>> GOOD MORNING, EVERYONE.
WELCOME TO THE NIMHD DIR
SEMINAR.
I'M YOUR HOST AND SCIENTIFIC
DIRECTOR OF THE NIMHD DIVISION
OF INTRAMURAL RESEARCH.
TODAY I AM VERY EXCITED TO BRING
YOU OUR SPEAKER.
NOW BEFORE I GO ON, I JUST WANT
TO WISH EVERYBODY AN EARLY
VALENTINE'S DAY, HOPE YOU HAVE A
SWEET DAY TOMORROW.
OUR SPEAKER TODAY IS
DR. LILIANNA PHAN, WHO IS A
SOCIAL AND BEHAVIORAL SCIENTIST
FOCUSED ON -- SHE UTILIZES
COMMUNITY ENGAGED MIXED
METHOD -- APPROACHES TO
UNDERSTANDING PSYCHOLOGICAL AND
SOCIAL FACTORS ASSOCIATED WITH
COMMERCIAL TOBACCO USE AND TO
DEVELOP HEALTH EDUCATION
INTERVENTION.
HER ONGOING NIH FDA FUNDED AWARD
K99/R00 FOCUSES ON DEVELOPING
CIGARETTE SMOKING PREVENTION
MESSAGES AMONG BLACK YOUNG
ADULTS.
-- AMONG RACIALLY MINORITIZED
POPULATIONS, PARTICULARLY YOUNG
ADULTS, BOTH LOCALLY AND
NATIONALLY.
DR. PHAN IS AN ASSISTANT
PROFESSOR AT DREXEL UNIVERSITY
THROUGH THE NIH COMMON FUND
FACULTY INSTITUTIONAL
RECRUITMENT FOR SUSTAINABLE
TRANSFORMATION PROGRAM, THE
FIRST PROGRAM, AT DREXEL
UNIVERSITY.
THE NIH FIRST PROGRAM AIMS TO
ENHANCE AND MAINTAIN CULTURES OF
INCLUSIVE LENS IN THE COMMUNITY.
SHE COMPLETED POSTDOCTORAL
TRAINING AT NIMHD DIVISION OF
INTRAMURAL RESEARCH THROUGH THE
INTRAMURAL RESEARCH TRAIN AIG
WARD.
AND SHE RECEIVED THE 2022
RESEARCH INNOVATION AWARD, AND
ALSO THE NIH SUMMER RESEARCH
MENTOR AWARD FOR THREE
CONSECUTIVE YEARS.
NOW ONE LITTLE LAST THING I
WOULD ADD IS THAT I HAD THE
FORTUNE TO ME MENTOR DR. PHAN AD
SHE IS DELIGHTFUL AND ALSO HAS A
VERY, VERY STRONG COMMITMENT TO
HEALTH DISPARITY RESEARCH.
SO I'M VERY HAPPY TO HAVE HER
TODAY AND I HOPE YOU ALL ENJOY
HER PRESENTATION.
WITHOUT FURTHER ADO, THE PODIUM
IS YOURS.
>> THANK YOU FOR THAT GENEROUS
AND WARM WELCOME.
THANK YOU SO MUCH FOR HAVING ME,
AND I'M VERY APPRECIATIVE OF
THIS OPPORTUNITY TO SHARE MORE
ABOUT OUR RESEARCH THROUGH THE
COLEMAN AWARD.
I'D LIKE TO START OFF OUR TIME
TOGETHER BY FIRST ACKNOWLEDGING
DR. COLEMAN AND HIS LEGACY.
DR. COLEMAN WAS THE FIRST
PERMANENT AFRICAN AMERICAN
SCIENTIFIC DIRECTOR AT NIH
THROUGH THE NIMHD DIR, AND
DR. COLEMAN WAS KNOWN FOR HIS
BELIEF IN THE POWER OF
MENTORSHIP.
AND ALTHOUGH I NEVER HAD AN
OPPORTUNITY TO MEET DR. COLEMAN
WITH HIS PASSING IN 2014,
THROUGH READING OTHER PEOPLE'S
STORIES ABOUT HIM AND LEARNING
MORE ABOUT HIS VALUES AS A
SCIENTIST, I REALLY HAVE COME TO
REFLECT THAT I'VE BE BENEFITED M
HIS VISION OF TRAINING FUTURE
SCIENTISTS.
UNDER HIS LEADERSHIP, THE
PROGRAM FOCUSED ON CANCER,
CARDIOVASCULAR DISEASE, AND
DIABETES, WHICH ALL THREE,
TOBACCO USE PRESENTS A HIGHER
RISK FOR.
SO MY FOCUS ON TOBACCO CONTROL
RESEARCH IS REALLY GROUNDED IN
THIS IDEA THAT IF WE CAN MOVE
THE NEEDLE AND ADDRESS TOBACCO
USE DISPARITIES, WE CAN ALSO
HELP WITH CANCER AND CHRONIC
DISEASES.
MY WORK IS ALSO GROUNDED IN THE
IDEA THAT COMMERCIAL TOBACCO USE
IS TRULY A SOCIAL JUSTICE ISSUE.
AND SO THINKING BACK TO 1954,
WITH THE FRANK STATEMENT TO
CIGARETTE SMOKERS, THROUGH THE
TOBACCO INDUSTRY AND ALSO THE
PUBLIC MANIPULATION OF
PERCEPTIONS WHERE THE TOBACCO
INDUSTRY REALLY KIND OF CREATED
THE VICTIM BLAMING NARRATIVE TO
DEFLECT BLAME FROM INDIVIDUALS
TO WHAT WE HAVE MORE PRESENT
DAY, WITH JUUL SENDING MILLIONS
TO PROMOTE E-CIGARETTES.
SO THOSE VALUES AND THAT
BACKGROUND REALLY KIND OF
EMPLPROVIDES A CONTEXT.
BUT LET'S START TALKING MORE
ABOUT CIGAR SMOKING IN THE
UNITED STATES.
USING DATA THROUGH THE NATIONAL
CANCER INSTITUTE TREND REPORT,
ON THE LEFT HERE, YOU SEE THE
FIGURE SHOWING THAT WE'VE MADE
TREMENDOUS DECLINES FROM 1965
THROUGH 2021 IN REDUCING THE
PREVALENCE OF CIGARETTE SMOKING
IN THE UNITED STATES AMONG U.S.
ADULTS, WHERE THE CURRENT
PREVALENCE IS ABOUT 11%.
THEN ON THE RIGHT HERE, WE SEE
THE PREVALENCE FOR CIGAR SMOKING
FROM 1998 THROUGH 2021, WHERE
THE PREVALENCE HAS REMAINED
STABLE IN THE UNITED STATES WITH
ABOUT 3.5% OF ADULTS CURRENTLY
SMOKING CIGARS.
SO WHEN WE DISAGGREGATE THE DATA
BY RACE, WE ACTUALLY SEE A VERY
DIFFERENT STORY.
USING THE NATIONAL SURVEY ON
DRUG USE AND HEALTH FROM 2002
THROUGH 2019, DR. PACEK AND TEAM
FOUND THAT CIGAR SMOKING HAS
INCREASED AMONG BLACK
INDIVIDUALS OVERALL DURING THIS
TIME PERIOD, AND THAT PREVALENCE
IS ABOUT 8%.
USING THE SAME DATA, OUR
RESEARCH HAS ALSO LOOKED AT AGE
OF CIGAR SMOKING INITIATION BY
BLACK INDIVIDUALS WHERE WE FIND
WIDENING EDUCATION-RELATED
DISPARITIES RELATED TO AGE OF
CIGAR SMOKING INITIATION.
AGE OF INITIATION FOR SMOKING IS
REALLY IMPORTANT AS A FACTOR TO
UNDERSTAND, BECAUSE IT'S
ASSOCIATED WITH HIGHER NICOTINE
DEPENDENCE, MORE DIFFICULTY WITH
CESSATION, AS WELL AS MORE
NEGATIVE HEALTH CONSEQUENCES.
AND SO WHILE THE CLASS OF CIGAR
PRODUCTS INCLUDES THREE
DIFFERENT TYPES OF TOBACCO
PRODUCTS, LITTLE FILTERED
CIGARS, CIGARILLOS AND LARGE
CIGARS, THE TWO TYPE OF CIGAR
PRODUCTS THAT ARE LARGELY
DRIVING THESE RACIAL DISPARITIES
EXPERIENCED BY BLACK INDIVIDUALS
ARE LITTLE FILTERED CIGARS AND
SICIGARILLOS.
THEY ARE DELIBERATELY MARKETED
TO SPECIFIC POPULATIONS
INCLUDING BLACK INDIVIDUALS AND
COMMUNITIES, AND THERE'S ALSO
VARYING USE PATTERNS FOR LITTLE
FILTERED CIGARS AND SILL CIGAR,
WHERE THE NATIONAL ACADEMY
CENSUS REPORT HAS SUGGESTED THAT
BECAUSE LITTLE FILTERED CIGARS
AND CIGARILLOS ARE USED AT A
GREATER FREQUENCY AND HIGHER
INTENSITY, THEIR HARM IS SIMILAR
TO THAT OF CIGARETTES AND WORSE
THAN LARGE CIGARS.
SO WE LOOKED AT THE PRE LA PREVE
USING THE 2018 THROUGH 2019
TOBACCO USE SUPPLEMENT TO THE
CURRENT POPULATION SURVEY.
WHAT WE SEE IS THAT BLACK ADULTS
18 TO 30 YEARS OLD HAVE THE
HIGHEST PREVALENCE OF LITTLE
FILTERED CIGAR AND CIGARILLO
SMOKING THAN ANY OTHER RACIAL
AND AGE GROUP IN THE UNITED
STATES.
WE ALSO SEE THAT COMPARED TO
WHITE YOUNG ADULTS, BLACK YOUNG
ADULTS HAVE ABOUT FOUR TIMES THE
ODDS OF SMOKING LITTLE FILTERED
CIGARS AND CIGARILLOS THAN NOT
SMOKING CIGARS AT ALL.
THEY ALSO HAVE ABOUT A FIVE
TIMES HIGHER ODDS OF SMOKING
LITTLE FILTERED CIGARS AND
CIGARILLOS COMPARED TO LARGE
CIGARS.
THIS ANALYSIS AS WELL AS OTHER
STUDIES HAVE SHOWN US THAT THESE
RACIAL DISPARITIES IN CIGAR
SMOKING SPAN ACROSS ADULTHOOD.
AND SO IF WE'RE ABLE TO MOVE THE
NEEDLE AND HELP TO PREVENT CIGAR
SMOKING AMONG BLACK YOUNG
ADULTS, WE CAN POTENTIALLY HAVE
A VERY LARGE IMPACT.
AND SO AS A BEHAVIORAL
SCIENTIST, I THOUGHT, YOU KNOW,
WHAT DO WE KNOW ABOUT CIGAR
SMOKING AMONG YOUNG ADULTS, WHAT
FACTORS ARE ASSOCIATED WITH IT,
AND WHAT CAN WE DO ABOUT IT?
SO I WAS REALLY INTERESTED AND
DRAWN TO DR. KIMBERLY STERLING'S
WORK, WHICH FOCUSES ON POSITIVE
AFFECT OR IN MY WORK, I'VE
ADAPTED IT AS POSITIVE ATTITUDES
TOWARDS CIGAR SMOKING.
DR. KIMBERLY STERLING AND TEAM'S
WORK HAS SHOWED THAT POSITIVE
AFFECT TOWARD CIGAR SMOKING
AMONG YOUNG ADULTS HAS BEEN
ASSOCIATED WITH LOWER
PERCEPTIONS OF HEALTH HARM FOR
DAILY SMOKE,, U. SUSCEPTIBILITYS
WELL AS CURRENT USE OF THIS
PRODUCT.
POSITIVE AFFECT HAS BEEN STUDIED
MORE AS AN OPEN-ENDED QUESTION,
SO JUST UNDERSTANDING WHETHER OR
NOT A YOUNG ADULT MAY PERCEIVE
CIGAR SMOKING POSITIVELY, LIKE
AS GOOD OR NEGATIVELY AS BAD.
SO SOME OTHER QUALITATIVE
RESEARCH THROUGH DR. STERLING
FOCUSES ON UNDERSTANDING MORE
POSITIVE AFFECT THEMES AMONG
YOUNG ADULTS, BUT THESE FOCUSED
MORE ON FLAVORED LITTLE CIGARS
AND CIGARILLOS.
MY CURRENT BODY OF RESEARCH IS
GROUNDED IN THE THEORY OF
PLANNED BEHAVIOR, WHERE IF WE
CONSIDER ATTITUDES TOWARD
SMOKING TO BE THIS POSITIVE
AFFECT CONSTRUCT, UNDERSTANDING
THE UNDERLYING BELIEFS CAN HELP
US MOVE THESE FACTORS IN ORDER
TO REDUCE INTENTION TO USE AND
ULTIMATELY REDUCE CIGAR SMOKING
AMONG BLACK YOUNG ADULTS.
AND SO FOR THE COLEMAN AWARD, I
WANTED TO BUILD ON THE PREVIOUS
RESEARCH BY EXPLORING BELIEFS
ABOUT CIGAR SMOKING,
SPECIFICALLY BY CIGAR TYPE AMONG
BLACK YOUNG ADULTS.
AND THEN ALSO THE SECOND GOAL
WAS TO DEVELOP A SELF-REPORTED
MEASURE OF OUTCOME EXPECTATIONS,
WHICH IS POSITIVE BEHAVIORAL
BELIEFS, OF CIGAR SMOKING BY
CIGAR TYPE FOR BLACK YOUNG
ADULTS THAT CAN BE USED IN
FUTURE RESEARCH.
AND SO JUST AS AN OVERVIEW OF
OUR METHOD, WE CONDUCTED BELIEVE
ELICIT -- THATWERE EITHER DEEMEE
BY FOUR DIFFERENT SUSCEPTIBILITY
SURVEY ITEMS OR HAVE
EXPERIMENTED WITH ONE OR MORE
CIGAR TYPE.
THE INTERVIEW LASTED ABOUT AN
HOUR EITHER BY PHONE OR ZOOM AND
PARTICIPANTS WERE COMPENSATED
$75 FOR THEIR TIME.
AND SO THIS IS HOW IN THIS
STUDY, WE WERE ABLE TO ADAPT AND
CONCEPTUALIZE THESE DIFFERENT
CATEGORIES OF BELIEFS.
SO WHAT WE DID IS, AT THE
BEGINNING OF THE PHONE CALL, I
INTRODUCED THE PARTICIPANT TO
THE WRITING EXERCISE TO CONDUCT
THE BELIEF ELICITATION EXERCISE,
AND WHAT WE DID IS I ASKED NINE
DIFFERENT QUESTIONS, AND SO AS
YOU CAN SEE HERE, THESE ARE THE
THREE DIFFERENT BELIEFS RELATED
TO THE THEORY OF PLANNED
BEHAVIOR, AND THEN THE QUESTIONS
THAT HELPED US CONCEPTUALIZE
THESE BELIEFS IN THE INTERVIEWS.
AND SO FOR EXAMPLE, BEHAVIORAL
BELIEFS, WHAT EMOTIONS OR
FEELINGS COME TO MIND WHEN YOU
THINK ABOUT SMOKING CIGARILLOS,
FOR EXAMPLE.
WE DID THESE SET OF QUESTIONS
FOR ALL THREE CIGAR TYPES, AS
WELL AS WHAT GOOD OR POSITIVE
THINGS COME TO MIND OR WHAT
NEGATIVE OR BAD THINGS COME TO
MIND.
AND FOR NORMATIVE BELIEFS,
THINKING ABOUT WHAT INDIVIDUALS
OR GROUPS OF PEOPLE IN YOUR LIFE
WOULD BE SUPPORTIVE OF YOU
SMOKING, FOR EXAMPLE, CIGARILLOS
OR WOULD NOT BE SUPPORTIVE OF
YOU SMOKING CIGARILLOS, AS WELL
AS WHAT INDIVIDUALS OR GROUPS OF
PEOPLE DO YOU THINK ARE MOST
LIKELY OR UNLIKELY TO SMOKE
CIGARILLOS, FOR EXAMPLE.
IN TERMS OF CONTROL BELIEFS, WE
LOOKED AT UNDERSTANDING MORE
ABOUT WHAT WOULD AN INDIVIDUAL
THICK WOULD MAKE IT EASIER OR
DIFFICULT FOR THEM TO TRY
CIGARILLOS, FOR EXAMPLE.
AND SO HERE IS A PICTURE OF MISS
KAYLEIGH FENTON, AMGEN SCHOLAR
WORKING WITH US.
AUDIO RECORDINGS WERE
TRANSCRIBED VERBATIM AND THERE
WAS AN ITERATIVE PROCESS WE WENT
THROUGH TO DEVELOP AND FINALIZE
THE CODE BOOK.
WE EXAMINED EMERGENT THEMES
WITHIN EACH BELIEF SO THAT
BEHAVIOR, NORMATIVE AND CONTROL
BELIEFS ACROSS THE CIGAR TYPES.
SO SHE CODED ALL THE
TRANSCRIPTS, I THINK IT WAS OVER
1500 DIFFERENT UNIQUE THEMES OR
CODES, AND THEN I SERVED AS THE
SECOND CODER, CODING 15% OF THE
TRANSCRIPTS.
RIGHT NOW, WE'RE STILL CODING,
AND SO THESE RESULTS THAT I'M
ABOUT TO SHARE ARE PRELIMINARY
RESULTS.
FOR PARTICIPANTS
CHARACTERISTICS, IN TERMS OF THE
SAMPLE, A LARGER MAJORITY, ABOUT
HALF, IDENTIFIED AS WOMEN.
THERE WAS ABOUT ALMOST AN EQUAL
DISTRIBUTION OF EDUCATION LEVEL,
AND THEN IN TERMS OF EMPLOYMENT,
ABOUT 44% WERE FULL-TIME
EMPLOYED.
THERE WAS ABOUT AN EQUAL
DISTRIBUTION FOR HOUSEHOLD
INCOME, AND THEN THE MAJORITY
IDENTIFIED AS
HETEROSEXUAL/SEXUAL ORIENTATION.
I'M GOING TO WALK US THROUGH THE
EMERGENT BELIEFS WITHIN EACH
BELIEF.
AND SO I'M JUST HIGHLIGHTING
MORE ABOUT THE GENERAL THEMES
THAT EMERGED.
SO FOR POSITIVE BEHAVIORAL
BELIEFS, GENERALLY PARTICIPANTS
HAD MORE GENERATIVE POSITIVE
FEELINGS OF THINKING THAT
CIGARILLOS AND LARGE CIGARS WERE
GOOD AND MORE POSITIVE THAN
LITTLE FILTERED CIGARS.
THEN FOR LARGE CIGARS, THE
FEELINGS THAT LARGE CIGARS WERE
ASSOCIATED WITH BEING AFFLUENT,
HAVING POSITIVE SOCIAL STATUS OR
BEING RELATED TO USE AMONG
CELEBRITIES EMERGED.
AND THEN FOR CIGARILLOS, IT WAS
REALLY ASSOCIATED WITH THIS
PERCEPTION OF IT BEING COOL OR
FUN OR RELATED TO FEELING HAPPY
DURING A SOCIAL EVENT, AND ALSO
AN INTEREST IN THE SENSORY
EXPERIENCE OF FLAVORS, TASTE AND
SMELL RELATED TO CIGARILLO
SMOKING.
RELAXATION, STRESS RELIEF AND
POSITIVE PHYSICAL EFFECTS FROM
NICOTINE SUCH AS EXPERIENCING A
NICOTINE BUZZ EMERGED FOR
CIGARILLOS AND LITTLE FILTERED
CIGARS.
AND THESE ARE SOME VERY BRIEF
QUOTES TO SUPPORT SOME OF THE EE
MER JEPT THEMESEMERGENT THEMES T
DESCRIBED.
FOR LARGE CIGARS, THINKING ABOUT
BERNIE MAC, DJ KHALID AND A
LUXURY BOAT, I AGAINST A SENSE
LIKE, YOU MADE IT.
FOR CIGARILLOS, ONE PARTICIPANT
MENTIONED THEY DO LIKE TRYING
NEW THINGS A LOT AND THEY THINK
IT'S FUN BUT GENERALLY THEY TRY
TO STAY AWAY FROM ANY SUBSTANCES
AND THINGS THAT MIGHT BE HARMFUL
TO THEIR HEALTH.
THE OTHER THING THAT WAS
MENTIONED WAS A PARTICIPANT
MENTIONED THE NICOTINE HEAD RUSH
THAT MIGHT BE A POSITIVE THINGS
THAT COMES TO MIND.
AND THAT FOR LITTLE FILTERED
CIGARS, IT WAS PERCEIVED MORE AS
A STRESS RELIEVER IN ORDER TO
PASS TIME.
SO SOMETHING AS LIKE A SOCIAL OR
AN ACTIVITY TO DO.
AND THEN ALSO A FOCUS ON THE
RELAXATION THAT YOU CAN GET FROM
IT.
IN TERMS OF NEGATIVE BEHAVIORAL
BELIEF, GENERALLY THE NEGATIVE
BELIEFS HAD EQUALLY EMERGED
ACROSS THE THREE CIGAR TYPES, AS
WELL AS FEELINGS OF DISGUST FROM
SMOKING AND ALSO CONCERN FOR
POLLUTION.
SO THINKING ABOUT THE TIP OF A
CIGAR PRODUCT OR THE BUTT, AND
HOW IT MIGHT BE POLLUTING THE
ENVIRONMENT OR JUST LOCAL
COMMUNITIES.
THEN ALSO THE IDEA THAT LARGE
CIGARS ARE ASSOCIATED WITH MORE
OF A NEGATIVE TASTE AND A LARGER
SIZE EMERGED AS NEGATIVE
BEHAVIORAL BELIEFS FOR LARGE
CIGARS.
IN TERMS OF MORE NORMATIVE
BELIEFS, SO WHAT INDIVIDUALS OR
GROUPS OF PEOPLE WOULD BE
SUPPORTIVE OF YOU USING A
PARTICULAR CIGAR PRODUCT.
THERE WAS SOME FEW REPORTING FA
FAMILY MEMBERS AND CO-WORKERS
WOULD SUPPORT THE PARTICIPANT IN
SMOKING A CIGAR PRODUCT.
BUT LARGELY, WE FOUND THAT FOR
CIGARILLOS, FRIENDS WOULD BE
SUPPORTIVE OF SMOKING CIGARILLOS
BY THE PARTICIPANT.
AND IN TERMS OF UNSUPPORTIVE
INDIVIDUALS IN ONE'S LIFE,
FAMILY INCLUDING GRANDPARENTS,
PARENTS OR SIBLINGS EMERGED
ACROSS THE THREE CIGAR TYPES.
SO THINKING ABOUT WHO
PARTICIPANTS MER RECE PERCEIVEDE
LIKELY AND UNLIKELY TO SMOKE
THESE THREE CIGAR PRODUCTS.
MIDDLE AGED ADULTS EMERGED FOR
ALL THREE.
CIGARILLOS WERE PERCEIVED TO BE
USED MOSTLY BY YOUTH AND YOUNG
ADULTS.
FOR LITTLE FILTERED CIGARS AND
LARGE CIGARS, THE THOUGHT THAT
THOSE WERE USED AMONG OLDER
ADULTS, AND WHILE CIGARILLOS
WERE USED MORE BROADLY AMONG
BOTH MEN AND WOMEN, LITTLE
FILTERED CIGARS AND LARGE CIGARS
WERE USED PREDOMINANTLY AMONG
MEN.
AND THEN FOR CIGARILLOS,
RELATIVE TO POSITIVE BEHAVIORAL
BELIEFS, THEY WERE ALSO THOUGHT
TO BE USED FOR THOSE WHO WERE
EXPERIENCING STRESS TO HELP
RELIEVE STRESS.
IN TERMS OF SOCIAL POSITION,
CIGARILLOS AND LITTLE FILTERED
CIGARS WERE SEEN TO BE USED
AMONG THOSE WITH HIGHER AND
LOWER SOCIOECONOMIC POSITION,
VERSUS LARGE CIGARS BEING USED
AMONG THOSE WITH HIGHER
SOCIOECONOMIC POSITION.
AND GENERALLY ACROSS THE THREE
DIFFERENT TYPES OF CIGAR
PRODUCTS, YOUNG ADULTS, YOUTH
AND WOMEN WERE THOUGHT TO BE
MOST LIKELY LI UNLIKELY TO SMOE
PRODUCTS.
FOR EASY TO USE, ACCESSIBILITY
CAME UP AS AN EMERGENT THEME FOR
CIGARILLOS.
AS WELL AS THE IDEA OF
ANTICIPATED POSITIVE MENTAL
HEALTH EFFECTS, SUCH AS THE
STRESS RELIEF WE MENTIONED
BEFORE AND NICOTINE BUZZ FOR
CIGARILLOS AND LITTLE FILTERED
CIGARS.
FOR CIGARILLOS, WE ALSO FOUND
THAT PARTICIPANTS FELT LIKE IF
SOMEONE OFFERED TO THEM, THEY
MIGHT BE WILLING TO TRY IT.
AND ALSO THAT IT WAS RELATED TO
SMOKING AT SOCIAL EVENTS OR
MAYBE FUN SETTINGS OR SOMEWHERE
THAT INVOLVED A SOCIAL ASPECT
PIECE.
AND THEN FOR LARGE CIGARS, THEY
WERE SEEN TO BE USED MORE LIKELY
AS A PART OF A SPECIAL OCCASION.
IN TERMS OF THINGS THAT WOULD
MAKE IT MORE DIFFICULT FOR A
PARTICIPANT TO USE A CIGAR
PRODUCT, ACCESSIBILITY AND COST
EMERGED ACROSS THE THREE CIGAR
TYPES.
AS WELL AS THE IDEA THAT SMOKING
CIGARILLOS OR LITTLE FILTERED
CIGARS WOULD NOT ALIGN WITH
ONE'S PERSONAL IDENTITY AND
VALUES.
AND THEN FOR LARGE CIGARS, THE
SMELL, LIKE SO A NEGATIVE
TOBACCO SMELL WAS ONE BELIEF
THAT WOULD MAKE IT DIFFICULT TO
TRY A LARGE CIGAR.
AND SO THOSE ARE A LOT OF
DIFFERENT THEMES WITHIN EACH
BELIEF, BUT IN SUMMARY, THESE
PRELIMINARY FINDINGS SHOW US
THAT THERE'S AN IMPORTANCE IN
POSITIVE BEHAVIORAL BELIEFS, SO
THERE'S ALSO SOME SALIENT
EMERGENT THEMES FOR EACH
DIFFERENT TYPE OF CIGAR PRODUCT
THAT SPANNED ACROSS BEHAVIORAL,
NORMATIVE AND CONTROL BELIEFS,
AND PERHAPS THAT'S SOMETHING
THAT SHOULD BE INVESTIGATED
MORE.
WITH THAT IN MIND, THERE'S ALL
THESE UNIQUE CIGAR PROFILES.
SO WITH CIGARILLOS, IT'S
ASSOCIATED WITH BEING COOL, FUN,
FEELING HAPPY, USED IN SOCIAL
SETTINGS, AND THAT YOUNG FRIENDS
WOULD BE MORE SUPPORTIVE OF
USING IT, AS WELL AS THAT IT
MIGHT HAVE ANTICIPATED POSITIVE
OUTCOME EXPECTATIONS RELATED TO
FEELING RELAXED OR BEING ABLE TO
HELP RELIEVE STRESS.
FOR LITTLE FILTERED CIGARS, IT
WAS THOUGHT MORE AS SOMETHING
FOR MIDDLE AGED OR OLDER ADULTS
TO USE, PARTICULARLY AMONG MEN,
AND THEY MAY ALSO HELP WITH
STRESS RELIEF.
AND THEN FOR LARGE CIGARS, THEY
WERE USED PARTICULARLY AMONG
INDIVIDUALS WITH HIGHER
SOCIOECONOMIC STATUS OR SOCIAL
POSITION, AND USED FOR ONLY
SPECIAL OCCASIONS.
AND SO BASED OFF OF OUR
PRELIMINARY FINDINGS AND REALLY
THINKING THROUGH THIS IDEA OF
THE SALE YEN SEE WITH POSITI
POSITIVE -- ACROSS THE THREE
DIFFERENT BELIEF CATEGORIES, I
WANTED TO KIND OF LEVERAGE THAT
UNDERSTANDING AND THINK MORE
ABOUT ACTION-ORIENTED RESEARCH
AND WHAT CAN WE DO.
AND SO THIS TO YOUR LEFT IS THE
COVER OF HEALTH EQUITY IN
TOBACCO PREVENTION AND CONTROL
BEST PRACTICES USER GUIDELINES
FROM THE CDC, AND ONE
RECOMMENDATION IN THAT IS THAT
IT'S TIME TO SWITCH THE MESSAGE
DEVELOPMENT PARADIGM.
SO TYPICALLY WHEN WE'RE DEVEL
DEVELOPING HEALTH COMMUNICATION
MESSAGES, WE DEVELOP A ONE SIZE
FITS ALL FOR THE POPULATION AND
THEN TAILOR IT TO CERTAIN
GROUPS.
AND WHAT THIS BEST PRACTICES IS
RECOMMENDING IS THAT WE ACTUALLY
START TO PRIORITIZE GROUPS THAT
WOULD MOST BENEFIT FROM HEALTH
COMMUNICATION IN ORDER TO
PROMOTE HEALTH EQUITY.
SO RIGHT NOW, THERE IS NO HEALTH
COMMUNICATION AT ALL TO ADDRESS
THE RACIAL DISPARITIES IN CIGAR
SMOKING, AND SO FOR MY K99 AND
R00, I FOCUSED ON DEVELOPING --
AND I AM FOCUSING ON DEVELOPING
CIGARILLO PUBLIC EDUCATION
MESSAGES FOR BLACK YOUNG ADULTS.
AND SO ON THE RIGHT HERE ARE MY
K99 MENTORS WHO HAVE JUST BEEN
SO INCREDIBLY GENEROUS WITH
THEIR TIME AND OPPORTUNITIES FOR
ME TO TRAIN AND LEARN FROM THEM.
SO THIS WORK IS, AGAIN, GROUNDED
IN THE IDEA OF THEORY OF PLANNED
BEHAVIOR, WHERE IF WE CAN START
TO ADDRESS THESE BEHAVIORAL
BELIEFS, MAYBE WE CAN CHANGE THE
POSITIVE AFFECT TO CHANGE
INTENTION AND ULTIMATELY REDUCE
CIGAR SMOKING AMONG BLACK YOUNG
ADULTS.
AND SO DURING THE K99 PHASE WHEN
I WAS A POSTDOC AT NIMHD DIR, I
FOCUSED ON DEVELOPING THE
CIGARILLO PUBLIC EDUCATION
MESSAGES THEMSELVES, AND SO WE
WENT THROUGH THE PROCESS OF
SELECTING DIFFERENT MESSAGE
THEMES AND THEN TESTING THE TEXT
PORTION OF THE MESSAGES.
SO HERE ARE TWO DIFFERENT
MESSAGE CONDITIONS.
AND SO I HAD MENTIONED THAT UP
UNTIL THIS POINT, THERE HAD NOT
BEEN ANY HEALTH COMMUNICATION ON
A POPULATION LEVEL FOR CIGARILLO
SMOKING.
AND SO THIS FIRST MESSAGE
CONDITION JUST FOCUSES ON
COMMUNICATING THE HEALTH HARM
AND NICOTINE ADDICTION RISK, SO
FOCUSING ON THE LONG TERM HEALTH
RISK, SHORT TERM HEALTH RISK,
SOCIAL HEALTH RISK AND NICOTINE
ADDICTION RISKS.
THEN FOR THE SECOND MESSAGE
CONDITION, WE USED WHAT WE FOUND
FROM THE COLEMAN FINDINGS TO
CONTEXTUALIZE THESE DIFFERENT
RISKS TO THE ANTICIPATED OUT
COME EXPECTATIONS OR POSITIVE
BEHAVIORAL BELIEFS.
SO THESE THEMES FOCUSED ON
SATISFACTION, THE IDEA OF
ANTICIPATED STRESS RELIEF OR
PLEASURE FROM THE SMOKING
EXPERIENCE, THE SENSORY
EXPERIENCE AS WELL, SO FOCUS ON
FLAVORS OR THE WAY THAT IT
SMELLS REALLY NICE.
THE IDEA THAT CIGARILLO SMOKING
IS ASSOCIATED TO BEING COOL OR
HAVING A FUN PE PERSONA, AS WELS
THE PERCEPTION THAT CIGARILLO
SMOKING CAN GO AGAINST ONE'S
PERSONAL VALUES AND
AUTHENTICITY.
AND SO WHAT YOU'LL SEE IS THAT
IN MESSAGE CONDITION ONE, FOR
EXAMPLE, IF YOU LOOK AT THIS
FIRST MESSAGE, WHAT WE DID IS WE
KEPT THE TEXAS SIMILAR AS
POSSIBLE BUT THEN CONTEXTUALIZED
TO THE THEME.
SO OVERALL WE HAVE 16 MESSAGES
WITHIN EACH MESSAGE CONDITION
FOR A TOTAL OF 32 MESSAGES.
WE JUST RECEIVED BACK THE
PRELIMINARY FINDINGS FROM
TESTING THE TEXT PORTION OF THE
MESSAGES.
WE USED QUALTRICS PANEL SERVICES
TO COMPLETE THE SURVEY AMONG
BLACK YOUNG ADULTS 18 TO 30
YEARS OLD WHO HAVE NEVER USED
TOBACCO PRODUCTS REGULARLY OR
HAVE EXPERIMENTED WITH CIGARILLO
SMOKING.
WHAT WE FOUND AS PRELIMINARY
FINDINGS IS THAT FOR PERCEIVED
MESSAGE EFFECTIVENESS, SO THE
IDEA THAT OVERALL THIS MESSAGE
CONDITION DISCOURAGED ME FROM
WANTING TO SMOKE, MADE ME
CONCERNED ABOUT THE HEALTH
EFFECTS, AND MADE ME CONCERNED
OR THINK THAT CIGARILLO SMOKING
WAS UNPLEASANT.
WE FOUND THAT OVERALL, THE
MESSAGES WERE RATED -- OR THE
MESSAGE CONDITIONS WERE RATED
PRETTY HIGHLY IN TERMS OF THE
OVERALL MESSAGE EFFECTIVENESS
ITEM, BUT THEN THAT MESSAGE
CONDITION ONE FOCUSED ON JUST
THE HEALTH HARM OR NICOTINE
ADDICTION RISK MIGHT BE
PERFORMING A LITTLE BIT HIGHER.
AND SO THEN WE ALSO LOOKED AT
HOW HARMFUL DO YOU THINK
CIGARILLOS ARE TO ONE'S HEALTH
OR HOW LIKELY IS SOMEONE TO BE
ADDICTED TO CIGARILLOS?
AND WE ALSO -- WHAT I SHOW HERE
IS THE PRE AND POST EXPOSURE
OUTCOMES FOR THIS, AND WHAT WE
ALSO SEE IS THAT FOR MESSAGE
CONDITION ONE, THEY'RE
PERFORMING JUST A LITTLE BIT
HIGHER, BUT AGAIN, THESE ARE
PRELIMINARY FINDINGS AND I
HAVEN'T DONE THE FULL ANALYSIS
YET OR CONTROLLED FOR ANYTHING.
WHAT IS INTERESTING, THOUGH,
BEYOND MESSAGE EFFECTIVENESS AND
HEALTH HARM AND NICOTINE
ADDICTION RISK PERCEPTION, IS
HOW THE CONTEXTUALIZED MESSAGES
MAY IMPACT ATTITUDES AROUND
CIGARILLO SMOKING GENERALLY
AMONG BLACK YOUNG ADULTS.
SO SOME EXCITING NEXT STEPS AT
THE PHAN LAB IS THAT FOR THE R0Y
DEVELOPING THE VISUAL DESIGN TO
PAIR WITH THE TEXT MESSAGE, AND
WE WILL START PRE-TESTING THE
FULL MESSAGES VIA EYE TRACKING
AND QUALITATIVE FEEDBACK WITH MY
HOPES OF LAUNCHING THE STUDY
MARCH 1ST, AND FOLLOWED BY THAT,
WE'LL CONDUCT A FULL RANDOMIZED
CONTROL TRIAL TO UNDERSTAND MORE
ABOUT THE IMPACT OF THESE
PREVENTION MESSAGES ON HARM
PERCEPTION AND ALSO EXPLORE THE
POTENTIAL IMPACT ON PREVENTING
CIGARILLO SMOKING AMONG BLACK
YOUNG ADULTS.
THEN ALSO I'M FOCUSING NOW ON
DEVELOPING THE POSITIVE AFFECT
FOR CIGAR SMOKING SCALE, SO THIS
WOULD BE UNDERSTANDING MORE OR
DEVELOPING A VALIDATED SCALE FOR
EACH OF THOSE DIFFERENT TYPES OF
BELIEFS BY CIGAR TYPE,
SPECIFICALLY FOR BLACK YOUNG
ADULTS IN FUTURE RESEARCH.
IN THIS LINE OF RESEARCH, TO
THINK MORE ABOUT COMMUNITY
ENGAGED EFFORTS, DR. LORETTA
SWEET JEMMOTT AND HER TEAM HAVE
BEEN EXTREMELY GENEROUS IN
CONNECTING WITH ME AND ALLOWING
ME TO START TO MEET COMMUNITY
MEMBERS IN FIRESIDE CHAT
CONVERSATIONS AS A STARTING
PLACE TO START UNDERSTANDING
MORE ABOUT COMMUNITY NEEDS
THROUGH HEALTH EDUCATION AND
OTHER INITIATIVES THAT WE CAN
DEVELOP.
AND SO I'D ALSO LIKE TO
ACKNOWLEDGE DR. CHOI FOR HIS
TREMENDOUS AND GREAT MENTORSHIP
AND OPPORTUNITY THAT HE'S
PROVIDED.
DR. KRISTEN HAMILTON-MOSELEY HAS
HELPED ME COMPLETE THE COLEMAN
STUDY WITH MY TRANSITION TO
DREXEL, AND THE REST OF THE
TOBACCO RELATED DISPARITIES AND
CONTROL LAB.
ALSO OUR GRADUATE RESEARCH
ASSISTANT HERE AT DREXEL, WHO'S
BEEN HELPING ME TO GET ALL THIS
RESEARCH OFF THE GROUND, LEM
PHAN, AND TO GET STARTED, AND
ALSO THE BIOSTATISTICS
SCIENTIFIC COLLABORATION CENTER
AT DREXEL THAT'S BEEN HELPING ME
WITH ANALYZING THE PRELIMINARY
FINDINGS TO SHARE WITH YOU TODAY
AS IT RELATES TO THE TESTING OF
THE TEXT MESSAGES.
AND THEN LASTLY, I JUST WANT TO
ACKNOWLEDGE AND SHARE THAT I'M
PART OF A COLLECTIVE OF HEALTH
DISPARITIES RESEARCHERS THROUGH
THE FIRST PROGRAM AT DREXEL, WHO
I'M GRATEFUL TO BE WORKING SIDE
BY SIDE WITH, LEARNING FROM, AND
GROWING WITH.
THANK YOU SO MUCH.
>> ALL RIGHT.
WELL, THANKS, DR. PHAN, FOR A
VERY INTERESTING AND INTRIGUING
PRESENTATION.
CERTAINLY THERE'S A LOT OF WORK
BEING DONE, AND THERE'S A LOT
MORE TO CONTINUE TO WORK ON.
JUST WANT TO REMIND FOLKS THAT
YOU CAN SEND AN EMAIL TO ME IF
YOU HAVE QUESTIONS, COMMENTS
ABOUT THE CONTENT BEING
PRESENTED OR YOU WANT TO CHIME
IN TO THIS CONVERSATION, YOU CAN
SEND AN EMAIL, YOU'LL FIND THE
EMAIL INFORMATION RIGHT BELOW
YOUR NIH VIDEOCAST WINDOW.
SO LET'S START WITH THIS.
I THINK THIS IS DEFINITELY
IMPORTANT WORK AND I THINK WE
CAN'T STRESS ENOUGH THAT WHILE
CIGAR USE, PARTICULARLY LITTLE
CIGAR AND CIGARILLO USE HAS BEEN
HAPPENING FOR A LONG TIME, IT'S
SPECIFICALLY FAIRLY PREVALENT
AMONG THE BLACK AND AFRICAN
AMERICAN COMMUNITY, REALLY NOT A
WHOLE LOT OF WORK BEING DONE.
SO I THINK IT'S -- I WANT TO
COMMEND YOU FOR DOING THE WORK
AND REALLY SHINING A LIGHT ON A
PRODUCT THAT IS
DISPROPORTIONATELY AFFECTING THE
HEALTH OF BLACK AND AFRICAN
AMERICAN POPULATION.
AND I THINK A LOT OF THE WORK
THAT YOU DO IS REALLY TRYING TO
INFORM THE COMMUNICATION OF
INTERVENTIONS AND HELPING PEOPLE
UNDERSTAND THE HARM OF CIGAR,
CIGARILLO AND LITTLE CIGAR NEWS,
AND ALSO TO CORRECT SOME OF THE
MISPERCEPTIONS.
TO THAT FRONT, I THINK IT'S
INTERESTING TO THINK ABOUT WHAT
ARE THE THEMES THAT YOU HAVE
DISCOVERED AND WHAT ARE SOME OF
THESE PERCEPTIONS THAT ARE OUT
THERE THAT WE OUGHT TO DO A
BETTER JOB OF CORRECTING
PEOPLE'S MISPERCEPTIONS.
>> THANK YOU FOR ASKING THAT,
DR. CHOI.
SO I DON'T THINK OF IT SO MUCH
AS MISPERCEPTION, BUT I ALSO
THINK ABOUT IT AS THE
PERCEPTIONS THAT HAVE BEEN SOLD
TO US BY THE TOBACCO INDUSTRY.
SO WHEN WE LOOKED AT SOME OF THE
SALIENT THEMES, SO THE THREE
DIFFERENT CIGAR PRODUCTS AND
UNIQUE CIGAR PROFILES, AS I PUT
IT, THAT'S EXACTLY HOW THEY'RE
BEING MARKETED OR THE
COMMUNICATIONS AROUND THEM, IN
TERMS OF WHAT THESE TOBACCO
PRODUCTS COULD BE USED AS.
SO WITH THAT IN MIND THEA REALLS
REALLY KIND OF SHAPED LOWER HARM
PERCEPTION, AND I THINK WHAT IS
REALLY NECESSARY IS TO CREATE A
MORE EQUITABLE COMMUNICATION
ENVIRONMENT.
SO INFORMATION TO HELP SHARE
MORE ACCURATE INFORMATION LIKE
THAT THESE PRODUCTS ARE HARMFUL,
AND THEN ALSO TO KIND OF
DISENTANGLE AND CHANGE ATTITUDES
THAT SMOKING A CIGARILLO, FOR
EXAMPLE, WOULD ACTUALLY, YOU
KNOW, LEAD TO STRESS RELIEF.
OR LEAD TO LIKE A MORE FUN
EXPERIENCE HANGING OUT WITH
FRIENDS.
AND SO IN TERMS OF LIKE THOSE
PERCEPTIONS, WE KNOW THAT
PERCEPTION IS MALLEABLE, WE
COULD AIM FOR CHANGING THEM LIKE
THEY DID FOR CIGARETTE SMOKING
YEARS AGO, SO I THINK NOW IS THE
TIME THAT WE FOCUS ON CIGAR
SMOKING AND CHANGING THOSE
PERCEPTIONS.
>> VERY TRUE INDEED.
NOW, YOU TALK ABOUT AN EQUITABLE
COMMUNICATION AND ENVIRONMENT,
AND YOU ALSO TOUCHED ON, OF
COURSE, THE ELEPHANT IN THE
ROOM, WHICH IS THE TOBACCO
INDUSTRY AND HOW THEY MARKET
PRODUCTS TO DIFFERENT
POPULATIONS WITH DIFFERENT
PRODUCTS, THEY POSITION THEM
DIFFERENTLY TO MAXIMIZE THEIR
PROFIT.
SO WHILE I THINK WE THINK ABOUT
EQUITABLE COMMUNICATION, WE ALSO
NEED TO FIGURE OUT HOW TO
REGULATE THE INDUSTRY'S
ADVERTISING EFFORT, PARTICULARLY
THOSE TARGETING THE RACIALLY
MINORITIZED GROUPS.
SO IN THAT SPIRIT, WHAT DO YOU
THINK ARE SOME OF THE REGULATORY
IMPLICATIONS OF THE WORK THAT
YOU HAVE DONE SO FAR, AND ALSO
WITH THE COLLECTIVE WORK THAT'S
BEING DONE SURROUNDING CIGAR,
CIGARILLOS, WHAT ARE SOME OF THE
REGULATIONS THAT COULD BE IN
PLACE THAT REALLY HELP
BALANCING -- NOT JUST BALANCING,
TO MAKE SURE PEOPLE GET THE
RIGHT INFORMATION, THE CORRECT
INFORMATION AND NOT BEING
CONFUSED BY THE INDUSTRY
TACTICS?
>> I THINK THE FIRST ONE IS
BANNING FLAVORS, AND SO THE USE
OF FLAVORS STILL EXISTS, THE
AVAILABILITY OF FLAVORS STILL
EXIST FOR LITTLE FILTERED CIGARS
AND CIGARILLOS AND WE KNOW IT'S
ASSOCIATED WITH GREATER
INITIATION AND USE AS WELL, AND
SO ONE POTENTIAL POLICY WOULD BE
RELATED TO BANNING FLAVORS IN
CIGAR PRODUCTS.
SECONDLY, THINKING ABOUT THE
PACKAGING OF CIGARILLOS, SO
THEY'RE SOLD AS PACKS OF 1, 3 OR
5 FOR VERY CHEAP AND A
PARTICIPANT MENTIONED THEY COULD
BUY IT FOR LESS THAN $3.
AND SO THAT IS CHANGING THE
PACKAGING AMOUNT IS ANOTHER
POTENTIAL AVENUE.
AND ALSO JUST THINKING ABOUT
LIKE WHAT KIND OF FEATURES ARE
BEING USED FOR ADVERTISING ON
THESE PRODUCTS.
LIKE A -- THAT I JUST SAW AT THE
GAS STATION, IT DOES LOOK REALLY
NICE IN TERMS OF PACKAGING, AND
THERE'S A LOT OF THOUGHT TO GET
THAT TO BE ATTRACTIVE TO YOUNG
ADULTS.
SO SOME POLICIES RELATED TO
MAKING PACKAGING LESS APPEALING
AS WELL.
>> YEAH, THE PACKAGING IS
INTERESTING BECAUSE THERE ARE
COUNTRIES THAT HAVE DONE -- AT
LEAST ON CIGARETTE PACKAGING,
THEY MAKE PLAIN PACKAGES WITH
KIND OF A BROWNISH-LOOKING COLOR
AND NOTHING ELSE, AND I THINK
THERE'S ONLY -- BROWNISH-LOOKING
COLOR, THE PRINT NAME OF THE
BRAND AND IT'S THE EXACTLY SAME
FONT FOR EVERY SINGLE PRODUCT
AND OF COURSE THE HUGE ONE OF
LABELS THAT THEY STICK ON THERE.
WHICH THEN BRINGS TO ANOTHER
QUESTION, BECAUSE I DON'T THINK
THE SAME KIND OF GRAPHIC LABELS
REQUIRED FOR CIGARETTES ARE
REQUIRED FOR LITTLE CIGARS AND
CIGARILLOS, AND I DON'T EVEN --
NOT JUST, YOU KNOW, IN THE U.S.,
I JUST CAN'T EVEN RECALL IF
THERE ARE OTHER COUNTRIES THAT
HAVE TREATED CIGAR, YOU KNOW, IN
THE SAME WAY IN TERMS OF THE
LABEL.
SO WHAT IS YOUR THOUGHT ON THAT?
>> I UNDERSTAND THAT THERE'S
SOME WORK BEING DONE THROUGH
SOME OTHER RESEARCHERS RELATED
TO MORE LIKE GRAPHIC WASHING WAG
LABELS FOR CIGAR PRODUCTS.
I THINK IT'S IMPORTANT AND WE
DEFINITELY NEED TO DO IT.
IT COULD POTENTIALLY MAKE A HUGE
DIFFERENCE IN TERMS OF OUR MORE
POSITIVE PERCEPTIONS ABOUT
CIGARILLOS, FOR EXAMPLE, AMONG
YOUNG ADULTS.
>> YEAH, I THINK THAT WOULD BE
INTERESTING TO SEE WHAT KIND
OF -- WHAT WOULD BE THE
REQUIREMENT.
AND THEN GIVEN THE PACKAGING
CHALLENGE.
SO WITH THE LITTLE CIGAR
COMING -- WHERE ARE YOU GOING TO
PUT THAT GRAPHIC WARNING LABEL
WHEN IT'S JUST LIKE A SINGLE
PACK OF LITTLE CIGARS, WHAT DO
YOU DO WITH THOSE?
>> WELL, MAYBE WE WON'T HAVE A
PACK OF A SINGLE CIGARILLO
ANYMORE.
>> I THINK THAT'S A GOOD POINT.
I THINK THERE'S PREVIOUS WORK
BEING DONE LOOKING AT LIKE THE
PACK SIZE AND HOW THAT RELATES
TO LITTLE CIGAR AND CIGARILLO
SMOKING.
AND IT DOES SHOW THAT -- I THINK
IT'S KIND OF ALSO MIRRORED THE
POLICY AND REGULATION
SURROUNDING CIGARETTES IN THE
PAST, WHICH WE NOW HAVE THE
STANDARDIZED 20 CIGARETTE PACK,
IF IT'S NOT BECAUSE OF THE
INDUSTRY DECIDED TO MAKE THEM,
YOU KNOW, 20 CIGARETTES PER
PACK, THEY WOULD RATHER SELL
SINGLES OR 5, YOU KNOW, WHATEVER
QUANTITY THEY SEE FIT, BUT IT
WAS ACTUALLY FOR REGULATIONS
THEY HAVE TO BE SOLD IN PACKS OF
20.
SO MAYBE SIMILAR STRATEGY WOULD
BE APPLIED, WILL BE APPLICABLE
IN THIS SITUATION SO WE DON'T
HAVE THOSE CHEAP CIGAR AND
CIGARILLOS FLOATING AROUND,
PARTICULARLY IN THE
SOCIOECONOMIC DISADVANTAGED
NEIGHBORHOODS.
SO ARE THERE OTHER THINGS THAT
YOU'RE WORKING ON AT DREXEL NOW
THAT YOU'RE THERE AND HAVE A
COHORT OF PEOPLE INTERESTED IN
HEALTH DISPARITY RESEARCH, ARE
YOU WALKING THE NEIGHBORHOOD AND
JUST TRYING TO FIGURE OUT WHERE
ARE THE TOBACCO OUTLETS AND
WHERE ARE THE PEOPLE SELLING
THESE THINGS AND JUST TELL THEM
THAT THEY SHOULD BE SELLING
SOMETHING ELSE?
[LAUGHTER]
>> I'M LEARNING A LOT THROUGH MY
FACULTY COHORT, THROUGH THE
FIRST PROGRAM, AND THEY'RE ALL
DOING REALLY AMAZING AND
INTERESTING WORK.
I THINK THERE'S A LOT OF OVERLAP
AS WELL, SO IF WE CAN REALLY
HONE IN ON THIS ENERGY THAT WE
HAVE FOCUSED ON HEALTH
DISPARITIES, WE COULD
POTENTIALLY DO SOME REALLY
EXCITING HEALTH DISPARITIES
RESEARCH TOGETHER.
SOME OF MY COLLEAGUES FOCUSED ON
UNDERSTANDING MORE ABOUT RACISM
AND DISCRIMINATION, AND OF
COURSE THAT REALLY ALSO RELATES
TO TOBACCO USE, AND SO I'M
INTERESTED IN LEARNING MORE
ABOUT HOW EXPERIENCING RACISM
AND DISCRIMINATION COULD IMPACT
TOBACCO USE.
ALSO I AM WORKING ON MORE
DISAGGREGATED DATA AMONG ASIAN
AMERICAN INDIVIDUALS AND
COMMUNITIES AS RELATES TO
TOBACCO USE, AND SO HERE
LOCALLY, I'VE PARTNERED WITH
JEFFERSON CHINATOWN COMMUNITY
CLINIC, WHERE WE'VE LAUNCHED A
TOBACCO SCREENING INITIATIVE
THAT'S MORE PRACTICE-BASED.
SO THAT CLINIC SERVES UNINSURED
PATIENTS IN CHINATOWN, AND SO
WITH A SENSITIVITY TO THAT
POPULATION AS WELL AS THEIR
NEEDS AND WANTING TO JUST CHANGE
AND, YOU KNOW, ADAPT WHAT WE
KNOW ABOUT THE EVOLVING TOBACCO
LANDSCAPE, WE'VE LAUNCHED A
SCREENING INITIATIVE FOR WE'RE
ASKING ABOUT ALL DIFFERENT TYPES
OF CIGAR PRODUCTS VERSUS JUST
CIGARETTES.
AND THEN ALSO UNDERSTANDING AND
THINKING THROUGH PATIENTS'
INTEREST IN LIKE HEALTH
EDUCATION MATERIALS OR WORKSHOPS
RELATED TO CESSATION.
AND SO THAT'S AN AREA THAT I'M
WORKING ON LOCALLY.
I'VE ALSO STARTED SHARING WITH
LARGER NATIONAL DATASETS AND
OPPORTUNITIES TO ASK ABOUT
DISAGGREGATED DATA, AND SO AMONG
ASIAN AMERICANS, SO THAT'S
SOMETHING THAT I'M REALLY
INTERESTED IN DOING AND I THINK
IS REALLY IMPORTANT IN ADDITION
TO UNDERSTANDING HEALTH
DISPARITIES RELATED TO TOBACCO
THAT ARE REALLY BURDENING BLACK
INDIVIDUALS AND COMMUNITIES.
>> THAT'S FASCINATING WORK.
I'M VERY HAPPY TO HEAR THAT
YOU'RE DOING WORK WITH THE ASIAN
AMERICAN POPULATION, AND
PARTICULARLY TRYING TO FIND WAYS
TO DISAGGREGATE THE DATA.
I THINK SIMILAR CAN BE SAID TO
THE BLACK COMMUNITY BETWEEN THE
PEOPLE OF DIFFERENT ETHNIC
ORIGIN VERSUS THOSE WHO ARE
DESCENDANTS OF THE SLAVE TRADE,
I THINK THEY ARE UNDER VERY
DIFFERENT CIRCUMSTANCES IN SOME
WAY, THAT THERE ALSO MIGHT BE
DIFFERENCES IN HOW THEY RESPOND
TO THESE DIFFERENT
ADVERTISEMENTS AS WELL AS
EDUCATIONAL MESSAGES.
ONE OF THE THINGS YOU MENTIONED
IS ALSO THINKING ABOUT -- AND I
WANTED TO HEAR YOUR THOUGHT ON
IT, THE FACT OF, YOU KNOW, I
THINK THIS IS NOT A SECRET, THIS
RACIAL DISCRIMINATION IN THIS
COUNTRY, AND -- F FABRIC AS PART
OF THE AMERICAN EXPERIENCE.
HOW WOULD THAT -- HAVE YOU
CONCEIVED WHETHER DISCRIMINATION
PLAYS A ROLE IN THE RECEPTION OF
THE INDUSTRY MESSAGES, AND ALSO
THE RECEPTION OF HEALTH
EDUCATION MESSAGES, AND IF THERE
ARE THINGS TO BE LEARNED FROM
THE TOBACCO INDUSTRY, ARE THERE
THINGS THAT WE COULD HAVE DONE
DIFFERENTLY IN OUR HEALTH
EDUCATION MESSAGES?
>> THOSE ARE REALLY GOOD
QUESTIONS, KELVIN, AND SOMETHING
THAT I'VE BEEN THINKING ABOUT.
SO THE TOBACCO INDUSTRY HAS DONE
A REALLY GOOD JOB OF PULLING IN
FROM SOCIAL MARKETING AND
ADVERTISING, FOR EXAMPLE, RIGHT
NOW IS BLACK HISTORY MONTH, AND
LUNAR NEW YEAR JUST PASSED, AND
SO THE TOBACCO INDUSTRY HAS
LEVERAGED THESE VERY IMPORTANT
EVENTS AND SOCIAL OPPORTUNITIES
TO HIGHLIGHT AND MANIPULATE OUR
PERCEPTIONS ABOUT THE TOBACCO
INDUSTRY AND THEIR PRODUCTS, IN
TERMS OF HEALTH EDUCATION WHAT
WE CAN BE DOING, I THINK IS ALSO
LEVERAGING AND UNDERSTANDING
MORE ABOUT SOCIAL MARKETING AND
WHAT IS REALLY IMPORTANT TO
INDIVIDUALS AND CREATING MORE --
I WOULD SAY LIKE OUT OF THE BOX
MESSAGING, WE'VE TYPICALLY
FOCUSED ON HEALTH HARM AND
NICOTINE ADDICTION WHICH OF
COURSE IS REALLY IMPORTANT, BUT
PART OF THE K99 R00 IS ALSO
UNDERSTANDING HOW CAN WE TIE IN
SOME OF THESE OTHER BELIEFS OR
THINGS THAT ARE IMPORTANT TO
YOUNG ADULTS TO CHANGE THOSE
ATTITUDES TOWARDS CIGAR SMOKING.
AND SO I THINK IT'S TIME FOR US
TO THINK CREATIVELY.
I'D LOVE TO HEAR OTHER PEOPLE'S
THOUGHTS THAT HAVE WORKED FOR
THEM OR THAT THEY'RE THINKING
THROUGH AS IT RELATES TO HEALTH
EDUCATION, BUT I THINK IT'S
THOSE UNDERLYING IDEAS AS WELL
AS THE MEDIANS THAT WE USE.
SO THINKING MORE ABOUT LIKE
HEALTH EDUCATION ON WEBSITES,
SOCIAL MEDIA PLATFORMS AS WELL
AS LIKE IN OUR NEIGHBORHOOD.
SO THERE'S A LOT OF TOBACCO
ADVERTISING IN CERTAIN
NEIGHBORHOODS, BUT THERE'S NO
SALIENT HEALTH EDUCATION THAT
ACTUALLY RESONATES WITH FOLKS OF
THAT COMMUNITY.
SO I THINK THAT IS REALLY
IMPORTANT.
SO A LOT OF OUR RESEARCH IS
UNDERSTANDING HOW DO WE START TO
SHIFT AND MAKE CHANGE WITH HOW
COMMUNICATION INEQUALITY.
>> I THINK THAT WOULD BE A
COMBINATION OF REGULATION AND
THEN, YOU KNOW, HEALTH EDUCATION
INTERVENTION BEING PRESENT IN
THE COMMUNITY, THAT BEING
AFFECTED THE MOST, AND SO WE CAN
THEN START CHANGING THE
PERCEPTIONS AND BELIEFS
GRADUALLY THROUGH THAT APPROACH,
AND I THINK IT'S INTERESTING,
AND I THINK YOUR RESUMMONS KINDD
OF REMINDED ME OF THE WORK DONE
BY DR. CARL BURKE IN TERMS OF
LOOKING AT -- OF CIGARETTE
SMOKERS.
I WONDER IF THERE'S SOMETHING
THAT CAN BE DONE IN PARALLEL
LOOKING AT THE PSYCHOGRAPHICS OF
CIGAR SMOKERS AND PARTICULARLY
USERS OF VARIOUS TYPE OF CIGAR
PRODUCT, IF THEY HAVE A
DIFFERENT TYPE OF ASPIRATION OR
THINGS THAT ARE VALUES THAT ARE
SALIENT TO THEM AND THAT SO THEN
YOU CAN TAILOR THE MESSAGE, THAT
MAY BE AN ADDITIONAL WAY HOW TO
THINK ABOUT FRAMING MESSAGES.
>> THE OTHER DIFFICULT THINGS TG
WHEN YOU'RE THINKING ABOUT
CHANGING SOME OF THESE ATTITUDES
IS THAT IF A CIGAR PRODUCT, FOR
EXAMPLE, IS SEEN TO BE USED IN
FUN SOCIAL EVENTS AND THAT'S AN
ATTITUDE THAT YOU'RE TRYING TO
CHANGE, IT MIGHT CREATE SOME
COGNITIVE DISSIDENCE, SO
THINKING ABOUT HOW DO YOU USE
HEALTH EDUCATION, AND WHAT KIND
OF WORDING OR CONTENT CAN REALLY
HELP DO THAT IN THE RIGHT WAY.
>> YEAH.
WELL, I GUESS WE HAVE TO START
GOING TO THESE FUN PLACES AND
SEE WHAT'S GOING ON THERE.
[LAUGHTER]
FOR RESEARCH.
ALL FOR RESEARCH PURPOSES.
WE'RE NOT HAVING FUN TODAY.
WE WON'T BE.
WELL, I JUST WANT TO THANK
DR. LAS VE PHAN FOR SHEDDING LIA
RESEARCH TOPIC THAT WE NEED
ATTENTION DOING THIS WORK AND
ALSO THE OTHER WORK THAT YOU'RE
DOING TO CONTINUE TO ADVANCE THE
RESEARCH IN TERMS OF TOBACCO USE
DISPARITY AND ACHIEVING HEALTH
EQUITY.
SO WE APPRECIATE YOUR TIME AND
YOUR PRESENTATION.
WE WISH YOU ALL THE BEST, AND
HOPEFULLY IN A COUPLE OF YEARS,
WE'LL INVITE YOU BACK AND GIVE
US AN UPDATE ON SOME OF THE WORK
THAT YOU'RE DOING AND THAT WE'LL
BE ABLE TO HEAR FROM YOU THAT
TOBACCO PROBLEMS ARE SOLVED.
>> WELL, THANK YOU SO MUCH FOR
HAVING ME.
THANK YOU SO MUCH, EVERYONE.
>> ALL RIGHT.
THANKS, EVERYONE, FOR LISTENING,
AND WE'LL SEE YOU NEXT MONTH.