a growing body of evidence that supports a ban on menthol flavored cigarettes in the US as well as stronger regulation of tobacco advertising at the point of sale.

    View details for DOI 10.1186/1471-2458-13-170

    View details for PubMedID 23442215

    View details for PubMedCentralID PMC3586353

  • Comprehensive tobacco marketing restrictions: promotion, packaging, price and place TOBACCO CONTROL Henriksen, L. 2012; 21 (2): 147-153


    Evidence of the causal role of marketing in the tobacco epidemic and the advent of the WHO Framework Convention on Tobacco Control have inspired more than half the countries in the world to ban some forms of tobacco marketing. This paper briefly describes the ways in which cigarette marketing is restricted and the tobacco industry's efforts to subvert restrictions. It reviews what is known about the impact of marketing regulations on smoking by adults and adolescents. It also addresses what little is known about the impact of marketing bans in relation to concurrent population-level interventions, such as price controls, anti-tobacco media campaigns and smoke-free laws. Point of sale is the least regulated channel and research is needed to address the immediate and long-term consequences of policies to ban retail advertising and pack displays. Comprehensive marketing restrictions require a global ban on all forms of promotion, elimination of packaging and price as marketing tools, and limitations on the quantity, type and location of tobacco retailers.

    View details for DOI 10.1136/tobaccocontrol-2011-050416

    View details for Web of Science ID 000300618200016

    View details for PubMedID 22345238

  • Targeted Advertising, Promotion, and Price For Menthol Cigarettes in California High School Neighborhoods NICOTINE & TOBACCO RESEARCH Henriksen, L., Schleicher, N. C., Dauphinee, A. L., Fortmann, S. P. 2012; 14 (1): 116-121


    To describe advertising, promotions, and pack prices for the leading brands of menthol and nonmenthol cigarettes near California high schools and to examine their associations with school and neighborhood demographics.In stores (n = 407) within walking distance (0.8 km [1/2 mile]) of California high schools (n = 91), trained observers counted ads for menthol and nonmenthol cigarettes and collected data about promotions and prices for Newport and Marlboro, the leading brand in each category. Multilevel modeling examined the proportion of all cigarette advertising for any menthol brand, the proportion of stores with sales promotions, and the lowest advertised pack price in relation to store types and school/neighborhood demographics.For each 10 percentage point increase in the proportion of Black students, the proportion of menthol advertising increased by 5.9 percentage points (e.g., from an average of 25.7%-31.6%), the odds of a Newport promotion were 50% higher (95% CI = 1.01, 2.22), and the cost of Newport was 12 cents lower (95% CI = -0.18, -0.06). By comparison, the odds of a promotion and the price for Marlboro, the leading brand of nonmenthol cigarettes, were unrelated to any school or neighborhood demographics.In high school neighborhoods, targeted advertising exposes Blacks to more promotions and lower prices for the leading brand of menthol cigarettes. This evidence contradicts the manufacturer's claims that the availability of its promotions is not based on race/ethnicity. It also highlights the need for tobacco control policies that would limit disparities in exposure to retail marketing for cigarettes.

    View details for DOI 10.1093/ntr/ntr122

    View details for Web of Science ID 000299219200014

    View details for PubMedID 21705460

    View details for PubMedCentralID PMC3592564

  • A Longitudinal Study of Exposure to Retail Cigarette Advertising and Smoking Initiation PEDIATRICS Henriksen, L., Schleicher, N. C., Feighery, E. C., Fortmann, S. P. 2010; 126 (2): 232-238


    Accumulating evidence suggests that widespread advertising for cigarettes at the point of sale encourages adolescents to smoke; however, no longitudinal study of exposure to retail tobacco advertising and smoking behavior has been reported.A school-based survey included 1681 adolescents (aged 11-14 years) who had never smoked. One measure of exposure assessed the frequency of visiting types of stores that contain the most cigarette advertising. A more detailed measure combined data about visiting stores near school with observations of cigarette advertisements and pack displays in those stores. Follow-up surveys 12 and 30 months after baseline (retention rate: 81%) documented the transition from never to ever smoking, even just a puff.After 12 months, 18% of adolescents initiated smoking, but the incidence was 29% among students who visited convenience, liquor, or small grocery stores at least twice per week and 9% among those who reported the lowest visit frequency (less than twice per month). Adjusting for multiple risk factors, the odds of initiation remained significantly higher (odds ratio: 1.64 [95% confidence interval: 1.06-2.55]) for adolescents who reported moderate visit frequency (0.5-1.9 visits per week), and the odds of initiation more than doubled for those who visited > or = 2 times per week (odds ratio: 2.58 [95% confidence interval: 1.68-3.97]). Similar associations were observed for the more detailed exposure measure and persisted at 30 months.Exposure to retail cigarette advertising is a risk factor for smoking initiation. Policies and parenting practices that limit adolescents' exposure to retail cigarette advertising could improve smoking prevention efforts.

    View details for DOI 10.1542/peds.2009-3021

    View details for Web of Science ID 000280565700006

    View details for PubMedID 20643725

    View details for PubMedCentralID PMC3046636

  • Is adolescent smoking related to the density and proximity of tobacco outlets and retail cigarette advertising near schools? PREVENTIVE MEDICINE Henriksen, L., Feighery, E. C., Schleicher, N. C., Cowling, D. W., Kline, R. S., Fortmann, S. P. 2008; 47 (2): 210-214


    To examine the quantity (density) and location (proximity) of tobacco outlets and retail cigarette advertising in high school neighborhoods and their association with school smoking prevalence.Data from the 135 high schools that participated in the 2005-2006 California Student Tobacco Survey were combined with retailer licensing data about the location of tobacco outlets within walking distance (1/2 mi or 805 m) of the schools and with observations about the quantity of cigarette advertising in a random sample of those stores (n=384). Multiple regressions, adjusting for school and neighborhood demographics, tested the associations of high school smoking prevalence with the density of tobacco outlets and retail cigarette advertising and with the proximity of tobacco outlets to schools.The prevalence of current smoking was 3.2 percentage points higher at schools in neighborhoods with the highest tobacco outlet density (>5 outlets) than in neighborhoods without any tobacco outlets. The density of retail cigarette advertising in school neighborhoods was similarly associated with high school smoking prevalence. However, neither the presence of a tobacco outlet within 1000 ft of a high school nor the distance to the nearest tobacco outlet from school was associated with smoking prevalence.Policy efforts to reduce adolescent smoking should aim to reduce the density of tobacco outlets and retail cigarette advertising in school neighborhoods. This may be achieved through local zoning ordinances, including limiting the proximity of tobacco outlets to schools.

    View details for DOI 10.1016/j.ypmed.2008.04.008

    View details for Web of Science ID 000258560300012

    View details for PubMedID 18544462

  • The effect of retail cigarette pack displays on impulse purchase ADDICTION Wakefield, M., Germain, D., Henriksen, L. 2008; 103 (2): 322-328


    To assess the extent to which point-of purchase (POP) cigarette displays stimulate impulse purchases.Telephone-administered population survey.Victoria, Australia.A total of 2996 adults, among whom 526 smoked factory-made cigarettes and 67 were recent quitters (quit in the past 12 months).Reported cigarette purchase behaviour; perceived effect on smoking of removing cigarettes from view in retail outlets; reported urges to buy cigarettes as a result of seeing the cigarette display.When shopping for items other than cigarettes, 25.2% of smokers purchased cigarettes at least sometimes on impulse as a result of seeing the cigarette display. Thirty-eight per cent of smokers who had tried to quit in the past 12 months and 33.9% of recent quitters experienced an urge to buy cigarettes as a result of seeing the retail cigarette display. One in five smokers trying to quit and one in eight recent quitters avoided stores where they usually bought cigarettes in case they might be tempted to purchase them. Many smokers (31.4%) thought the removal of cigarette displays from stores would make it easier for them to quit.POP cigarette displays act as cues to smoke, even among those not explicitly intending to buy cigarettes, and those trying to avoid smoking. Effective POP marketing restrictions should encompass cigarette displays.

    View details for DOI 10.1111/j.1360-0443.2007.02062.x

    View details for Web of Science ID 000252318800024

    View details for PubMedID 18042190

  • Receptivity to alcohol marketing predicts initiation of alcohol use JOURNAL OF ADOLESCENT HEALTH Henriksen, L., Feighery, E. C., Schleicher, N. C., Fortmann, S. P. 2008; 42 (1): 28-35


    This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined.Data were obtained from in-class surveys of sixth, seventh, and eighth graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n = 1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics.At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity), and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline.Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents' receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors' marketing tactics.

    View details for DOI 10.1016/j.jadohealth.2007.07.005

    View details for Web of Science ID 000252001500005

    View details for PubMedID 18155027

    View details for PubMedCentralID PMC2175037

  • The relationship between exposure to alcohol advertising in stores, owning alcohol promotional items, and adolescent alcohol use ALCOHOL AND ALCOHOLISM Hurtz, S. Q., Henriksen, L., Wang, Y., Feighery, E. C., Fortmann, S. P. 2007; 42 (2): 143-149


    This paper describes adolescents' exposure to alcohol advertising in stores and to alcohol-branded promotional items and their association with self-reported drinking.A cross-sectional survey was administered in non-tracked required courses to sixth, seventh, and eighth graders (n = 2125) in three California middle schools. Logistic regressions compared the odds of ever (vs. never) drinking and current (vs. ever) drinking after controlling for psychosocial and other risk factors for adolescent alcohol use.Two-thirds of middle school students reported at least weekly visits to liquor, convenience, or small grocery stores where alcohol advertising is widespread. Such exposure was associated with higher odds of ever drinking, but was not associated with current drinking. One-fifth of students reported owning at least one alcohol promotional item. These students were three times more likely to have ever tried drinking and 1.5 times more likely to report current drinking than students without such items.This study provides clear evidence of an association of adolescent drinking with weekly exposure to alcohol advertising in stores and with ownership of alcohol promotional items. Given their potential influence on adolescent drinking behaviour, retail ads, and promotional items for alcohol deserve further study.

    View details for DOI 10.1093/alcal/agl119

    View details for Web of Science ID 000246015000015

    View details for PubMedID 17218364

  • An evaluation of four measures of adolescents' exposure to cigarette marketing in stores NICOTINE & TOBACCO RESEARCH Feighery, E. C., Henriksen, L., Wang, Y., Schleicher, N. C., Fortmann, S. P. 2006; 8 (6): 751-759


    This study evaluates four measures of exposure to retail cigarette marketing in relation to adolescent smoking behavior. The measures are (a) shopping frequency in types of stores known to carry more cigarette advertising than other store types, (b) shopping frequency in specific stores that sell cigarettes in the study community, (c) the amount of exposure to cigarette brand impressions in stores where students shopped, and (d) perceived exposure to cigarette advertising. The study combined data from classroom surveys administered to 6th-, 7th-, and 8th-grade students in three California middle schools, and direct store observations quantifying cigarette marketing materials and product placement in stores where students shopped. Logistic regression models were used to examine how each exposure measure related to the odds of ever smoking and susceptibility to smoke, controlling for grade, gender, ethnicity, school performance, unsupervised time, and exposure to household and friend smoking. Frequent exposure to retail cigarette marketing as defined by each of the four measures was independently associated with a significant increase in the odds of ever smoking. All but the measure of exposure to store types was associated with a significant increase in the odds of susceptibility to smoke. Four measures of exposure to retail cigarette marketing may serve equally well to predict adolescent smoking but may vary in cost, complexity, and meaning. Depending on the outcomes of interest, the most useful measure may be a combination of self-reported exposure to types of stores that contain cigarette marketing and perceived exposure to such messages.

    View details for DOI 10.1080/14622200601004125

    View details for Web of Science ID 000242992300005

    View details for PubMedID 17132522

  • Industry sponsored anti-smoking ads and adolescent reactance: test of a boomerang effect TOBACCO CONTROL Henriksen, L., Dauphinee, A. L., Wang, Y., Fortmann, S. P. 2006; 15 (1): 13-18


    To examine whether adolescents' exposure to youth smoking prevention ads sponsored by tobacco companies promotes intentions to smoke, curiosity about smoking, and positive attitudes toward the tobacco industry.A randomised controlled experiment compared adolescents' responses to five smoking prevention ads sponsored by a tobacco company (Philip Morris or Lorillard), or to five smoking prevention ads sponsored by a non-profit organisation (the American Legacy Foundation), or to five ads about preventing drunk driving.A large public high school in California's central valley.A convenience sample of 9th and 10th graders (n = 832) ages 14-17 years.Perceptions of ad effectiveness, intention to smoke, and attitudes toward tobacco companies measured immediately after exposure.As predicted, adolescents rated Philip Morris and Lorillard ads less favourably than the other youth smoking prevention ads. Adolescents' intention to smoke did not differ as a function of ad exposure. However, exposure to Philip Morris and Lorillard ads engendered more favourable attitudes toward tobacco companies.This study demonstrates that industry sponsored anti-smoking ads do more to promote corporate image than to prevent youth smoking. By cultivating public opinion that is more sympathetic toward tobacco companies, the effect of such advertising is likely to be more harmful than helpful to youth.

    View details for DOI 10.1136/tc.2003006361

    View details for Web of Science ID 000234842100010

    View details for PubMedID 16436398

    View details for PubMedCentralID PMC2563637

  • Association of retail tobacco marketing with adolescent smoking AMERICAN JOURNAL OF PUBLIC HEALTH Henriksen, L., Feighery, E. C., Wang, Y., Fortmann, S. P. 2004; 94 (12): 2081-2083


    A survey of 2125 middle-school students in central California examined adolescents' exposure to tobacco marketing in stores and its association with self-reported smoking. Two thirds of sixth-, seventh-, and eighth-grade students reported at least weekly visits to small grocery, convenience, or liquor stores. Such visits were associated with a 50% increase in the odds of ever smoking, even after control for social influences to smoke. Youth smoking rates may benefit from efforts to reduce adolescents' exposure to tobacco marketing in stores.

    View details for Web of Science ID 000225560800016

    View details for PubMedID 15569957

  • Reaching youth at the point of sale: cigarette marketing is more prevalent in stores where adolescents shop frequently TOBACCO CONTROL Henriksen, L., Feighery, E. C., Schleicher, N. C., Haladjian, H. H., Fortmann, S. P. 2004; 13 (3): 315-318


    Although numerous studies describe the quantity and nature of tobacco marketing in stores, fewer studies examine the industry's attempts to reach youth at the point of sale. This study examines whether cigarette marketing is more prevalent in stores where adolescents shop frequently.Trained coders counted cigarette ads, products, and other marketing materials in a census of stores that sell tobacco in Tracy, California (n = 50). A combination of data from focus groups and in-class surveys of middle school students (n = 2125) determined which of the stores adolescents visited most frequently.Amount of marketing materials and shelf space measured separately for the three cigarette brands most popular with adolescent smokers and for other brands combined.Compared to other stores in the same community, stores where adolescents shopped frequently contained almost three times more marketing materials for Marlboro, Camel, and Newport, and significantly more shelf space devoted to these brands.Regardless of whether tobacco companies intentionally target youth at the point of sale, these findings underscore the importance of strategies to reduce the quantity and impact of cigarette marketing materials in this venue.

    View details for DOI 10.1136/tc.2003.006577

    View details for Web of Science ID 000223532700027

    View details for PubMedID 15333890

    View details for PubMedCentralID PMC1747887

  • A content analysis of Web sites promoting smoking culture and lifestyle HEALTH EDUCATION & BEHAVIOR Ribisl, K. M., Lee, R. E., Henriksen, L., Haladjian, H. H. 2003; 30 (1): 64-78


    The present study examined smoking culture and lifestyle Web sites listed on Yahoo!, a popular Internet search catalog, to determine whether the sites were easily accessible to youth, featured age or health warnings, and mentioned specific tobacco brands. A content analysis of photographs on these sites assessed the demographics of individuals depicted and the amount of smoking and nudity in the photographs. The sample included 30 Web sites, all of which were accessible to youth and did not require age verification services to enter them. Cigarette brand names were mentioned in writing on 35% of the sites, and brand images were present on 24% of the sites. Nearly all of the photographs (95%) depicted smoking, 92% featured women, and 7% contained partial or full nudity. These results underscore the need for greater research and monitoring of smoking-related Internet content by health educators and tobacco control advocates.

    View details for DOI 10.1177/10901098102239259

    View details for Web of Science ID 000180566900004

    View details for PubMedID 12564668

  • Young adults' opinions of Philip Morris and its television advertising TOBACCO CONTROL Henriksen, L., Fortmann, S. P. 2002; 11 (3): 236-240


    To determine what young people think about the tobacco company Philip Morris and how it affects their evaluations of the company's new television advertising.Data were gathered in the context of a controlled experiment in which participants saw four Philip Morris ads about youth smoking prevention, four Philip Morris ads about charitable works, or four Anheuser-Busch ads about preventing underage drinking (the control group). Knowledge and opinion of Philip Morris were measured before ad exposure.A California state university in the San Francisco Bay area.A convenience sample of undergraduates (n = 218) aged 18-25 years.Advertising evaluation measured by 12 semantic differential scales.A little more than half of the students knew that Philip Morris is a tobacco company. Neither this knowledge nor students' smoking status was related to their opinion of the company. Philip Morris ads were rated less favourably by students who were aware that the sponsor is a tobacco company than by students who were unaware.Advertisements designed to discredit the tobacco industry typically avoid references to specific companies. This study suggests that such counter-advertising would benefit from teaching audiences about the industry's corporate identities.

    View details for Web of Science ID 000177902000021

    View details for PubMedID 12198275

  • Effects on youth of exposure to retail tobacco advertising JOURNAL OF APPLIED SOCIAL PSYCHOLOGY Henriksen, L., Flora, J. A., Feighery, E., Fortmann, S. P. 2002; 32 (9): 1771-1789
  • Third-person perception and children - Perceived impact of pro- and anti-smoking ads COMMUNICATION RESEARCH Henriksen, L., Flora, J. A. 1999; 26 (6): 643-665
  • Reliability of children's self-reported cigarette smoking ADDICTIVE BEHAVIORS Henriksen, L., Jackson, C. 1999; 24 (2): 271-277


    Youth who first smoke cigarettes during childhood are a high risk for habitual smoking. Evaluating the reliability of children's smoking initiation is essential to research efforts to explain or prevent smoking onset. The present study is the first to establish reliability of self-reported smoking behavior with questionnaire data from elementary school children (N = 1,184). Data from a longitudinal investigation are used to examine the consistency of children's self-reported smoking across items and over time. Both cross-sectional and longitudinal analyses demonstrate that children report having tried smoking and lifetime use remarkably consistently. However, only about half the children reliably estimated their grade at first use. The study results suggest that some but not all standard questionnaire items yield reliable self-report data about initial smoking behavior from respondents as young as 8 to 11 years.

    View details for Web of Science ID 000079294400011

    View details for PubMedID 10336108

  • A longitudinal study predicting patterns of cigarette smoking in late childhood HEALTH EDUCATION & BEHAVIOR Jackson, C., Henriksen, L., Dickinson, D., Messer, L., ROBERTSON, S. B. 1998; 25 (4): 436-447


    Early initiation of cigarette smoking so strongly predicts future smoking that several investigators have advocated delaying the age of initiation as a prevention strategy. To complement retrospective studies of early initiation, this study assessed prospectively patterns of smoking behavior in a sample of 401 children who were surveyed in the fifth, sixth, and seventh grades. The principal findings were (1) modeling of smoking by parents and friends is sufficient to influence children to initiate smoking, particularly when children also have low behavioral self-control, and (2) when modeling occurs in combination with poor adjustment to school, low parental monitoring, easy access to cigarettes, and other risk attributes, early initiators are significantly more likely to continue smoking. The results suggest that delaying initiation of smoking without also modifying child attributes and socialization factors that predict early initiation and persistent smoking is unlikely to reduce the proportion of children who become habitual smokers.

    View details for Web of Science ID 000074933300003

    View details for PubMedID 9690102