摘要：Objectives. We assessed young adults’ exposure to the tobacco industry marketing strategy of sponsoring social events at bars, nightclubs, and college campuses. Methods. We analyzed data from the 2001 Harvard College Alcohol Study, a random sample of 10904 students enrolled in 119 nationally representative 4-year colleges and universities. Results. During the 2000–2001 school year, 8.5% of respondents attended a bar, nightclub, or campus social event where free cigarettes were distributed. Events were reported by students attending 118 of the 119 schools (99.2%). Attendance was associated with a higher student smoking prevalence after we adjusted for demographic factors, alcohol use, and recent bar/nightclub attendance. This association remained for students who did not smoke regularly before 19 years of age but not for students who smoked regularly by 19 years of age. Conclusions. Attendance at a tobacco industry–sponsored event at a bar, nightclub, or campus party was associated with a higher smoking prevalence among college students. Promotional events may encourage the initiation or the progression of tobacco use among college students who are not smoking regularly when they enter college. Tobacco use among young adults in the United States is a growing public health concern. Cigarette smoking rates declined between 1993 and 2000 among all US adults except those aged 18 to 24 years. 1 Among US college students, the prevalence of smoking rose dramatically during the 1990s before it declined slightly between 1999 and 2001. 2– 4 Smoking rates among young adults who do not attend college are higher than smoking rates among college students. 4 Several factors account for young adults’ increased tobacco use. One factor is the aging of the cohort of adolescents whose smoking rates increased after 1991, but it does not explain all of the change. 2– 5 Another factor may be that young adults are initiating regular tobacco use in larger numbers. 5 Young adults (aged 18–24 years) are the youngest legal targets of tobacco industry marketing. Internal tobacco industry documents show that tobacco marketing targets young adults. 6– 9 The industry envisions the uptake of smoking as a process that extends into young adulthood, during which time adolescents’ experimental or occasional smoking becomes solidified into a regular smoking habit. 9 The tobacco industry has developed novel marketing strategies to promote this transition. A well-documented strategy is to sponsor social events at bars and nightclubs where free cigarettes and promotional items are distributed. 6, 7, 9 Similar promotions take place at college social events sponsored by organizations such as fraternities and sororities. 10 Bars and nightclubs have assumed greater importance for tobacco marketing since the 1998 Master Settlement Agreement between the tobacco industry and 46 states’ attorneys general, because the agreement limits the distribution of free cigarette samples to facilities that do not admit minors. 6, 9, 11 Bars and nightclubs also are smoker-friendly environments for the tobacco industry, because they are among the few places where smoking is not generally restricted by clean-air laws. 7 Promotional events at bars, nightclubs, and college social events aim to link alcohol with tobacco use and to make tobacco products a visible part of young adults’ social lives. 6, 7 The events reinforce brand visibility, allow the industry to reach specific target groups, and generate names for future marketing efforts. 6, 7, 9 Promotions at social events have the potential to increase tobacco use by encouraging nonsmokers to try cigarettes, by encouraging experimental smokers to develop regular use, and by discouraging current smokers from quitting. There is no information about the extent of young adults’ exposure to these new tobacco promotions or about the impact of these promotions on young adults’ tobacco use. The potential impact could be substantial, because young adults are more susceptible to tobacco marketing than adults in older age groups. 12 Colleges and universities provide a key channel for reaching young adults, because approximately one third of young adults attend college. 13 Our study used data from a large nationally representative random sample of US college and university students to assess the prevalence of students’ exposure to tobacco promotions at bars, nightclubs, and campus social events and to explore the association between that exposure and smoking behavior. We hypothesized that students’ tobacco use before entering college might modify this association, because students who did not smoke regularly before college would be more susceptible to bar/nightclub promotions than students who entered college as regular smokers.
