Sandra Braun | Universidad de Buenos Aires (original) (raw)

Papers by Sandra Braun

Research paper thumbnail of Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study

Tobacco Induced Diseases, 2018

Research paper thumbnail of Factores de riesgo asociados al consumo de tabaco, alcohol y otras drogas en adolescentes escolarizados de tres ciudades de Argentina

Archivos Argentinos de Pediatria

Comunicaciones breves RESUMEN El consumo de tabaco, alcohol y otras drogas comienza a temprana ed... more Comunicaciones breves RESUMEN El consumo de tabaco, alcohol y otras drogas comienza a temprana edad. Es importante identificar los factores de riesgo asociados al inicio. En 2014, se encuestaron estudiantes de primer año del secundario en Buenos Aires, Córdoba y Tucumán. Respondieron 3172 alumnos (42% de mujeres); edad media de 12,8 años. El 10% había fumado; el 32% había consumido alcohol; el 17% había tenido consumo excesivo durante el último mes, y 8% había consumido, al menos, una droga ilícita en su vida. El índice de búsqueda de emociones alto se asoció al consumo de tabaco (

Research paper thumbnail of Evaluación de la efectividad de un programa de cesación tabáquica

Introduction. Although many therapeutic interventions have proven efficacy through randomized con... more Introduction. Although many therapeutic interventions have proven efficacy through randomized control trials (RCT) with extensive use in Neonatal Intensive Care Units (NICU) for Very Low Birth Weight Infants (VLBWI), doubts remain about its overall effectiveness. Objective. To ...

Research paper thumbnail of Prevalence of non psychotic mental disorders in smokers assisted in a unit of smoking cessattion in Buenos Aires City: cross sectional study

Several researches showed that the prevalence of anxiety and depression are higher in smokers. Th... more Several researches showed that the prevalence of anxiety and depression are higher in smokers. There is significant variability in the literature depending if we consider cross-sectional studies conducted in the general population, population attended in primary care or at smoking cessation clinics. In Argentina there is not of studies which describe prevalence in this área. Objective: The main objective is to describe the prevalence of depression and non-psychotic mental disorders (NPMD) in patients treated at a smoking cessation unit. In addition, the prevalence of previous psychiatric disease and use of psychotropic drugs in this population are described. Method: This is a cross-sectional study conducted in patients assisted during 2008-2014 at the smoking cessation unit of the General Internal Medicine Program (SCU-PMIG), an ambulatory clinic for adult patients from the “Hospital de Clínicas”, University of Buenos Aires, Argentina. The sample included 665 patients selected syste...

Research paper thumbnail of An Argentinean icon as a useful tool to sell BAT's cigarettes

Tobacco Control, 2008

In 1995, Marlboro was the leading brand of cigarettes in Argentina. In order to challenge Marlbor... more In 1995, Marlboro was the leading brand of cigarettes in Argentina. In order to challenge Marlboro's position, BAT undertook a psychographic study of Argentinean youth. They found that based on their political and religious convictions ''young adults'' could be classified into three different groups: ''progressives,'' ''jurassics,'' and ''crudos'' or ''spoiled brats.'' ''Jurassics,'' or conservatives, representing 40% of the youth market, were strict, macho, religious, pro-United States and nationalistic. 1 Using this research, BAT developed a strategy for their main national brand, Jockey Club (JC), to compete with Marlboro in this large and important segment. BAT have linked JC with the ''national values'' important to the jurassics, such as family, friendship, the father/son relationship and love of country. 2 Cigarette packaging has long been recognised by tobacco companies as one of the most effective marketing tools and so BAT redesigned the JC pack to gain market share in the Jurassic segment. This new design, unlike BAT's traditional red packaging, is black with silver thread, using a well known local painting technique ''fileteado porteño'' (fig 1). Since the middle of 2007, it has been available in local kiosks and tobacco stores. What does ''fileteado porteño'' mean? Literally, ''filete'' is a fine thread used in decoration and ''porteño'' signifies anything related to a port. In Buenos Aires, however, the port is central to the city's identity, and the word has taken on a special meaning. ''Porteño'' can be used to refer to the people of Buenos Aires or to any other element specific to the city. Together, the words ''fileteado porteño'' denote a popular decorative pictorial art form born in Buenos Aires. If Buenos Aires is identified musically with the tango, the ''fileteado porteño'' is its iconography (fig 2). Flowers, ribbons, leaves and birds in strong colours are their

Research paper thumbnail of Assessing tobacco marketing receptivity among youth: integrating point of sale marketing, cigarette package branding and branded merchandise

Tobacco Control, 2015

Background As countries prohibit tobacco marketing through traditional channels, marketing at poi... more Background As countries prohibit tobacco marketing through traditional channels, marketing at point of sale (PoS) and through tobacco packaging is increasingly important for promoting tobacco consumption. Objectives Assess the validity of a novel marketing receptivity index that considers frequency of PoS exposures, tobacco brand recall and ownership of branded merchandise. Methods Data come from a cross-sectional survey of 3172 secondary school students in Argentina. Questions assessed frequency of going to stores where tobacco is often sold; cued recall of brand names for 3 cigarette packages with brand name removed and ownership of branded merchandise. A four-level marketing receptivity index was derived: low PoS exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise. Indicators of marketing receptivity and smoking involvement were regressed on the index, including in adjusted models that controlled for sociodemographics, social influences and sensation seeking. Findings Among never-smokers, the index had independent positive associations with smoking susceptibility (ie, adjusted OR (AOR) 2v1 =1.66; AOR 3v1 =1.64; AOR 4v1 =2.95), willingness to try a specific brand (ie, AOR 2v1 =1.45; AOR 3v1 =2.38; AOR 4v1 =2.20) and positive smoking expectancies (ie, B adj 2v1 =0.09; B adj 3v1 =0.18; B adj 4v1 =0.34). A more marked dose-response independent association was found with current smoking behaviour (ie, AOR 2v1 =2.47; AOR 3v1 =3.16; AOR 4v1 =3.62). Conclusions The marketing receptivity index was associated with important variation in smoking-related perceptions, intentions and behaviour among Argentine adolescents. Future research should determine the predictive validity and generalisability of this measure to other contexts, including the explanatory power gained by integrating cigarette package brand recognition tasks.

Research paper thumbnail of Movies promote tobacco use amongst adolescents: The need for policies to prevent this phenomenon

Revista de la Asociacion Medica Argentina, 2018

Tobacco use is the primary preventable cause of death and disability in the world. To combat the ... more Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation's Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.

Research paper thumbnail of Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents

Salud Pública de México

Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adole... more Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents.

Research paper thumbnail of Predictive validity of the tobacco marketing receptivity index among non-smoking youth

Addictive behaviors, Jan 2, 2018

In a previous cross-sectional study of early adolescents, we developed a marketing receptivity in... more In a previous cross-sectional study of early adolescents, we developed a marketing receptivity index (MRI) that integrates point-of-sale (PoS) marketing exposures, brand recall, and ownership of branded merchandise. The MRI had independent, positive associations with smoking susceptibility among never smokers and with current smoking behavior. The current longitudinal study assessed the MRI's predictive validity among adolescents who have never smoked cigarettes METHODS: Data come from a longitudinal, school-based survey of 33 secondary schools in Argentina. Students who had never smoked at baseline were followed up approximately 17months later (n=1700). Questions assessed: PoS marketing exposure by querying frequency of going to stores where tobacco is commonly sold; cued recall of brand names for 3 cigarette packages from dominant brands but with the brand name removed; and ownership of branded merchandise. A four-level MRI was derived: 1.low PoS marketing exposure only; 2. hi...

Research paper thumbnail of Risk factors associated with tobacco, alcohol and drug use among adolescents attending secondary school in three cities from Argentina

Archivos argentinos de pediatria, Apr 1, 2017

Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors as... more Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR:...

Research paper thumbnail of Time trends for tobacco and alcohol use in youth-rated films popular in Mexico and Argentina, from 2004-2012

Salud Pública de México, 2017

Objective. To examine and compare overall prevalence and time trends in tobacco and alcohol portr... more Objective. To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. Materials and methods. Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant crosscountry differences in the mean number of tobacco and alcohol seconds. Results. Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001) and (OR=7.2; p<0.001). Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. Conclusions. Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.

Research paper thumbnail of La Importancia Del Uso Sistematico De Escalas De Depresion en Cesacion Tabaquica

European Scientific Journal, May 26, 2015

Research paper thumbnail of Parental Restriction of Mature-rated Media and Its Association with Substance Use among Argentinian Adolescents

Academic Pediatrics, 2015

To assess the independent relation between parental restrictions on mature-rated media (M-RM) and... more To assess the independent relation between parental restrictions on mature-rated media (M-RM) and substance use among South American adolescents. Cross-sectional school-based youth survey of n=3,172 students (mean age 12.8 years; 57.6% boys) in three large Argentinian cities. The anonymous survey queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Adolescents reported M-RM restriction for internet and videogames use, television programming and movies rated for adults. Multivariate logistic regression models assessed the association between parental M-RM restriction and substance use after adjusting for hourly media use, measures of authoritative parenting style, sociodemographics, and sensation seeking. Substance use rates were 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking, and 8% for illicit drug use (marijuana or cocaine). Half of respondents reported parental M-RM restriction (internet 52%, TV 43%, adult movies 34%, videogame 25%). Parental M-RM restriction was only modestly correlated with authoritative parenting measures. In multivariate analyses M-RM restriction on all four venues was strongly protective for all substance use outcomes. Compared with no restriction, odds ratios for substance use for full restrictions were 0.32 (0.18-0.59), 0.53 (0.38-0.07), 0.36 (0.22-0.59), and 0.49 (0.26-0.92) for current smoking, drinking, binge drinking, and illicit drug use respectively. The most important single M-RM venue was movies. This study confirms the protective association between parental M-RM restriction during adolescence and multiple substance use outcomes, including illicit drugs. M-RM restriction is independent of traditional parenting measures. The preponderance of the evidence supports intervention development.

Research paper thumbnail of Validation of Non-Smoking Status by Spouse Following a Cessation Intervention

Journal of Smoking Cessation, 2015

Background: Following cessation interventions, self-reported smoking abstinence with biochemical ... more Background: Following cessation interventions, self-reported smoking abstinence with biochemical verification is the “gold standard” for defining outcomes. Because obtaining biochemical verification is challenging in community studies, we compared self-reported cessation among smokers completing treatment to the smoking status reported by each participant's spouse or proxy. Method: Participants were smokers who had reported quitting 12 months after a cessation intervention. Participants had either attended a smoking cessation clinic or they were patients seen by physicians who had recently participated in a cessation-training program. Proxies living with these participants were interviewed by telephone to ask about their partner's smoking status. We compared the participants' responses to those from their spouses. Results: At 12 months, 346 of 1423 baseline smokers had quit; 161/346 reported non-smokers were called and 140 proxies were interviewed. The participants avera...

Research paper thumbnail of Tobacco industry targeting youth in Argentina

Tobacco Control, 2008

Background/aim: Argentina has one of the highest cigarette smoking rates among both men and women... more Background/aim: Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. Methods: We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. Results: The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco (BAT) undertook a young adult psychographic study and classified them as ''progressives'', ''Jurassics'' or ''conservatives'' and ''crudos'' or ''spoiled brats''. BAT marketed Lucky Strike to the ''progressives'' using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with ''nationalistic values'' in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. Conclusions: The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions.

Research paper thumbnail of Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth? A comparison of rating systems in Argentina, Brazil, Mexico, and the United States

Background: This study aimed to determine between-country differences and changes over time in th... more Background: This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States.

Research paper thumbnail of Piggybacking as a media advocacy strategy to increase enrolments in a gender-oriented smoking cessation programme

Tobacco Control, 2013

Argentina is probably moving to the third phase of the smoking epidemic. Female smoking prevalenc... more Argentina is probably moving to the third phase of the smoking epidemic. Female smoking prevalence is expected to increase over the coming years. In Argentina, smoking cessation programmes usually do not provide specific treatment tailored to women. We implemented a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;piggybacking&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; media strategy with the goal of announcing the opening of the first gender-oriented smoking cessation programme in Argentina. Piggybacking is a well-known media advocacy strategy in which the newsworthiness of a particular story is increased by releasing it at the same time as a breaking news story about a related topic. We prepared a press release/report about tobacco use among women, as well as our gender-oriented clinic, for the local news media, which appeared in print around the time a well-known young Argentinean actress died. To assess the impact of this strategy, we reviewed media coverage after the press release was issued. We also compared the number of new participants in our programme during the 4 months before and after the report&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s publication. During the 4 months following our press release, we found five reports in print media, gave 22 radio and seven television interviews, and found 30 digital media publications drawing on our press release. When comparing the 4 months before with the 4 months after the strategy, new participants in our programme increased by 246.15%. This strategy could be a suitable alternative to other media advocacy strategies to increase the number of new participants in smoking cessation programmes.

Research paper thumbnail of Tobacco advertising and press coverage of smoking and health in 10years of Argentinean newspapers

CVD Prevention and Control, 2011

Objective: To describe the extent and content of tobacco-related images, advertising and articles... more Objective: To describe the extent and content of tobacco-related images, advertising and articles published in the largest Argentinean newspapers before and after a voluntary advertising ban implemented in 2001. Methods: Issues from four months of each year of the four main national newspapers were examined from 1995 to 2004. We recorded the number of tobacco images (advertisement or not), tobacco-focused articles, space used, and placement within the newspaper. Regression analyses evaluated time trends. Results: We identified 1800 images and articles from 4828 different issues. Non-advertisement images were the most frequent (71.2%), followed by articles (20%) and advertisement images (8.8%). Advertisements only appeared in the two best selling newspapers with a majority (57%) in the Sunday magazine and 21% in the sports sections. Non-advertisement images were published in the sports and entertainment sections (55%) and showed a public figure in 88%. Of 336 articles, 39% focused on health topics and 55% emphasized the negative effects of tobacco on health. Regression models showed that prior to 2001 there were significant time-related decreases in ad images and articles and significant increases in non-ad images. The trend of each outcome changed direction beginning in 2001 and the magnitude of the change in trend was significant for ad images and non-ad images.

Research paper thumbnail of Smoking in Movies and Adolescent Smoking Initiation

American Journal of Preventive Medicine, 2013

Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of sm... more Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of smoking in movies and adolescent smoking onset. This study investigates whether adolescent smoking onset is predicted by the amount of exposure to smoking in movies across six European countries with various cultural and regulatory approaches to tobacco. Longitudinal survey of 9987 adolescent never-smokers recruited in the years 2009-2010 (mean age=13.2 years) in 112 state-funded schools from Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom (UK), and followed up in 2011. Exposure to movie smoking was estimated from 250 top-grossing movies in each country. Multilevel mixed-effects Poisson regressions were performed in 2012 to assess the relationship between exposure at baseline and smoking status at follow-up. During the observation period (M=12 months), 17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TV screen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13% (95% CI=8%, 17%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The crude relationship between movie smoking exposure and smoking initiation was significant in all countries; after covariate adjustment, the relationship remained significant in Germany, Iceland, The Netherlands, Poland, and UK. Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exposure to movie smoking might be an effective way to decrease adolescent smoking onset.

Research paper thumbnail of Exposure to advertising of tobacco products at points of sale and consumption of tobacco in adolescents from 3 large cities in Argentina. Cross-sectional study

Tobacco Induced Diseases, 2018

Research paper thumbnail of Factores de riesgo asociados al consumo de tabaco, alcohol y otras drogas en adolescentes escolarizados de tres ciudades de Argentina

Archivos Argentinos de Pediatria

Comunicaciones breves RESUMEN El consumo de tabaco, alcohol y otras drogas comienza a temprana ed... more Comunicaciones breves RESUMEN El consumo de tabaco, alcohol y otras drogas comienza a temprana edad. Es importante identificar los factores de riesgo asociados al inicio. En 2014, se encuestaron estudiantes de primer año del secundario en Buenos Aires, Córdoba y Tucumán. Respondieron 3172 alumnos (42% de mujeres); edad media de 12,8 años. El 10% había fumado; el 32% había consumido alcohol; el 17% había tenido consumo excesivo durante el último mes, y 8% había consumido, al menos, una droga ilícita en su vida. El índice de búsqueda de emociones alto se asoció al consumo de tabaco (

Research paper thumbnail of Evaluación de la efectividad de un programa de cesación tabáquica

Introduction. Although many therapeutic interventions have proven efficacy through randomized con... more Introduction. Although many therapeutic interventions have proven efficacy through randomized control trials (RCT) with extensive use in Neonatal Intensive Care Units (NICU) for Very Low Birth Weight Infants (VLBWI), doubts remain about its overall effectiveness. Objective. To ...

Research paper thumbnail of Prevalence of non psychotic mental disorders in smokers assisted in a unit of smoking cessattion in Buenos Aires City: cross sectional study

Several researches showed that the prevalence of anxiety and depression are higher in smokers. Th... more Several researches showed that the prevalence of anxiety and depression are higher in smokers. There is significant variability in the literature depending if we consider cross-sectional studies conducted in the general population, population attended in primary care or at smoking cessation clinics. In Argentina there is not of studies which describe prevalence in this área. Objective: The main objective is to describe the prevalence of depression and non-psychotic mental disorders (NPMD) in patients treated at a smoking cessation unit. In addition, the prevalence of previous psychiatric disease and use of psychotropic drugs in this population are described. Method: This is a cross-sectional study conducted in patients assisted during 2008-2014 at the smoking cessation unit of the General Internal Medicine Program (SCU-PMIG), an ambulatory clinic for adult patients from the “Hospital de Clínicas”, University of Buenos Aires, Argentina. The sample included 665 patients selected syste...

Research paper thumbnail of An Argentinean icon as a useful tool to sell BAT's cigarettes

Tobacco Control, 2008

In 1995, Marlboro was the leading brand of cigarettes in Argentina. In order to challenge Marlbor... more In 1995, Marlboro was the leading brand of cigarettes in Argentina. In order to challenge Marlboro's position, BAT undertook a psychographic study of Argentinean youth. They found that based on their political and religious convictions ''young adults'' could be classified into three different groups: ''progressives,'' ''jurassics,'' and ''crudos'' or ''spoiled brats.'' ''Jurassics,'' or conservatives, representing 40% of the youth market, were strict, macho, religious, pro-United States and nationalistic. 1 Using this research, BAT developed a strategy for their main national brand, Jockey Club (JC), to compete with Marlboro in this large and important segment. BAT have linked JC with the ''national values'' important to the jurassics, such as family, friendship, the father/son relationship and love of country. 2 Cigarette packaging has long been recognised by tobacco companies as one of the most effective marketing tools and so BAT redesigned the JC pack to gain market share in the Jurassic segment. This new design, unlike BAT's traditional red packaging, is black with silver thread, using a well known local painting technique ''fileteado porteño'' (fig 1). Since the middle of 2007, it has been available in local kiosks and tobacco stores. What does ''fileteado porteño'' mean? Literally, ''filete'' is a fine thread used in decoration and ''porteño'' signifies anything related to a port. In Buenos Aires, however, the port is central to the city's identity, and the word has taken on a special meaning. ''Porteño'' can be used to refer to the people of Buenos Aires or to any other element specific to the city. Together, the words ''fileteado porteño'' denote a popular decorative pictorial art form born in Buenos Aires. If Buenos Aires is identified musically with the tango, the ''fileteado porteño'' is its iconography (fig 2). Flowers, ribbons, leaves and birds in strong colours are their

Research paper thumbnail of Assessing tobacco marketing receptivity among youth: integrating point of sale marketing, cigarette package branding and branded merchandise

Tobacco Control, 2015

Background As countries prohibit tobacco marketing through traditional channels, marketing at poi... more Background As countries prohibit tobacco marketing through traditional channels, marketing at point of sale (PoS) and through tobacco packaging is increasingly important for promoting tobacco consumption. Objectives Assess the validity of a novel marketing receptivity index that considers frequency of PoS exposures, tobacco brand recall and ownership of branded merchandise. Methods Data come from a cross-sectional survey of 3172 secondary school students in Argentina. Questions assessed frequency of going to stores where tobacco is often sold; cued recall of brand names for 3 cigarette packages with brand name removed and ownership of branded merchandise. A four-level marketing receptivity index was derived: low PoS exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise. Indicators of marketing receptivity and smoking involvement were regressed on the index, including in adjusted models that controlled for sociodemographics, social influences and sensation seeking. Findings Among never-smokers, the index had independent positive associations with smoking susceptibility (ie, adjusted OR (AOR) 2v1 =1.66; AOR 3v1 =1.64; AOR 4v1 =2.95), willingness to try a specific brand (ie, AOR 2v1 =1.45; AOR 3v1 =2.38; AOR 4v1 =2.20) and positive smoking expectancies (ie, B adj 2v1 =0.09; B adj 3v1 =0.18; B adj 4v1 =0.34). A more marked dose-response independent association was found with current smoking behaviour (ie, AOR 2v1 =2.47; AOR 3v1 =3.16; AOR 4v1 =3.62). Conclusions The marketing receptivity index was associated with important variation in smoking-related perceptions, intentions and behaviour among Argentine adolescents. Future research should determine the predictive validity and generalisability of this measure to other contexts, including the explanatory power gained by integrating cigarette package brand recognition tasks.

Research paper thumbnail of Movies promote tobacco use amongst adolescents: The need for policies to prevent this phenomenon

Revista de la Asociacion Medica Argentina, 2018

Tobacco use is the primary preventable cause of death and disability in the world. To combat the ... more Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation's Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.

Research paper thumbnail of Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents

Salud Pública de México

Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adole... more Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents.

Research paper thumbnail of Predictive validity of the tobacco marketing receptivity index among non-smoking youth

Addictive behaviors, Jan 2, 2018

In a previous cross-sectional study of early adolescents, we developed a marketing receptivity in... more In a previous cross-sectional study of early adolescents, we developed a marketing receptivity index (MRI) that integrates point-of-sale (PoS) marketing exposures, brand recall, and ownership of branded merchandise. The MRI had independent, positive associations with smoking susceptibility among never smokers and with current smoking behavior. The current longitudinal study assessed the MRI's predictive validity among adolescents who have never smoked cigarettes METHODS: Data come from a longitudinal, school-based survey of 33 secondary schools in Argentina. Students who had never smoked at baseline were followed up approximately 17months later (n=1700). Questions assessed: PoS marketing exposure by querying frequency of going to stores where tobacco is commonly sold; cued recall of brand names for 3 cigarette packages from dominant brands but with the brand name removed; and ownership of branded merchandise. A four-level MRI was derived: 1.low PoS marketing exposure only; 2. hi...

Research paper thumbnail of Risk factors associated with tobacco, alcohol and drug use among adolescents attending secondary school in three cities from Argentina

Archivos argentinos de pediatria, Apr 1, 2017

Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors as... more Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR:...

Research paper thumbnail of Time trends for tobacco and alcohol use in youth-rated films popular in Mexico and Argentina, from 2004-2012

Salud Pública de México, 2017

Objective. To examine and compare overall prevalence and time trends in tobacco and alcohol portr... more Objective. To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. Materials and methods. Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant crosscountry differences in the mean number of tobacco and alcohol seconds. Results. Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001) and (OR=7.2; p<0.001). Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. Conclusions. Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.

Research paper thumbnail of La Importancia Del Uso Sistematico De Escalas De Depresion en Cesacion Tabaquica

European Scientific Journal, May 26, 2015

Research paper thumbnail of Parental Restriction of Mature-rated Media and Its Association with Substance Use among Argentinian Adolescents

Academic Pediatrics, 2015

To assess the independent relation between parental restrictions on mature-rated media (M-RM) and... more To assess the independent relation between parental restrictions on mature-rated media (M-RM) and substance use among South American adolescents. Cross-sectional school-based youth survey of n=3,172 students (mean age 12.8 years; 57.6% boys) in three large Argentinian cities. The anonymous survey queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Adolescents reported M-RM restriction for internet and videogames use, television programming and movies rated for adults. Multivariate logistic regression models assessed the association between parental M-RM restriction and substance use after adjusting for hourly media use, measures of authoritative parenting style, sociodemographics, and sensation seeking. Substance use rates were 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking, and 8% for illicit drug use (marijuana or cocaine). Half of respondents reported parental M-RM restriction (internet 52%, TV 43%, adult movies 34%, videogame 25%). Parental M-RM restriction was only modestly correlated with authoritative parenting measures. In multivariate analyses M-RM restriction on all four venues was strongly protective for all substance use outcomes. Compared with no restriction, odds ratios for substance use for full restrictions were 0.32 (0.18-0.59), 0.53 (0.38-0.07), 0.36 (0.22-0.59), and 0.49 (0.26-0.92) for current smoking, drinking, binge drinking, and illicit drug use respectively. The most important single M-RM venue was movies. This study confirms the protective association between parental M-RM restriction during adolescence and multiple substance use outcomes, including illicit drugs. M-RM restriction is independent of traditional parenting measures. The preponderance of the evidence supports intervention development.

Research paper thumbnail of Validation of Non-Smoking Status by Spouse Following a Cessation Intervention

Journal of Smoking Cessation, 2015

Background: Following cessation interventions, self-reported smoking abstinence with biochemical ... more Background: Following cessation interventions, self-reported smoking abstinence with biochemical verification is the “gold standard” for defining outcomes. Because obtaining biochemical verification is challenging in community studies, we compared self-reported cessation among smokers completing treatment to the smoking status reported by each participant's spouse or proxy. Method: Participants were smokers who had reported quitting 12 months after a cessation intervention. Participants had either attended a smoking cessation clinic or they were patients seen by physicians who had recently participated in a cessation-training program. Proxies living with these participants were interviewed by telephone to ask about their partner's smoking status. We compared the participants' responses to those from their spouses. Results: At 12 months, 346 of 1423 baseline smokers had quit; 161/346 reported non-smokers were called and 140 proxies were interviewed. The participants avera...

Research paper thumbnail of Tobacco industry targeting youth in Argentina

Tobacco Control, 2008

Background/aim: Argentina has one of the highest cigarette smoking rates among both men and women... more Background/aim: Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. Methods: We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. Results: The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco (BAT) undertook a young adult psychographic study and classified them as ''progressives'', ''Jurassics'' or ''conservatives'' and ''crudos'' or ''spoiled brats''. BAT marketed Lucky Strike to the ''progressives'' using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with ''nationalistic values'' in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. Conclusions: The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions.

Research paper thumbnail of Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth? A comparison of rating systems in Argentina, Brazil, Mexico, and the United States

Background: This study aimed to determine between-country differences and changes over time in th... more Background: This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States.

Research paper thumbnail of Piggybacking as a media advocacy strategy to increase enrolments in a gender-oriented smoking cessation programme

Tobacco Control, 2013

Argentina is probably moving to the third phase of the smoking epidemic. Female smoking prevalenc... more Argentina is probably moving to the third phase of the smoking epidemic. Female smoking prevalence is expected to increase over the coming years. In Argentina, smoking cessation programmes usually do not provide specific treatment tailored to women. We implemented a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;piggybacking&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; media strategy with the goal of announcing the opening of the first gender-oriented smoking cessation programme in Argentina. Piggybacking is a well-known media advocacy strategy in which the newsworthiness of a particular story is increased by releasing it at the same time as a breaking news story about a related topic. We prepared a press release/report about tobacco use among women, as well as our gender-oriented clinic, for the local news media, which appeared in print around the time a well-known young Argentinean actress died. To assess the impact of this strategy, we reviewed media coverage after the press release was issued. We also compared the number of new participants in our programme during the 4 months before and after the report&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s publication. During the 4 months following our press release, we found five reports in print media, gave 22 radio and seven television interviews, and found 30 digital media publications drawing on our press release. When comparing the 4 months before with the 4 months after the strategy, new participants in our programme increased by 246.15%. This strategy could be a suitable alternative to other media advocacy strategies to increase the number of new participants in smoking cessation programmes.

Research paper thumbnail of Tobacco advertising and press coverage of smoking and health in 10years of Argentinean newspapers

CVD Prevention and Control, 2011

Objective: To describe the extent and content of tobacco-related images, advertising and articles... more Objective: To describe the extent and content of tobacco-related images, advertising and articles published in the largest Argentinean newspapers before and after a voluntary advertising ban implemented in 2001. Methods: Issues from four months of each year of the four main national newspapers were examined from 1995 to 2004. We recorded the number of tobacco images (advertisement or not), tobacco-focused articles, space used, and placement within the newspaper. Regression analyses evaluated time trends. Results: We identified 1800 images and articles from 4828 different issues. Non-advertisement images were the most frequent (71.2%), followed by articles (20%) and advertisement images (8.8%). Advertisements only appeared in the two best selling newspapers with a majority (57%) in the Sunday magazine and 21% in the sports sections. Non-advertisement images were published in the sports and entertainment sections (55%) and showed a public figure in 88%. Of 336 articles, 39% focused on health topics and 55% emphasized the negative effects of tobacco on health. Regression models showed that prior to 2001 there were significant time-related decreases in ad images and articles and significant increases in non-ad images. The trend of each outcome changed direction beginning in 2001 and the magnitude of the change in trend was significant for ad images and non-ad images.

Research paper thumbnail of Smoking in Movies and Adolescent Smoking Initiation

American Journal of Preventive Medicine, 2013

Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of sm... more Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of smoking in movies and adolescent smoking onset. This study investigates whether adolescent smoking onset is predicted by the amount of exposure to smoking in movies across six European countries with various cultural and regulatory approaches to tobacco. Longitudinal survey of 9987 adolescent never-smokers recruited in the years 2009-2010 (mean age=13.2 years) in 112 state-funded schools from Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom (UK), and followed up in 2011. Exposure to movie smoking was estimated from 250 top-grossing movies in each country. Multilevel mixed-effects Poisson regressions were performed in 2012 to assess the relationship between exposure at baseline and smoking status at follow-up. During the observation period (M=12 months), 17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TV screen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13% (95% CI=8%, 17%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The crude relationship between movie smoking exposure and smoking initiation was significant in all countries; after covariate adjustment, the relationship remained significant in Germany, Iceland, The Netherlands, Poland, and UK. Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exposure to movie smoking might be an effective way to decrease adolescent smoking onset.