Understanding How Cigarette Direct Mail Marketing Influences Smoking Behaviors Among High and Low Socioeconomic Status Young Adult Smokers

Smoking remains a public health problem in the US, and cigarette marketing has been concluded
as one of the causal factors for the epidemic. Previous studies on cigarette direct mail
marketing yielded a limited data on mechanisms influencing smoking behavior. Therefore, there
is a need for a study that would provide a stronger evidence on how direct mail marketing
influences smoking behavior. The prosed study will consist of two parts where pilot data are
to be collected in Part 1, and further data are to be collected in Part 2 conducted as a
randomized comparative trial. Up to a total of 530 healthy volunteers ages 18-29 are to be
recruited for the study. After meeting the eligibility and enrolling onto the study,
participants will have their biospecimens collected followed by an experiment in which they
are to be shown images on the computer. Study participants will then take a break and
afterwards will provide additional sociodemographic and psychosocial information through an
audio computer assisted self-administered interview.

- INCLUSION CRITERIA:

- Age: 18 to 29 years, given our focus on young adults.

- Smoking status: Current smokers who report smoking every day and who have smoked at
least 100 cigarettes in their lifetime.

- Gender: Both male and female

- SES: For the purpose of the study, we will use the empirical groups from our analysis
of the Current Population Survey Tobacco Use Supplement data. Two groups are chosen
based on their social determinants and prevalence of smoking.

1. Low SES: Young adults who do not have a four-year college degree, are not
currently enrolled in a four-year college, were born in the US, and have an
annual income less than $50,000. This is the group that has been shown to have
the highest prevalence of smoking.

2. High SES: Young adults who are currently enrolled in or graduated from a four
year college. This is the group that has been shown to have the lowest prevalence
of smoking.

- English proficiency: since study materials are available only in English, only
participants who are able to understand English and follow instructions in English are
to be enrolled.

- Cognitive ability: Able to understand and willing to sign a written informed consent
document.

- General health: Participants need to be generally healthy, as defined as someone with
no known significant health problems. Participants can have chronic health conditions
if the condition is well managed.

EXCLUSION CRITERIA:

- Inability, in the judgment of the investigator, to understand and follow the
requirements of the protocol.

- Currently enrolled in high school.

- Participants with eye conditions that restrict their ability to track an object with
their eyes.

- Participants with myopia, hyperopia, and/or astigmatism who cannot pass a simple
vision test even with corrective lenses.

- Participants with medical condition(s) that may be triggered by infrared radiation
(e.g., epilepsy).

- Self-reported use of alcohol, recreational drugs or prescription medications used for
recreational purposes (e. i. amphetamines, cannabis, cocaine, MDMA, ketamines, LSD,
opiates and opioids, tranquilizers or opioid analgesics) that may influence their
judgement at the time of study in the past 12 hours before the study visit.