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[crowd chatting]
Hi may name is Shannon Lee Watkins.

I'm a post doctoral fellow at the

Center for Tobacco Control in
Research and Education

at UCSF, University of California-San Francisco.

Today I'm presenting preliminary work

using a big longitudinal data set
of tobacco use behavior.

And I'm looking at flavored tobacco initiation.

We have a puzzling,
kind of challenge to tackle now

as we see overall,
cigarette smoking prevalence decrease,

we see an increase of
these alternative tobacco products

like e-cigarettes, little cigars, and hookah.

And while cigarettes are no longer

allowed to be flavored,
other than menthol,

all of these other products
can still be flavored.

So there are a couple of questions here.

The first is whether the emergence of

these other products is diverting you

from using cigarettes,

or encouraging them to use cigarettes.

And then the second is whether

the flavor nature of these products

is getting those kids that
wouldn't have otherwise

taken a risky behavior,

sort of, gotten them over the threshold,

to use those products,

and then whether they lead, of course,
on to cigarette smoking,

or to use of these tobacco products

which have their own health risks.

So what I'm presenting today

is a preliminary tackle at

describing flavored tobacco users,
as the first goal.

We have a lot of understanding about

disparities in menthol tobacco use,
relate to,

or as a result of,
intentional tobacco industry targeting

of African American communities,
and other communities

with menthol cigarettes.

So we see higher menthol use among women,

LGBT folks, and people of color

in a variety of communities.

We don't know much, actually,
about the patterns

of flavor tobacco use in other products, um,

and non-menthol.

So what I find in this first tack,

using regression models,

controlling for a bunch of
demographic characteristics,

we find significant differences
across most products

for women and people of color.

Although a couple of products,

like smokeless tobacco,

have an inverse relationship
in urban environments,

where we're talking
about these populations,

like, when we're talking about flavor bans

for example, happening in San Francisco,

the folks that are using them are not --

prevalence of smokeless is not very high.

So the policy implication from this is that

as we see the emergence
of flavored tobacco bans,

in California, in Rhode Island, etcetera,

that they might affect
these marginalized groups,

people of color.

We might also see some impacts on

women who are not initiating smoking.

The second aim of this poster
is to look at

whether flavored tobacco initiation

predicts future cigarette use,

and while in other research I find that,

flavored tobacco initiation
of a product,

predicts current use of
that particular product,

here, for now, we see that

starting with menthol cigarettes,

for example, predicts current cigarette use.

And the other relationships are inverse,

But, I think because we can't quite identify

the self-selection process of flavors,

that this is not a causal statement.

It might actually be capturing folks

that started with cigarettes,

then went on to use e-cigarettes,

and, of course, they're less likely
to start with flavors

'cause they are already using cigarettes.

So teasing out this puzzle
is where I'm headed.

And I'm gonna be using
this really fascinating

longitudinal data set to do so.
Thanks.