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. 2011 Oct 5;2011(10):CD003439. doi: 10.1002/14651858.CD003439.pub2

Hanewinkel 2011.

Methods Cohort Study
Baseline survey: 2008
Follow‐up: 9 months after baseline
Site: Brandenburg, Hamburg, and Schleswig‐Holstein, Germany
Research Question: Is there is a specific association between cigarette advertisements and adolescent smoking initiation?
Analysis: Multilevel mixed‐effects Poisson regression was used to determine the associations between the amount of advertising exposure and smoking initiation.
Controlled for age, gender, socioeconomic status, parent smoking, peer smoking, rebelliousness, sensation‐seeing, school performance, and average television screen time.
Participants 2346 students, aged 10‐17 and who were not smokers at baseline completed the first survey (81.4% response rate).
2102 completed the follow‐up survey (89.6% retention rate).
Survey method: School‐based survey
Interventions At baseline, participants were provided with masked coloured images of different advertisements (6 cigarette advertisements and 8 'control' advertisements for other consumer brands). Other consumer brands included sweets, clothes, mobile telephones and cars. Images were mostly from billboard and television advertisements. All brand information was digitally removed. Two measures of exposure were combined into a single scale:
(1) Advertisement contact frequency was measured by asking students to rate, on a 4‐point scale, how often they had seen the advertisement extract (0 = never; 1= 1‐4 times; 2 = 5‐10 times; 3 = >10 times).
(2) Cued brand recall performance was measured by asking students to name the brand that was advertised (open format). Correct brand names were post coded as 1 and all other answers as 0 (misspellings of brand were counted as correct).
Outcomes Lifetime smoking was assessed at baseline and 9‐months follow‐up by asking "How many cigarettes have you smoked in your life?" (never, smoked, just a few puffs, 1‐19 cigarette, 20‐100 cigarettes, or >100 cigarettes). The cohort consisted of participants who had never smoked at baseline. Any smoking at follow‐up, even just a few puffs, was considered initiation of smoking.
Notes