Reducing Tobacco Use Amongst Priority Young Adult Populations - Successes with Hispanics & "Other Race" In San Diego, CA

Theoretical Background and research questions/hypothesis: In 2009, multi-racial adults in California had the highest tobacco use rate at 19.9% (BRFSS). In addition, young adults (18-24) and 24-35 year-olds were more at-risk of tobacco use than other age groups (13.3% and 15.4%, respectively, BRFSS). About 1/3 of California YA attend bars or clubs at least sometimes in 2002, which is associated with increased smoking. Tobacco industry strategies were utilized in innovative psychographic market segmentation in a prevention campaign that integrates branding with hard hitting anti-tobacco messaging to foster passionate, market-driven resistance against tobacco industry bar/club promotions. We hypothesize that 1) bars and clubs attract higher-risk YAs from ethnic populations with disproportionate tobacco use risk; and 2) YAs who prioritize social success are more likely to use tobacco to express social identity and membership in a pro-smoking subculture. A branded intervention, "Commune," was developed in San Diego with innovative social marketing concepts, addressing the "Hipster" subculture using cultural experiences, social leaders, and hard-hitting messaging.

Methods: A random venue-based sampling strategy was utilized to gather cross-sectional samples of YAs at bars and clubs. Evaluation began with baseline sample of 1,200 YAs, followed by another 1,200-person sample after 10 months of intervention. Beginning at 22 months after launch, 400 YAs are surveyed every 4 months, totaling 1,200 subjects per year. To date, the baseline, 10-month follow-up, and three 400-person follow-up samples have been gathered.

Results: Baseline found 55.9% bar and club-going YAs smoke tobacco (59.8% for Hispanics, 61.4% for “other races”). Campaign exposure was measured using Commune brand recognition, liking, and having attended an event or visited campaign website. Hipsters report higher levels of exposure than the rest of the sample. More than half of those exposed to Commune reported liking Commune, with Hipsters liking Commune more frequently than the general sample.  At 32 Months, tobacco use rates in the overall sample decreased to 49.2% (p<.05), while Hispanics and “other races” decreased to 44.6% (p<.01)  and 42.1% (p<.05), respectively. Significant decreases were not observed among other measured races (Caucasians, African Americans or Asian/P.I.) identifying a possible unique impact of this intervention on Hispanics and “other races.”

Conclusions: The Commune intervention achieved significant reduction in tobacco use amongst high-risk sub-populations without defining itself as an intervention specifically for those populations. By targeting the culture and environments that YAs who are at high-risk identify with, the intervention was able to succeed in behavior change. Today, many interventions to target certain races use the ethnic culture to design the intervention; Commune presents an alternative, and possibly more effective method.

Implications for research and/or practice: The industry’s market research strategies can be counter- engineered to develop tailored YA tobacco control strategies to reach those at highest risk.  Rather than defining their brands as “for Hispanics” or other races, the industry has used modern cultures, like Hipster culture, to successfully reach these groups. Tobacco prevention efforts can be implemented at bars/clubs using a similar approach to culture, reaching a segment of YAs that is disproportionately using tobacco.