Sherry L Emery

NORC at the University of Chicago · Health Media Collaboratory

Background The tobacco industry has spent millions of dollars promoting racialised narratives against the US Food and Drug Administration’s recently announced ban on menthol as a characterising cigarette flavour. This research investigates racialised narratives in online discourse following the ban’s announcement. Methods Tweets and users respondi...

Introduction Systemic racism and tobacco-industry targeting contribute to disparities in communities of color. However, understanding tobacco as a social justice issue and the industry’s role in perpetuating inequities remains limited. This study explored youth and young adult awareness of tobacco marketing and perceptions of tobacco marketing as a...

Introduction In April 2021, the U.S. Food and Drug Administration (FDA) announced its intention to ban the sale of menthol cigarettes and cigars. Decades of research support the premise that a menthol ban will reduce initiation and disparities in tobacco-related disease among menthol smokers. The tobacco industry opposed such a policy and worked fo...

Introduction Prior research on the effects of social media promotion of tobacco products has predominantly relied on survey-based self-report measures of marketing exposure, which potentially introduce endogeneity, recall, and selection biases. New approaches can enhance measurement and help better understand the effects of exposure to tobacco-rela...

Influencer marketing spending in the United States was expected to surpass $6 billion in 2023. This marketing tactic poses a public health threat, as research suggests it has been utilized to undercut decades of public health progress—such as gains made against tobacco use among adolescents. Public health and public opinion researchers need practic...

Social media dominate today’s information ecosystem and provide valuable information for social research. Market researchers, social scientists, policymakers, government entities, public health researchers, and practitioners recognize the potential for social data to inspire innovation, support products and services, characterize public opinion, an...

Introduction E-cigarettes have rapidly grown in use among US adolescents; in response, the FDA engaged in an “enforcement policy on banned e-cigarette flavors” (“enforcement action”) for pod-based e-cigarettes in January 2020, which accounted for most US e-cigarette sales. No literature has yet examined long-term changes in e-cigarette sales patter...

Background: Little cigars or cigarillos (LCCs) are frequently modified to smoke cannabis ("blunts") by youth and young adults. This study investigated whether young blunt users who are otherwise nicotine-naïve are more likely to initiate other tobacco products compared to never blunt users. Methods and materials: Data were from four waves of the...

We report on a preliminary investigation into the relationship between partisan media consumption (PMC) among U.S. adults and their (1) opioid use disorder (OUD) stigma, (2) national OUD policy support (e.g., Medicaid coverage for OUD treatment), (3) local OUD policy support (e.g., safe injection sites), (4) discriminatory OUD policies (e.g., denyi...

Introduction: The COVID-19 pandemic and its associated social distancing policies such as lockdowns and quarantine influenced people's lives and health behaviors. We comprehensively assessed national trends in sales of cigarettes, cigars, e-cigarettes, and over-the-counter nicotine replacement therapy (NRT) products before and during the pandemic,...

Introduction Most e-cigarettes contain highly addictive nicotine. This study assessed trends in nicotine strength in e-cigarettes sold in the United States during January 2017–March 2022. Aims and Methods We obtained January 2017–March 2022 national retail e-cigarette sales data from NielsenIQ. We assessed monthly average nicotine strength overall...

Introduction: It is unknown whether and to what extent the duration of smoking abstinence may modify the association between receiving cigarette coupons and smoking relapse in the U.S. This study aims to fill this gap. Methods: Data were from the Population Assessment of Tobacco and Health study Wave 4 (December 2016-January 2018, baseline) and...

Introduction: In 2019, an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) occurred in the US. We used Nielsen retail sales data to assess trends in sales of e-cigarettes, cigarettes, and nicotine replacement therapy (NRT) products before, during, and after the EVALI outbreak. Methods: Monthly unit sales of e-cigare...

BACKGROUND Twitter is an important avenue through which tobacco regulation evolves in the public consciousness. That said, prior research has identified the spread of mis and dis-information regarding tobacco products on Twitter and a possibly disproportionate influence of e-cigarette advocates on the platform taking an anti-regulatory stance. OBJ...

Social media are an important marketing platform for emerging tobacco products. Heated tobacco products (HTPs) have been introduced in a limited number of local test markets in the United States as potentially reduced-exposure tobacco products. HTPs can be used to heat tobacco as well as marijuana. However, due to growing digital media promotion of...

Tobacco promotion is prolific on social media, with each platform setting their own restrictions on tobacco promotion and sales. We evaluated the policies related to tobacco product promotion and sales on 11 sites that are popular with youth in May 2021: Discord, Facebook, Instagram, Pinterest, Reddit, Snapchat, TikTok, Tumblr, Twitch, Twitter and...

Background: Social media discussion tends to follow news about proposed or enacted government policies. Thus, digital discourse surveillance may be an effective and unobtrusive way of understanding industry and public response to policies and regulations, including in the domain of tobacco control. Recently, the US Food and Drug Administration res...

Youth and young adult (YYA) use of e-cigarettes increased rapidly between 2010 and 2019 in the United States, during which exposure to e-cigarette advertising was also increased. We aimed to examine whether exposure to e-cigarette advertising among YYAs may lead to subsequent e-cigarette use. A cohort of 3886 YYAs ages 13–24 was recruited from two...

Importance Little is known about the roles of advertising and parental and peer influence in e-cigarette use among US adolescents in recent years, hindering efforts to address the increasing rate of youth vaping. Objective To examine how e-cigarette advertising exposure and parental and peer e-cigarette use were associated with e-cigarette use amo...

Introduction: To examine the associations between baseline receipt of cigarette and non-cigarette tobacco discounts/coupons and smoking cessation at follow-up among US adult cigarette smokers with intention to quit at baseline. Methods: Data were from the Population Assessment of Tobacco and Health (PATH) study Wave 3 (Oct. 2015-Oct. 2016), Wave...

Background The prevalence of smoking is higher among sexual minority (SM) individuals compared with heterosexuals. The impact of televised anti-tobacco mass media campaigns on smoking outcomes among SMs is not known. Aims We examined whether televised anti-tobacco advertising was differentially associated with current smoking and smoking intensity...

Health behavior theory establishes that exposure to media messages about a topic influences related knowledge, attitudes, and behavior. Marijuana-related messages proliferating on digital media likely affect attitudes and behavior about marijuana. Most research studying marijuana-related media effects on behavior relies on self-reported survey meas...

Objective: Nicotine pouch products are an emerging and rapidly growing smokeless tobacco (ST) category in the USA. Little is known about the promotional strategies and media channels used to advertise this ST category or the extent to which the marketing strategies differ from strategies used to promote 'conventional' smokeless products (eg, snuff...

Introduction Anti-tobacco media campaigns can prevent youth smoking, but there is little research on how adult-targeted campaigns affect youth. We investigated the association between the Tips From Former Smokers (Tips) campaign and youth smoking behaviors and anti-tobacco attitudes, and variation by sex, race/ethnicity, or socioeconomic status (SE...

Objective: To examine conversations among JUUL users on Reddit related to restrictions on flavored ENDS and the shifting policy landscape. Methods: Posts and comments (n = 166,169) between May 2019 and May 2020 on the subreddit r/JUUL were scraped using pushshift.io API. Keyword filters were used to identify texts discussing flavored ENDS produc...

BACKGROUND Misinformation about a potential protective role of nicotine against COVID-19 spread on Twitter despite significant evidence to the contrary. We suggest that the pro-vaping ideological slant of Twitter’s opinion leaders on this subject or “gatewatchers” helped drive the dissemination of such misinformation. OBJECTIVE This research exami...

Background: Misinformation about a potential protective role of nicotine against COVID-19 spread on Twitter despite significant evidence to the contrary. We examine the role of vape advocates in the dissemination of such information through the lens of the gatewatching framework, which posits that top users can amplify and exert disproportionate i...

Importance: Significant disparities exist in smoking behaviors by sexual minority status in the US. Objective: To examine potential differences in the associations between exposure to the Tips From Former Smokers (Tips) campaign and intentions and attempts to quit smoking by sexual minority status. Design, setting, and participants: This cross...

Objective: To understand the relationship between exposure to online tobacco advertising and current smokeless tobacco use in the context of tobacco control policies. Methods: Three waves of a national probability-based sample of (n = 15,985) youth and young adults were used. Analysis consisted of GEE logistic models controlling for social media...

Background E-cigarette promotion on social media coincided with the rapid growth of e-cigarette use among American youth, particularly with the increased JUUL pod vaporiser use. We examined commercial JUUL-related messages on Instagram to identify marketing appeals used to target users along the continuum of e-cigarette use; we mapped the appeals t...

In today’s complex media environment, does media coverage influence youth and young adults’ (YYA) tobacco use and intentions? We conceptualize the “public communication environment” and effect mediators, then ask whether over time variation in exogenously measured tobacco media coverage from mass and social media sources predicts daily YYA cigarett...

Introduction Cigar smoking has increased in recent decades as the cigar product landscape has diversified. This study assessed trends in U.S. cigar sales during 2016–2020. Methods Unit sales and average unit price for cigars were assessed during January 3, 2016–June 13, 2020, overall and by product and flavor type, for the 48 contiguous U.S. state...

Introduction To analyze the impact of Truth and state-sponsored anti-tobacco media campaigns on youth smoking in the U.S., and their potential to reduce tobacco-related health disparities. Methods Our study included data from the 2000-2015 Monitoring the Future study, an annual nationally representative survey of youth in 8 th (n=201,913), 10 th (...

Objectives Few e-cigarette social media posts are authentic posts to friends; most come from commercially sponsored influencers. Potential disclosure strategies need to be tested to confirm whether users recognize such posts as commercially sponsored. Methods: Between July - August 2019, young adult (ages 16-24; n = 200) participants were recruited...

This study used semantic network analysis to investigate the themes of JUUL electronic cigarette-related messages on Instagram posted by three account types (commercial, vape community, and organic users) and explore the function of hashtags in the JUUL-related discourse across these groups. Posts were collected from 1 March 2018 to 15 May 2018. We...

In 2016, a tobacco product commonly referred to as nicotine pouches entered the US market. These prefilled, microfiber pouches contain nicotine powder that dissolves in the mouth without requiring spitting. Nicotine pouches contain nicotine salts that deliver high levels of nicotine with less irritation than the free-base nicotine in most smokeless...

Background: Little is known regarding long-term impacts of anti-tobacco media campaigns on youth smoking and related disparities in the United States. Methods: We examined longitudinal cohort data from Monitoring the Future (MTF) between 2000 and 2017 in modified Poisson regression models to understand the long-term impacts of televised Truth an...

This study aims to examine how e-cigarette prices and advertising, key determinants of e-cigarette demand, are associated with the demand for smokeless tobacco (SLT) products in the US. Market-level sales and price data by year (2010–2017), quarter, and type of retail store were compiled from Nielsen retail store scanner database. E-cigarette TV ad...

Objective In April 2018, JUUL Labs announced a $30 million investment in efforts to combat underage use of its products through ‘independent research, youth and parent education and community engagement’. Prior evidence demonstrates that tobacco industry-funded prevention programmes are ineffective and may work against tobacco control efforts; they...

Introduction E-cigarette advertising has been shown to increase e-cigarette awareness and use. Although e-cigarette marketing in the early 2010s has been well-documented, little is known about how it has changed in recent years in response to the regulatory scrutiny from the FDA and the Congress to combat youth vaping epidemic. This study aims to e...

Purpose To evaluate sociodemographic differences in the relationship between state and national anti-smoking media campaigns and cessation behaviors among adult smokers in the U.S. Design Repeated cross-sectional analysis. Setting U.S. nationally representative survey of adults ages 18 and older, 2001-2015. Subjects 76,278 year-ago smokers from...

Despite mixed evidence, many smokers use e-cigarettes to quit smoking. With the substantial growth of e-cigarette sales in recent years, it is important to understand how it may affect FDA-approved nicotine replacement therapy (NRT) products in the US. This study aims to investigate the impact of e-cigarette prices and TV advertising on the demand...

Youth and young adults are the largest consumers of social media content. Individuals with large followers are paid to share social media content using specific products for compensation. This type of activity is considered commercial sponsorship and requires a disclosure in order to comply with Federal Trade Commission regulations. Between July an...

Background: Sexual minority (SM) (gay, lesbian and bisexual) adults are at higher risk of smoking compared with heterosexual individuals, yet little is known about how the tobacco control policy landscape interacts with sexual orientation smoking disparities. Methods: We conducted a descriptive analysis to explore differential exposure to smoke-...

BACKGROUND With a rapidly evolving tobacco retail environment, it is increasingly necessary to understand the point of sale (POS) advertising environment as part of tobacco surveillance and control. Advances in machine learning and image processing suggest the ability for more efficient and more nuanced data capture than previously available. OBJE...

Background: With a rapidly evolving tobacco retail environment, it is increasingly necessary to understand the point-of-sale (POS) advertising environment as part of tobacco surveillance and control. Advances in machine learning and image processing suggest the ability for more efficient and nuanced data capture than previously available. Objecti...

Reducing tobacco use is an important public health objective. It is the largest preventable cause of death and disease, yet inequalities remain. This study examines combined educational and racial/ethnic disparities in the United States related to cigarette smoking for the three largest racial/ethnic groups (African Americans, Hispanics/Latinos, an...

Introduction Digital e-cigarette marketing is largely unregulated and remains easily accessible to young people. The growing public concern around youth JUUL use and its viral presence on social media led the company to engage in several voluntary actions to remove and reduce JUUL-related content on Instagram in May 2018. The current study examined...

Introduction: As media exposure can influence people's opinions and perceptions about vaping and smoking, analyzing the valence of media content about tobacco products (i.e., overall attitude toward tobacco, cigars, electronic cigarettes, etc.) is an important issue. This study advances the field by analyzing a large amount of media content about...

Public health organizations are increasingly turning to social media as a channel for health campaign dissemination, as these platforms can provide access to “hidden” or at-risk audiences such as populations of color and youth. However, few studies systematically assess the effects of such campaigns in a competitive communication environment charac...

Background Electronic nicotine delivery systems (ENDS) are the most-used tobacco product by adolescents, and Juul has rapidly become the most popular ENDS brand. Evidence indicates that Juul has been marketed heavily on social media. In light of recent lawsuits against the FDA spurred by claims that the agency responded inadequately to this marketi...

Background Tobacco product advertising has been shown to reach youth and promote initiation. This study assessed trends in e-cigarette advertising expenditures in the USA during 2014–2018, overall and by manufacturer and media type. Methods Data came from Kantar Media, which provides information on US advertising expenditures, including for e-ciga...

Public health and social science increasingly use Twitter for behavioral and marketing surveillance. However, few studies provide sufficient detail about Twitter data collection to allow either direct comparisons between studies or to support replication. The three primary application programming interfaces (API) of Twitter data sources are Streami...

Media content can shape people’s descriptive norm perceptions by presenting either population-level prevalence information or descriptions of individuals’ behaviors. Supervised machine learning and crowdsourcing can be combined to answer new, theoretical questions about the ways in which normative perceptions form and evolve through repeated, incid...

Exposure to media content can shape public opinions about tobacco. Accurately describing content is a first step to showing such effects. Historically, content analyses have hand-coded tobacco-focused texts from a few media sources which ignored passing mention coverage and social media sources, and could not reliably capture over-time variation. B...

Objectives: Industry, policymakers, researchers, and others have interest in social media, assuming that they influence – or reflect – individual behavior, despite limited supporting research. Electronic nicotine delivery systems (ENDS) emerged in the United States in the past decade alongside strong social media presence, making ENDS relevant for...

Background JUUL, a high-tech, popular vaping device, was the first major electronic cigarette (e-cigarette) brand to incorporate social media into its marketing strategy. There is growing concern around the increasing use of JUUL and other electronic nicotine delivery devices among youth, and their potential to addict a new generation to nicotine....

Objective As a remedy to committing fraud and violating civil racketeering laws, in November 2017, four major tobacco companies were court-ordered to develop and disseminate corrective statements regarding smoking health risks using mass media channels. We aimed to describe the nature, timing, reach of and exposure to the court-mandated tobacco ind...

E-cigarettes(vape) are now the most commonly used tobacco product among youth in the United States. Ads are claiming e-cigarettes help smokers quit, but most of them contain nicotine, which can cause addiction and harm the developing adolescent brain. Therefore national, state and local health organizations have proposed anti-vaping campaigns to wa...

Our research provides social scientists with areas of inquiry in tobacco-related health disparities in young adult women and opportunities for intervention, as Instagram may be a powerful tool for the public health surveillance of smoking behavior and social norms among young women. Social media has fundamentally changed how to engage with health-r...

There is growing interest in conducting public health research using data from social media. In particular, Twitter “infoveillance” has demonstrated utility across health contexts. However, rigorous and reproducible methodologies for using Twitter data in public health are not yet well articulated, particularly those related to content analysis, wh...

Background While national surveys showed declines in e-cigarette use in the USA between 2015 and 2016, recent reports indicate that JUUL, a sleekly designed e-cigarette that looks like a USB drive, is increasingly being used by youth and young adults. However, the extent of JUUL’s growth and its marketing strategy have not been systematically exami...

The purpose of the study is to investigate how vaping marijuana, a novel but emerging risky health behavior, is portrayed on YouTube, and how the content and features of these YouTube videos influence their popularity and retransmission. A content analysis of vaping marijuana YouTube videos published between July 2014 to June 2015 (n = 214) was con...

Background: LGBT populations use tobacco at disparately higher rates nationwide, compared to national averages. The tobacco industry has a history targeting LGBT with marketing efforts, likely contributing to this disparity. This study explores whether exposure to tobacco content on traditional and social media is associated with tobacco use among...

Objective To examine the impact of flavour, device type and health warning messages on youth preference for electronic nicotine delivery systems (ENDS), and to provide evidence and data to inform the Food and Drug Administration’s potential regulatory actions on ENDS. Design An online discrete choice experiment was conducted in September 2015. Eac...

Context: Testosterone replacement therapy (TRT) is currently approved by the Food and Drug Administration only for classic hypogonadism, although off-label indications have resulted in a dramatic expansion in prescriptions in the USA. Marketing may significantly affect prescriber behavior. Objective: To systematically review all available eviden...

The 60% decline in the prevalence of cigarette smoking among U.S. adults over the past 50 years represents a significant public health achievement. This decline was steered in part by national, state, and local tobacco control programs and policies, such as public education campaigns; widespread smoke-free air laws; higher cigarette prices that hav...

Importance: The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. Objective: We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. Design, s...

Anti-tobacco mass media campaigns are designed to influence tobacco users. It has been proved that campaigns will produce users’ changes in awareness, knowledge, and attitudes, and also produce meaningful behavior change of audience. Antismoking television advertising is the most important part in the campaign. Meanwhile nowadays successful online...

This study examines the relationships between exposure to food and beverage product television advertisements and consumption and obesity outcomes among youth. Individual-level data on fast food and soft drink consumption and body mass index (BMI) for young adolescents from the Early Childhood Longitudinal Study, kindergarten cohort, (1998–1999) an...