Momentary Effects of Exposure to Prosmoking Media on College Students' Future Smoking Risk

Objective: This study used ecological momentary assessment to examine acute changes in college students' future smoking risk as a function of their exposure to prosmoking media (e.g., smoking in movies, paid advertising, point-of-sale displays). Method: A sample of 135 college students ("ever" and "never" smokers) carried handheld computers for 21 days, recording their exposures to all forms of prosmoking media during the assessment period. They also responded to three investigator-initiated control prompts during each day of the assessment period (i.e., programmed to occur randomly). After each prosmoking media exposure and after each random control prompt they answered questions that measured their risk of future smoking. Responses between prosmoking media encounters were compared (within subjects) to responses made during random control prompts. Results: Compliance with the study protocol was high, with participants responding to over 83% of all random prompts. Participants recorded nearly three encounters with prosmoking media each week. Results of linear mixed modeling indicated that all participants had higher future smoking risk following exposure to prosmoking media compared with control prompts (p < .05); this pattern of response did not differ between ever and never smokers (p = .769). Additional modeling of the variances around participants' risk of future smoking revealed that the response of never smokers to prosmoking media was significantly more variable than the response of ever smokers. Conclusion: Exposure to prosmoking media is associated with acute changes in future smoking risk, and never smokers and ever smokers respond differently to these exposures.