Background: Tobacco marketing has been established as the main motivator for tobacco use among youth. A proliferation of tobacco promotional activities in retail stores has been observed yet little is known about its impact on adolescent smoking behaviours. The purpose of this study is to use secondary data to describe the prevalence of retail tobacco point-of-purchase (PoP) activities, examine its associations with adolescent smoking behaviours, and determine what ecological factors moderate the relationship between PoP activities and student smoking behaviours in British Columbia. Methods: This cross-sectional study surveyed grade 10-11 students from 22 randomly-selected schools in BC on student smoking behaviour and conducted observations in 57 retail stores on tobacco PoP activities located within a 1 km radius of these schools. Descriptive analysis was conducted on retail tobacco PoP variables. Individual data on smoking behaviour and school level data on retailers were linked to analyse the association between retail tobacco PoP activities and student smoking behaviour using logistic regression. Moderating effects of contextual factors were also examined. GIS maps were generated to illustrate study findings. Result: A moderate to strong presence of tobacco PoP activities was observed in all tobacco retail stores located in BC school neighbourhoods. Nearly all stores displayed cigarette products in a visible manner (98.25%) and posted tobacco control signage (94.74%). In this model, proportion of stores in the school neighbourhood with presence of tobacco advertising increased the odds of a student being a smoker (OR = 1.28-3.27). Proportion of stores in the school neighbourhood with presence of tobacco control signage decreased the odds of a student being a smoker (OR = 0.11-0.66). The odds of a student being a smoker increased if they resided on the island compared to living in the lower mainland (OR = 1.11-1.75). Discussion: Convenience stores exhibited more tobacco PoP activities than other store types. Retailers in the school neighbourhood that had tobacco advertisements and tobacco control signage exhibited both detrimental and protective effects on student smoking. This provides supportive evidence to ban tobacco advertising in retail stores and increase efforts for creating an anti-tobacco environment in neighbourhood retail stores. Maps generated served descriptive and hypothesis generating purposes.

Background: Tobacco marketing has been established as the main motivator for tobacco use among youth. A proliferation of tobacco promotional activities in retail stores has been observed yet little is known about its impact on adolescent smoking behaviours. The purpose of this study is to use secondary data to describe the prevalence of retail tobacco point-of-purchase (PoP) activities, examine its associations with adolescent smoking behaviours, and determine what ecological factors moderate the relationship between PoP activities and student smoking behaviours in British Columbia. Methods: This cross-sectional study surveyed grade 10-11 students from 22 randomly-selected schools in BC on student smoking behaviour and conducted observations in 57 retail stores on tobacco PoP activities located within a 1 km radius of these schools. Descriptive analysis was conducted on retail tobacco PoP variables. Individual data on smoking behaviour and school level data on retailers were linked to analyse the association between retail tobacco PoP activities and student smoking behaviour using logistic regression. Moderating effects of contextual factors were also examined. GIS maps were generated to illustrate study findings. Result: A moderate to strong presence of tobacco PoP activities was observed in all tobacco retail stores located in BC school neighbourhoods. Nearly all stores displayed cigarette products in a visible manner (98.25%) and posted tobacco control signage (94.74%). In this model, proportion of stores in the school neighbourhood with presence of tobacco advertising increased the odds of a student being a smoker (OR = 1.28-3.27). Proportion of stores in the school neighbourhood with presence of tobacco control signage decreased the odds of a student being a smoker (OR = 0.11-0.66). The odds of a student being a smoker increased if they resided on the island compared to living in the lower mainland (OR = 1.11-1.75). Discussion: Convenience stores exhibited more tobacco PoP activities than other store types. Retailers in the school neighbourhood that had tobacco advertisements and tobacco control signage exhibited both detrimental and protective effects on student smoking. This provides supportive evidence to ban tobacco advertising in retail stores and increase efforts for creating an anti-tobacco environment in neighbourhood retail stores. Maps generated served descriptive and hypothesis generating purposes.

Background: Tobacco marketing has been established as the main motivator for tobacco use among youth. A proliferation of tobacco promotional activities in retail stores has been observed yet little is known about its impact on adolescent smoking behaviours. The purpose of this study is to use secondary data to describe the prevalence of retail tobacco point-of-purchase (PoP) activities, examine its associations with adolescent smoking behaviours, and determine what ecological factors moderate the relationship between PoP activities and student smoking behaviours in British Columbia. Methods: This cross-sectional study surveyed grade 10-11 students from 22 randomly-selected schools in BC on student smoking behaviour and conducted observations in 57 retail stores on tobacco PoP activities located within a 1 km radius of these schools. Descriptive analysis was conducted on retail tobacco PoP variables. Individual data on smoking behaviour and school level data on retailers were linked to analyse the association between retail tobacco PoP activities and student smoking behaviour using logistic regression. Moderating effects of contextual factors were also examined. GIS maps were generated to illustrate study findings. Result: A moderate to strong presence of tobacco PoP activities was observed in all tobacco retail stores located in BC school neighbourhoods. Nearly all stores displayed cigarette products in a visible manner (98.25%) and posted tobacco control signage (94.74%). In this model, proportion of stores in the school neighbourhood with presence of tobacco advertising increased the odds of a student being a smoker (OR = 1.28-3.27). Proportion of stores in the school neighbourhood with presence of tobacco control signage decreased the odds of a student being a smoker (OR = 0.11-0.66). The odds of a student being a smoker increased if they resided on the island compared to living in the lower mainland (OR = 1.11-1.75). Discussion: Convenience stores exhibited more tobacco PoP activities than other store types. Retailers in the school neighbourhood that had tobacco advertisements and tobacco control signage exhibited both detrimental and protective effects on student smoking. This provides supportive evidence to ban tobacco advertising in retail stores and increase efforts for creating an anti-tobacco environment in neighbourhood retail stores. Maps generated served descriptive and hypothesis generating purposes. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Plain packaging first appeared on the UK policy agenda in the Department of Health’s 2008 ‘Consultation on the Future of Tobacco Control’. Since then, plain (or standardised) packaging has been framed through the potential benefit to young people. Within the period of this thesis, plain packaging has been actively debated and draft plain packaging regulations were published in June 2014. An extended literature review of academic and practitioner marketing literature, internal tobacco company documents and public health packaging research, establishes that the research informing the policy debate, while consistent in its approach and findings, fails to recognise the strategic nature of pack design, the full extent of the influence that branded design can have on consumer responses, and the importance of product design as a marketing tool. This thesis attempts to address these gaps in the plain packaging evidence base. It explores if, and how, adolescents engage with different styles of packaging and product design, whether or not an association between tobacco packaging and adolescent smoking exists, and whether it is possible to observe cognitive, affective and behavioural responses to packaging. The study uses a sequential exploratory mixed methodology design with two stages of research. First, focus groups were conducted with 15 year olds (n=48) to explore adolescent responses to tobacco packaging and product design. The findings show that adolescents are most appreciative of ‘novelty’ pack designs. These ‘novelty’ packs, for instance with innovative structures or distinctive designs and colours, generated positive user imagery and influenced affective feelings among participants. Cigarettes with slim diameters, white tips and decorative designs increased appeal and communicated a weaker tasting and less harmful product. Conversely, a plain pack eliminated positive perceptions and feelings, and exposed tobacco as harmful, dirty and not for young people. The qualitative findings were used to develop measures and hypotheses which were tested in a quantitative survey. The second stage of research utilised a cross-sectional in-home survey (n=1373) with 11 to 16 year olds. Respondents were asked to rate three different pack styles - ‘novelty’, ‘regular’ and ‘plain’ - on 11 pack ratings items and four pack feelings items. The findings show adolescents hold ‘novelty’ packaging in higher regard than ‘regular’ packaging across pack ratings items. There were fewer differences between ‘novelty’ and ‘regular’ packaging for the pack feelings items. Plain packaging was consistently rated most negatively across all survey items. Logistic regressions, controlling for factors known to influence youth smoking, showed that susceptibility to smoke was associated with positive appraisal and also receptivity for ‘novelty’ packaging. There was no association with pack appraisal or receptivity for the plain pack. While susceptibility is not a direct behavioural response it is a reasonable predictor of future tobacco use. Collectively the findings show that ‘novelty’ packaging and product design holds greatest appeal for adolescents. Plain packaging limits the opportunity for tobacco companies to communicate with, mislead and influence consumers. Based upon the role of packaging for consumer goods in general, and tobacco in particular, plain packaging would effectively reduce the promotional role of packaging.

Tobacco use is a major preventable cause of morbidity and mortality worldwide. Most smokers initiate smoking in childhood, become addicted, and continue the habit into adulthood. Various factors have been shown to impact smoking behavior. It is important to determine how these factors impact smoking behavior in developing regions of the world, such as in South Africa. This study examines the association between parental smoking status; peer smoking status; exposure to pro-tobacco marketing; and current smoking status among adolescents in South Africa. It also determines which factor is the most significant predictor of current smoking status among the study population and further examines the trends in these factors among survey populations from 1999 – 2008. Secondary analysis was conducted on data obtained from the Global Youth Tobacco Survey. Logistic regression analyses were conducted to determine the association between the independent variables; parental smoking status, peer smoking status, and exposure to pro-tobacco marketing; and the dependent variable, current smoking status, controlling for other factors. Adolescents who had at least a parent or a friend who smoked had greater odds of being current smokers as compared to those who had neither a parent nor a friend who smoked. Similarly, exposure to average and high levels of pro-tobacco marketing was associated with greater odds of an adolescent being a current smoker as compared to exposure to low levels of pro-tobacco marketing. Maternal smoking appeared to have a greater impact on adolescent smoking behavior as compared to paternal smoking. Also, peer smoking had the greatest impact on smoking behavior as compared to the other independent factors. Smoking rates among South African adolescents has decreased from 23% in 1999 to about 17% in 2008. Similarly, the proportion of adolescents who had a parent or a friend who smoked, or had been exposed to average and high levels of pro-tobacco marketing has also decreased over the same period. Programs must be implemented to educate parents on how their smoking behavior is being transmitted to their children, with a special focus on maternal influences. Tobacco use prevention campaigns aimed at the youth should also be implemented, and laws restricting tobacco marketing must be enforced.

An experiment was done to investigate whether or not there is a need to treat smokers and non-smokers as separate target audiences when creating tobacco counter-advertisements. The Extended Parallel Process Model (Witte, 1992) and Reactance Theory (Brehm, 1966) were used to guide the development of predictions. The study revealed that social marketers need to have different advertising tactics for smokers and non-smokers, since smokers have reported more maladaptive coping responses and fewer adaptive coping responses than non-smokers. Moreover, based on the fact that a smoker’s brand forms an essential part of their self-identity (Goldberg et al., 1995) the experiment was also designed to see if smokers would have differing levels of reactance and other maladaptive coping responses if they saw a counter-advertisement attacking their brand, one attacking a competing brand, and a non-branded one. The study did not reveal any significant differences in reactions among the three conditions. / x, 125 leaves : ill. ; 29 cm