Understanding Newport Brand Preference in Young Adult Urban African Americans Living in Inner City Baltimore ACS: Bridging the Health Care Divide Conference April 18 – 20, 2007 Simona C. Kwon, DrPH, MPH Frances Stillman, EdD, Lee R. Bone, MPH,RN, Katherine Smith, PhD, Norman Yancey, Community Advisory Board

 Absence of research on non-college attending, inner-city adults years of age.  Tobacco industry is targeting this age group  Preliminary community survey findings indicate 66% are current smokers (64% females & 68% males (N=150)).  Of current smokers, 96% report smoking Newport brand cigarettes Smoking in the Target Group

Study Aims  To explore the socio-cultural meaning of tobacco use to understand why this population of urban young African Americans smoke exclusively Newport brand cigarettes using a CBPR approach.  To use this information to develop strategies to properly target tobacco control activities to this population.

Community-Academia Partnerships   Community: Community Building in Partnership, Inc. Youth Build-Education & Job Training (16-21 yrs old) Urban Youth Corp Education & Job Training* (18-24 yrs old) Youth Opportunities Program (YO!) (18 – 24 yrs old)   Academia: Bloomberg School of Public Health, Johns Hopkins University

African Americans & Mentholated Cigarettes   Mentholated cigarettes are smoked by more African American smokers (70%) compared to whites (30%).   Studies indicate African Americans report fewer & less successful quit attempts than whites.   While African Americans smoke fewer cigarettes/day than whites: They have disproportionately higher mortality rates for lung cancer; They have been found to have higher levels of cotinine. Nicotine & Tobacco Research, 2004; Chest, 1996; 110(5):

Potential Factor Influencing Mentholated Cigarette Use   Targeted marketing to young, urban African Americans   the use of menthol as a folk remedy in African American culture,   a strongly developed ethnic identity and social cohesion in urban African American enclaves.

Targeted Marketing   In the 1960s tobacco companies began marketing mentholated cigarettes directly to the urban African American community.   At the same time, mentholated tobacco companies donated money to black community organizations, and civil rights groups.   From the 1950s s mentholated cigarette use in the African American community more than tripled.

Targeted Marketing cont. 70’s Newport Ad X

Newport’s Share of 18 Year Old Smokers (1939 – 1979)

Targeted Marketing cont.

Study Methods   Target Population Members of the Urban Youth Corps Program aged years.   4 Focus Groups of 6-8 participants (N=29). 19 current smokers 10 non-smokers (former or never smokers).   In-depth Interviews 7 individual face-to-face, in-depth interviews

Study Implementation   1. Regular attendance of UYC meetings Developing rapport   2. Held discussion groups on the topic Gauging feasibility of study Working collaboratively to create the topic guide   3. Began data collection

Study Participants Current Smokers (N=19) Non-Smokers (N=10) Former SmokerNever Smoker Gender14 Males5 Females 1 Male 5 Female 2 Males 2 Females Age of initiation 14 years old13 years old Avg. # cig/day Brand Preference Newport*Newport

Study Findings 3 major themes identified around the successful marketing of Newport in the target community:   Newport cigarettes are viewed as the only cigarette for this young, urban, black community;   Newport cigarettes are a ubiquitous part of the community landscape;   Smokers reported being addicted to Newport (not all cigarettes).

Study Findings Target populations positive Newport brand association: Because they [Newport] the best cigarette--the flavor, the tobacco, the color of them, everything. (Y+) I think its [Newport] the most top notch brand that’s out there. (P-) M: Newports is #1 and Kools is like #2 A: No, Kools is like #6. Newports is 1, 2, 3, 4, and 5 in Baltimore. (+)

Study Findings Newport viewed as the preferred brand for the young, urban, black community. Oh Yeah, Newports, that’s just straight African- American. (P-) Us, black people smoke Newports. (Y+) I know people that smoke Newports look a little funny when they see someone [from the neighborhood] go into a store and buy like a pack a generic cigarettes or something. I know I do ‘cause I don’t know how people can smoke that. (R+)

Study Findings This happened to me, my homeboy smokes Kool right and I smoke Newport. We went in there [into a store] and he’s like, ‘ let me have a pack of Kools,’ and I said, ‘man don’t come around me with that,’ and he was like low. I: Why? Kools, because it’s not like urban. You ain’t catch a black person smoking Kools like that, not young anyway. They smoke Newports. (C+)

Study Findings Newport’s pervasiveness in the community: Majority of black people smoke Newport. It’s just been passed on, down and down the line. (B+) It’s because it’s the brand back in the day that was marketed the most to the black community. …it’s the real reason why we smoke. They put it out there. We come to it now. It’s now like—it’s almost like hereditary now. Your mama smoke it, your grandma smoked it. You gonna smoke it. (M+)

Study Findings cont. Like my father, he smoked Newports. Everywhere I went at when I was younger that’s all I saw the green pack--the green pack and I knew they was Newports…And most people see it around [people smoking Newports]. Like everywhere in urban cities and urban neighborhoods too…It’s [Newports] a part of life like the everyday routine. It’s what you see. (C+)

Study Findings Being addicted to Newport: I been smoking Newports since I started smoking so that’s like the only brand that I really know for real and if I tried to smoke another cigarette, it wouldn’t taste the same as a Newport. If offered a Camel cigarette: I don’t do Camels. If that’s all there was, I’d go to the store and buy a loose one [Newport]. (K+) If Newport or sometimes other menthol cigarettes were not available, the majority of current smokers said they would rather forego a smoke.

Study Conclusions   Smoking Newport cigarettes is a well established social and cultural norm in this isolated urban community.   Newport cigarettes have successfully aligned themselves in this community as the cigarette of choice for urban African Americans.   To successfully target smoking in this community, need to address the popularity of the Newport brand and subsequently the different challenges and characteristics of Newport smokers.

Study Implications Because of the dominance of Newport in this community, successful interventions to reduce smoking in this group must address the brand preference. Working with our partners, findings from this study will be used to develop strategies to effectively address the high smoking rates among non- college attending year olds enrolled in work-education training programs in inner city Baltimore.