Exposure to Tobacco Marketing in Bars Is Associated with Use of Multiple Tobacco Products

Introduction. Young adults frequently report being exposed to marketing for tobacco and nicotine products such as cigarettes, electronic nicotine devices (ENDS), smokeless tobacco, and cigars. The marketing of non-cigarettes products is largely unregulated and occurs through many venues including the bars or nightclubs. However, bars and clubs are generally unregulated venues that have received little attention. Therefore, the purpose of this study is to determine the association between exposure to marketing and free samples in bars and clubs and tobacco/nicotine product use among college students.

Method. Participants were 1945 18-29 year old students who reported going to bars or clubs at least rarely (M age=21.4; 66% female; 45% non-Hispanic white, 30% Hispanic, 11% Asian, 7% African American/black and 7% other). Students completed an online survey in fall 2014/spring 2015. Students self-reported exposure to tobacco/nicotine product advertisements, free samples, industry representatives in bars/clubs, and exposure to free samples of e-cigarettes at events or parties on campus (e.g. How often have you been to a bar/club when free samples of tobacco products or ENDS products (i.e. e-cigarettes, vape pens, or e-hookahs) were available?). Response options ranged from never (1) to frequently (4). Students also self-reported current use (past 30 days) of tobacco and nicotine products including cigarettes, ENDS, smokeless tobacco, cigars, and hookah. A variable was created which represented the number of products used in the past 30 days which ranged from 0 (no products) to 5 (all 5 products). Multilevel Poisson regression models were used to assess the relationship between exposure to marketing and product use controlling for school type (2-year versus 4-year), age, gender, and race/ethnicity.  

Results. Greater exposure to free samples at bars was significantly associated with a greater number of products used (z=6.14, p<.001). Greater exposure to tobacco or ENDS product advertising in bars was also significantly associated with a greater number of products used (z=2.93, p=.003). Finally, greater exposure to industry representatives at bars was significantly associated with a greater number of products used (z=6.72, p<.001). 

Conclusion. Young adults are the youngest legal targets of tobacco product marketing. Bars and clubs are largely unrestricted in their ability to market tobacco and nicotine products to young adults. Given the findings from this study that greater exposure is associated with using multiple tobacco or nicotine products, further research is needed to document the types of advertising and promotions that occur in this setting.