Addictive Behaviors 82 (2018) 28–34

Contents lists available at ScienceDirect

Addictive Behaviors
journal homepage: www.elsevier.com/locate/addictbeh

The Hip Hop peer crowd: An opportunity for intervention to reduce tobacco T
use among at-risk youth
⁎
Matthew W. Walkera, , Mario A. Navarroa, Leah Hoffmana, Dana E. Wagnerb,
Carolyn A. Stalgaitisb, Jeffrey W. Jordanb
a
Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
b
Rescue Agency, 2437 Morena Boulevard, San Diego, CA 92110, USA

H I G H L I G H T S

• Research has demonstrated elevated tobacco risk among Hip Hop peer crowd youth.
• FDA's multicultural youth tobacco education campaign focuses on Hip Hop peer crowd.
• We report on the first nationally-recruited sample of youth peer crowds and smoking.
• Compared to three crowds, Hip Hop youth were found to have elevated cigarette use.
• Hip Hop peer crowd targeting may reduce multicultural teen tobacco use.

A R T I C L E I N F O A B S T R A C T

Keywords: Introduction: Peer crowds, peer groups with macro-level connections and shared norms that transcend geo-
Hip Hop graphy and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop
Peer crowds peer crowd identification, which is common among multicultural youth, is associated with increased risk of
Multicultural tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco
Tobacco
education campaign tailored for Hip Hop youth aged 12–17 who are multicultural (Hispanic, African American,
Youth
Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream,
Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally
recruited sample.
Methods: Youth were recruited via targeted social media advertisements. Participants aged 13–17 (n = 5153)
self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in
smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific
differences.
Results: Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop
youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country
youth, and more likely to be Experimenters than Popular and Mainstream youth.
Conclusions: Representative studies show that Alternative is relatively small compared to other high-risk crowds,
such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored
to larger at-risk crowds for campaigns like Fresh Empire.

1. Introduction
Preference for Hip Hop music has been associated with increased
tobacco use risk among youth (Mulder et al., 2009, 2010), and studies
of Hip Hop music videos report portrayals of substance use, including
tobacco (Cranwell et al., 2015; DuRant et al., 1997; Gruber, Thau, Hill,
Fisher, & Grube, 2005; Primack, Dalton, Carroll, Agarwal, & Fine,
2008). However, Hip Hop is more than a genre of music; it is a powerful
“peer crowd,” or culture, that influences millions of people, including
many African American and Hispanic youth, given the culture's roots in
these communities (Chang, 2005; Motley & Henderson, 2008). In fact,
tobacco companies have historically utilized Hip Hop culture to market

⁎
Corresponding author.
E-mail addresses: Matthew.Walker@fda.hhs.gov (M.W. Walker), Mario.Navarro@fda.hhs.gov (M.A. Navarro), Leah.Hoffman@fda.hhs.gov (L. Hoffman),
Dana@rescueagency.com (D.E. Wagner), Carolyn@rescueagency.com (C.A. Stalgaitis), Jeff@rescueagency.com (J.W. Jordan).

https://doi.org/10.1016/j.addbeh.2018.02.014
Received 26 July 2017; Received in revised form 3 January 2018; Accepted 9 February 2018
Available online 10 February 2018
0306-4603/ Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
M.W. Walker et al.
tobacco products in minority communities through promotional activ-
ities aligning Hip Hop cultural values with tobacco use (Cruz, Wright, &
Crawford, 2010; Hafez & Ling, 2006). As a result, the connection be-
tween tobacco use and Hip Hop culture, and the peer crowd's influence
on youth beliefs and norms, were critical considerations when the Food
and Drug Administration (FDA) Center for Tobacco Products (CTP) and
its marketing and research contractor, Rescue Agency, began devel-
oping a national tobacco public education campaign for multicultural
youth.
1.1. The Fresh Empire campaign
To achieve the FDA's mission to reduce disease, disability, and death
caused by tobacco use, CTP has employed a comprehensive approach
that includes investing in campaigns to support its mission of educating
the public—especially young people—about the dangers of regulated
tobacco products. The Center for Tobacco Product's strategy was to
target populations most at risk for tobacco use, including historically
underserved and hard-to-reach multicultural youth who may face a
disproportionately high burden of tobacco-related death and disease
(Centers for Disease Control and Prevention, 2013a,b; Safford et al.,
2012; Keenan & Shaw, 2011). Fresh Empire is FDA's first public educa-
tion campaign designed to prevent and reduce tobacco use among at-
risk multicultural youth ages 12–17, specifically African American,
Hispanic, Asian-Pacific Islander, and Multiracial youth. Launched in the
Southeastern United States in May 2015 and expanded nationally in
October 2015, Fresh Empire targets the Hip Hop peer crowd to reach its
intended audience.
1.2. Peer crowds & peer crowd targeting
Peer crowds are defined as macro-level connections between peer
groups with similar interests, lifestyles, and influencers that transcend
race/ethnicity and geography (Moran, Walker, Alexander, Jordan, &
Wagner, 2017; Sussman, Pokhrel, Ashmore, & Brown, 2007). Common
adolescent peer crowds found in the United States include Mainstream,
Popular (or Preppy), Alternative, Hip Hop, and Country (Jordan,
Stalgaitis, Charles, Madden, Radhakrishnan, and Saggese, 2018; Moran
et al., 2017; Sussman et al., 2007); these crowds have been described in
detail elsewhere by Moran et al. (2017) and Jordan et al. (2018). Peer
crowds are particularly salient during adolescence as youth are devel-
oping their identities, a process strongly influenced by peers (Arnett,
2007; Brechwald & Prinstein, 2011; Erikson, 1994; Moran et al., 2017).
Adolescents absorb and adapt to the perceived norms of the peer
crowds with which they identify to gain group approval and a sense of
belonging (Berkowitz, 2005; Rimal, 2008; Terry & Hogg, 1996).
To capitalize on the sway peer crowds hold over youth and their
behavior, peer crowd targeting is an audience segmentation tool that
can be applied to health education efforts to target communications to
high-risk groups (Moran et al., 2017). Because peer crowds have unique
values, norms, beliefs, and behaviors, peer crowd targeting presents an
opportunity for campaigns to effectively reach at-risk groups through
identity-based messaging (Cohen, 2001; Lisha, Jordan, & Ling, 2016;
Moran et al., 2017; Sussman et al., 2007). By focusing on a specific peer
crowd, communicators can develop relevant messages and utilize a
crowd's preferred message channels to maximize salience and like-
lihood of positive reception (Jordan, Turner, & Djakaria, 2013; Moran
et al., 2017;Moran & Sussman, 2014, 2015). For example, adolescents
sometimes engage in risky behaviors as a way of rebelling or differ-
entiating themselves (Burt, Dinh, Peterson, & Sarason, 2000; Chassin,
1984; Petraitis, Flay, & Miller, 1995; Segal & Stewart, 1996). Given peer
crowds' ties to behavior, a peer crowd-targeted message grounded in
formative research allows a campaign to align itself with youth who
identify with non-Mainstream culture and demonstrate how they can
maintain their individuality while also engaging in healthy behaviors.
In this way, while a broadly-targeted campaign can be effective for
29
Addictive Behaviors 82 (2018) 28–34
many youth, a peer crowd-targeted campaign offers complimentary
messaging aimed at those who identify with specific sub-cultures.
The potential of this approach has been demonstrated in experi-
mental studies (Moran & Sussman, 2014, 2015), and in several real-
world applications such as Commune, a young adult Hipster peer crowd-
targeted tobacco prevention campaign in California (Ling et al., 2014;
Ling & Jordan, 2011); HAVOC, a young adult Partier peer crowd-tar-
geted tobacco prevention campaign in Oklahoma and New Mexico
(Fallin, Neilands, Jordan, Hong, & Wreaking, 2015; Kalkhoran, Lisha,
Neilands, Jordan, & Ling, 2016); and Syke, an adolescent Alternative
peer crowd-targeted tobacco prevention campaign in Virginia (Jordan
et al., 2013). Additionally, by facilitating focus on peer crowds re-
presenting larger pockets of high-risk adolescents and young adults,
peer crowd targeting may allow for more efficient reach of those in
need of health education (Ling, Holmes, Jordan, Lisha, & Bibbins-
Domingo, 2017). Taken together, experimental and evaluation studies
demonstrate both internal and external validity of a peer crowd tar-
geting approach to tobacco education campaigns.
1.3. The Hip Hop peer crowd and tobacco use risk
Like other peer crowds in the literature, the Hip Hop peer crowd is
defined by its shared norms and values. These values extend beyond
engaging in Hip Hop culture and identifying with the lyrics of Hip Hop
music, to include an urban clothing style; identification with a sense of
facing struggles in life; and values such as being fashionable, authentic,
and creative, and working hard to achieve culturally relevant success
(Lisha et al., 2016; Moran et al., 2017). Research has also documented
associations between the Hip Hop peer crowd and tobacco use (Jordan
et al., 2018; Lee, Jordan, Djakaria, & Ling, 2014; Lisha et al., 2016;
Sussman et al., 2007). For example, a 2009 study found that among
African American youth in Virginia, Hip Hop-identifying youth were
almost twice as likely to smoke cigarettes as Mainstream-identifying
youth (Lee et al., 2014). Recently, the 2015 state-wide representative
Virginia Youth Survey (Virginia Department of Health, 2015) found
that greater Hip Hop identification was associated with a 28% increase
in current tobacco use risk (95% CI: 1.18–1.39), a 22% increase in ci-
garette use risk (95% CI: 1.12–1.34), a 39% increase in cigar/cigarillo
use risk (95% CI: 1.25–1.53), and a 43% increase in hookah/water pipe
use risk (95% CI: 1.29–1.59) (Jordan et al., 2018). While these studies
provide useful data on peer crowd tobacco use generally, and on the
Hip Hop peer crowd specifically, an understanding of risk of tobacco
use by peer crowd at a national level could further inform and
strengthen public health education efforts (Moran et al., 2017).
1.4. The current study
The current study provides the largest nationally-recruited sample
of youth that includes data on peer crowd identification and cigarette
use to date. Furthermore, the study tests the relationship between Hip
Hop identification and risk of cigarette smoking, thereby providing a
cross-sectional view of susceptibility to and experimentation with ci-
garette smoking among Hip Hop youth in the United States.
2. Methods
2.1. Design and procedures
Data analyzed in this study were selected from a sample of 15,831
youth who completed the screener for a message testing study fielded
from April to August 2016 to inform the development of Fresh Empire
campaign advertising (Fig. 1). The screener data were primarily used
for determining eligibility for participation in the message testing
study. The current study utilizes the final screener sample that was
required to achieve the number of qualified participants needed for the
message testing study, and therefore was not informed by a power
M.W. Walker et al.
Initially screened from social media recruitment = 15,831
Non-susceptible Non-triers, Susceptible Non-triers, and
Experimenters ages 13-17 in U.S. states and D.C.= 13,032
Strong identifiers (scored 7 or higher on the I-Base Survey)
for any peer crowd = 5,153
Alternative = 944 Hip Hop = 1,695
Fig. 1. Participant selection for final analyses.
analysis. Participants ages 13–17 were recruited online from 48 con-
tiguous U.S. states and Washington, D.C. via social media advertise-
ments targeting youth who identified with the Hip Hop peer crowd.
Recruitment advertisements directing individuals to the screener were
served to Facebook and Instagram users identified using the platforms'
ad-targeting features such as age, geo-targeting, and interest-based
keywords. This study was approved by Chesapeake Institutional Review
Board (IRB) and the FDA IRB.
As shown in Fig. 1, the analytic sample excluded established smo-
kers (those who have smoked 100 or more cigarettes in their lifetime),
youth from outside the geographic target, and youth under the age of
13 (to comply with Children's Online Privacy Protection Act regulations
regarding online research with minors) or older than 17. Finally, only
youth who strongly identified with a single peer crowd as determined
by the I-Base Survey™ photo-based peer crowd measurement tool (de-
scribed in Section 2.2.3) were retained in the analytic sample. The final
sample included 5153 participants.
2.2. Measures
Participants reported lifetime cigarette smoking, susceptibility to
cigarette smoking, peer crowd identification, and demographics in-
cluding age, race/ethnicity, and sex. A cigarette smoking status variable
was created using an algorithm on susceptibility developed by Pierce
and colleagues (Pierce, Farkas, Evans, & Gilpin, 1995), and in-
corporating an experimentation category suggested by Mowery,
Farrelly, Haviland, Gable, & Wells (2004) and Okoli et al. (2009) to
investigate three groups of interest: Non-susceptible Non-triers, Sus-
ceptible Non-triers, and Experimenters.
2.2.1. Cigarette smoking behavior
Cigarette smoking behavior was measured by two items. First, youth
were asked “Have you ever tried cigarette smoking, even one or two
puffs?” with response options of “Yes” or “No” (Pierce et al., 1995;
Pierce, Choi, Gilpin, Farkas, & Merritt, 1996; Richardson, Okoli, Ratner,
& Johnson, 2010). Those responding ‘Yes’ were asked, “About how
many cigarettes have you smoked in your entire life?” (Pierce et al.,
1995, 1996). Participants who reported “1 or more puffs but never a
whole cigarette” to “26 to 99 cigarettes (more than 1 pack, but less than
5 packs)” were labeled as Experimenters. Participants who reported
“100 or more cigarettes (5 or more packs)” were categorized as
Addictive Behaviors 82 (2018) 28–34
Excluded = 2,799
Outside of 48 U.S. states and D.C. = 301
Outside of 13-17 age range = 1,953
Smoked 100 or more cigarettes in lifetime = 545
Excluded = 7,879
Scored less than 7 on the I-Base Survey for all
peer crowds = 7,879
Popular = 748 Country = 211 Mainstream = 1,555
Established Smokers and excluded from final analyses.
2.2.2. Cigarette smoking susceptibility
Cigarette smoking susceptibility was assessed using the three-item
index developed by Pierce et al. (1995). This index included the fol-
lowing items: “Do you think you will smoke a cigarette soon?”, “Do you
think you will smoke a cigarette in the next year?”, and “If one of your
best friends were to offer you a cigarette, would you smoke it?”. Re-
sponses were measured on a 4-point Likert scale from “Definitely yes”
to “Definitely not.” For participants who were not categorized as Ex-
perimenters or Established Smokers, those who selected “Definitely
not” on all three items were categorized as Non-susceptible Non-triers;
otherwise, they were categorized as Susceptible Non-triers.
2.2.3. Peer crowd identification
Peer crowd identification was assessed using a photo-based peer
crowd measurement tool known as the I-Base Survey. Developed by
Rescue Agency, the I-Base Survey has been used previously by FDA and
other researchers to assess peer crowd identification (Jordan et al.,
2018; Kalkhoran et al., 2016; Ling et al., 2014; Lisha et al., 2016) and
has been described in detail by Lee and colleagues (Lee et al., 2014).
Participants were shown 32 female and 32 male photos of unfamiliar
young people representing a mix of races/ethnicities and five common
peer crowds (Hip Hop, Popular, Mainstream, Alternative, Country).
Pages of female and male photos were presented separately. On each
page, participants were asked to select, in rank order, the three photos
that would best fit with their main group of friends, and the three
photos that would least fit with their main group of friends. Photo ar-
rangement was randomized by participant, and participants were not
informed of the peer crowd labels used for analyses.
A participant's score for each peer crowd was calculated by attri-
buting 3 points to the peer crowd of the photo ranked as best fit, 2
points for the photo ranked second best fit, and 1 point for third best fit.
Similarly, scores of −3, −2, and −1 were attributed to the least fit
photo selections. Points for each peer crowd across female and male
selections were summed to create a single score for each peer crowd
ranging from −12 to 12. In the current study, participants who scored a
7 or greater for a particular peer crowd were considered “high identi-
fiers” and were grouped with that crowd for analyses. Those who did
not score a 7 or greater for any crowd were excluded from final ana-
lyses. This ensured that participants within a particular crowd had not
30
M.W. Walker et al. Addictive Behaviors 82 (2018) 28–34

scored equally or higher for another peer crowd. indicates that p < .05.

2.2.4. Demographic characteristics 3. Results

Sex, age, and self-identified race/ethnicity were measured. Sex was
measured by the item, “What is your sex?” Participants could respond
“Female” or “Male.” Age was measured by the item, “How old are you?”
Participants could indicate “11 years old or younger” through “18 years
old or older,” in increments of one year. The self-identified race/eth-
nicity variable was created from two items. First, participants were
asked “Are you of Hispanic, Latino/a, or Spanish origin?”. Second, they
were asked “What race or races do you consider yourself to be? (You
may select more than one answer)”. The available responses were
“American Indian or Alaska Native,” “Asian,” “Black or African
American,” “Native Hawaiian or Other Pacific Islander,” “White,” and
“Other.” Those who responded "yes" to “Are you of Hispanic, Latino/a,
or Spanish origin?” were categorized as “Hispanic.” Those who re-
sponded “no” were categorized by their response to the race item, with
“Asian” and “Native Hawaiian or Other Pacific Islander” combined into
“Non-Hispanic Asian-Pacific Islander.” “Non-Hispanic Other” included
those who responded “American Indian or Alaska Native” and/or
‘Other.’ “Non-Hispanic Multiracial” consisted of those who identified as
multiple races.
2.3. Data analysis
Analyses were conducted using IBM SPSS version 20. Participant
demographics were examined to describe the sample through fre-
quencies and percentages (Table 1). Additionally, demographic fre-
quencies and percentages for each peer crowd were examined (Table 2).
To explore the association between smoking status and peer crowd, a
Pearson chi-square test was used assessing significance at the p < .05
level. For follow-up analyses to identify differences between specific
peer crowds, comparisons of column proportions were assessed using z-
tests at the p < .05 level, using the Bonferroni correction to correct for
Type I error (Table 3). Within IBM SPSS, the Bonferonni correction was
completed by having the significance value that would be regularly
computed multiplied by the number of comparisons taking place. The
comparison significance value remained p = .05 but the p-value com-
puted was multiplied by a factor of 10, as there were 10 comparisons in
the current study. IBM SPSS does not report the exact value but rather
Table 1
Sample descriptive statistics.
Variable n %
As Table 1 demonstrates, 61% of the sample was female, and the
sample was diverse in terms of race/ethnicity with 32% of respondents
self-reporting as Non-Hispanic White, 24% as Hispanic, and 19% as
Non-Hispanic African American. The majority of the sample did not
have experience with cigarettes (53% Non-susceptible Non-triers, 22%
Susceptible Non-triers), which is consistent with national surveys
among U.S. youth; for example, among non-triers in this sample, 30%
were susceptible to cigarettes, which is similar to susceptibility rates
found in the 2014 National Youth Tobacco Survey (range: 21%–30% of
middle and high school students) (El-Toukhy, Sabado, & Choi, 2016).
The largest proportion of respondents identified with the Hip Hop peer
crowd (33%), which was expected based on the targeted methods used
in recruitment.
Demographic characteristics by peer crowd are presented in
Table 2. Variations in gender and race/ethnicity were found across peer
crowds. Specifically, the Alternative sample skewed female (74%),
while the Country sample skewed male (63%). For race/ethnicity, 51%
of the Alternative sample and 67% of the Country sample self-identified
as Non-Hispanic White, while more than three-quarters of the Hip Hop
sample identified as multicultural (Hispanic, Non-Hispanic African
American, Non-Hispanic Asian-Pacific Islander, or Non-Hispanic Mul-
tiracial). Mean age was similar across peer crowds, ranging from 15.18
to 15.31.
The relationship between peer crowd identification and cigarette
smoking status (Table 3) was significant χ2 (8, n = 5153) = 387.35,
p < .001. Based on follow-up tests, the Mainstream, Country, and
Popular peer crowds had significantly larger proportions of Non-sus-
ceptible Non-triers than Hip Hop and Alternative. Mainstream also had
a significantly larger proportion of Non-susceptible Non-triers than
Popular, while Hip Hop had a significantly larger proportion of Non-
susceptible Non-triers than Alternative. There were no significant dif-
ferences among proportions of Susceptible Non-triers between any of
the crowds. The Alternative peer crowd had a significantly larger pro-
portion of Experimenters than all other peer crowds, while the Hip Hop
peer crowd had a significantly larger proportion of Experimenters than
Popular and Mainstream. The Mainstream peer crowd had the smallest
proportion of Experimenters. These results suggest a hierarchy of risk
within the sample, with Alternative at the highest risk followed by Hip
Hop; Country and Popular at moderate risk; and Mainstream at lowest
risk.

Sex 4. Discussion
Male 2007 38.85
Female 3146 61.05 The current study lends support to a growing body of literature
Self-identified race/ethnicity
demonstrating that the Hip Hop peer crowd is at increased risk for
Hispanic 1250 24.26
Non-Hispanic African American 1002 19.44 tobacco use and is a promising audience for health education efforts
Non-Hispanic Asian-Pacific Islander 351 6.81 (Jordan et al., 2018; Sears & Mildner, 2015; Lee et al., 2014; Lisha et al.,
Non-Hispanic Multiraciala 456 8.85 2016). Moving beyond previous studies, the current study replicates
Non-Hispanic White 1672 32.45 these findings with a large and nationally-recruited sample to provide
Non-Hispanic Otherb 422 8.19
further evidence of the association between risk of cigarette smoking
Smoking status
Non-susceptible Non-trier 2735 53.08 and Hip Hop peer crowd identification.
Susceptible Non-trier 1146 22.24 Additionally, this study supports previous research showing that the
Experimenter 1272 24.68 Alternative crowd is at increased risk of tobacco use compared to other
Peer crowd
peer crowds (Jordan et al., 2018; Sears & Mildner, 2015). While pre-
Alternative 944 18.32
Hip Hop 1695 32.89 vious research has found the Alternative peer crowd to be relatively
Popular 748 14.52 small in comparison to others (Jordan et al., 2018; Sears & Mildner,
Country 211 4.09 2015), the current study confirms the Alternative peer crowd is another
Mainstream 1555 30.18 viable population for peer crowd-targeted health education campaigns,
Mean age (standard deviation) 5153 15.22 (1.02)
such as the Syke campaign in Virginia (Jordan et al., 2013).
a
Non-Hispanic Multiracial includes those who identified as two or more races. Given evidence from other studies on peer crowds and tobacco use
b
Non-Hispanic Other includes those who identified as American Indian/Alaskan (Jordan et al., 2018; Sears & Mildner, 2015; Lee et al., 2014; Lisha et al.,
Native and/or Other. 2016), it might be expected that the Hip Hop peer crowd would have a

31
M.W. Walker et al. Addictive Behaviors 82 (2018) 28–34

Table 2
Sample descriptive statistics by peer crowd.

Variable Alternative Hip Hop Popular Country Mainstream

n % n % n % n % n %

Sex
Male 246 26.06 725 42.77 395 52.81 133 63.03 508 32.67
Female 698 73.94 970 57.23 353 47.19 78 36.97 1047 67.33
Self-identified race/ethnicity
Hispanic 196 20.76 528 31.15 176 23.53 21 9.95 329 21.16
Non-Hispanic African American 45 4.77 514 30.32 123 16.44 2 0.95 318 20.45
Non-Hispanic Asian-Pacific Islander 21 2.22 54 3.19 49 6.55 8 3.79 219 14.08
Non-Hispanic Multiraciala 67 7.10 205 12.09 51 6.82 5 2.37 128 8.23
Non-Hispanic White 486 51.48 284 16.76 292 39.04 141 66.82 469 30.16
Non-Hispanic Otherb 129 13.67 110 6.49 57 7.62 34 16.12 92 5.92
Mean age (standard deviation) 944 15.24 (1.00) 1695 15.20 (1.05) 748 15.31 (0.99) 211 15.25 (1.00) 1555 15.18 (1.01)

a
Non-Hispanic Multiracial includes those who identified as two or more races.
b
Non-Hispanic Other includes those who identified as American Indian/Alaskan Native and/or Other.

significantly higher proportion of Susceptible Non-triers than lower-risk
crowds, which was not the case in the current study. However, focusing
on Susceptible Non-triers masks a broader trend, wherein the Hip Hop
peer crowd reported a significantly lower proportion of Non-susceptible
Non-triers than the three lower-risk crowds and a significantly higher
proportion of Experimenters than the two lowest-risk crowds. This in-
dicates that in fact, the Hip Hop peer crowd is particularly at risk of
cigarette smoking, with more youth progressing to experimentation
than in lower-risk crowds.
4.1. Limitations
This study and many others suggest that the Hip Hop peer crowd is
an important target population for youth tobacco prevention (Jordan
et al., 2018; Sears & Mildner, 2015; Lee et al., 2014; Lisha et al., 2016).
However, at this time, no nationally representative study of peer
crowds and tobacco use has been reported. Although this study used
nationwide recruitment, it lacks national representativeness. In addi-
tion, the social media advertisements used in the study recruitment
were specifically targeted to Hip Hop youth. As such, representation of
Hip Hop youth in the sample is likely larger than would be expected in a
nationally representative sample, and representation of other crowds
such as Country is smaller than might be expected due to the highly-
targeted nature of the recruitment strategy. A nationally representative
study would provide accurate size estimates, demographics, and risk
levels of each peer crowd in the United States, to better understand the
association between peer crowds and health behaviors. This study is
also limited by its cross-sectional design and its focus on cigarette use.
Longitudinal studies that include a broader range of tobacco products
could facilitate examining the relationship between peer crowd and
tobacco initiation and use trajectories over time. In addition, existing
evidence of the effectiveness of peer crowd targeting is limited to ex-
perimental studies and local campaign evaluations targeting peer
crowds other than Hip Hop. Future studies, including the previously
mentioned message testing study and forthcoming evaluations of Fresh
Empire, should elucidate the effectiveness of peer crowd targeting
generally and for the Hip Hop peer crowd specifically.
In the current study, participants were included in final analyses
only if they scored 7 or more points for a single peer crowd on the I-
Base Survey. Since the maximum score was 12 points, this prevented
teens from being categorized in more than one peer crowd, and ex-
cluded teens that did not score 7 or more points for any crowd.
However, it may be more realistic to conceptualize an individual as
having varying levels of identification with several peer crowds to more
accurately reflect the complexity of adolescent identity (Moran et al.,
2017). Future studies should examine the non-mutually exclusive
nature of peer crowd identity, including patterns of multiple peer crowd
identification and risk of tobacco use, to expand knowledge of how peer
crowd identification can interact with and affect behavior.
4.2. Implications
While there are many examples of risk promotion in Hip Hop cul-
ture (Cranwell et al., 2015; DuRant et al., 1997; Gruber et al., 2005;
Kostygina, Tran, Shi, Kim, & Emery, 2016; Mulder et al., 2009, 2010;
Primack et al., 2008; Richardson, Ganz, & Vallone, 2014) some Hip Hop
artists have organically harnessed the power of the culture's values to
bring awareness to and promote positive change for health and social
issues, including recent examples focusing on opioid abuse (Haggerty,
2016) and the contamination of drinking water in Flint, Michigan
(Madden, 2016). These examples demonstrate the potential of the un-
ique norms and values associated with Hip Hop to promote public
health and potentially provide a template for motivational peer crowd-
tailored messaging. By shaping the perceived norms and attitudes of a
peer crowd, health education campaigns such as Fresh Empire may
achieve positive behavior change as those identifying with the peer
crowd revise their social identities to adopt healthier behaviors or drop
unhealthy ones. Therefore, it is important to continue to explore the

Table 3
Distribution of cigarette smoking status by peer crowd.

Smoking status Alternative (a) Hip Hop (b) Popular (c) Country (d) Mainstream (e)

n % n % n % n % n %

Non-susceptible Non-trier 316 33.47 827 48.79a 415 55.48ab 126 59.72ab 1051 67.59abc
Susceptible Non-trier 242 25.64 357 21.06 178 23.80 40 18.96 329 21.16
Experimenter 386 40.89bcde 511 30.15ce 155 20.72e 45 21.33e 175 11.25
Total 944 100.00 1695 100.00 748 100.00 211 100.00 1555 100.00

Note. Superscripts indicate significant differences in proportion by peer crowd using a z-test with the Bonferroni correction. The letter of the superscript signifies that the proportion is
statistically greater (p < .05) than the proportion for the column labeled with that letter.

32
M.W. Walker et al.
connection between Hip Hop peer crowd identification and tobacco use
risk, especially in light of its potential as a vehicle for change.
Evidence suggests that the Hip Hop peer crowd is relatively
common among young people overall, and although peer crowd iden-
tification transcends race/ethnicity, research indicates the Hip Hop
crowd has a higher than average representation of multicultural youth
(Jordan et al., 2018; Sears & Mildner, 2015). For example, re-
presentative samples of Virginia high school students from both 2011
and 2015 found that the proportion of Hip Hop youth who identified as
multicultural was almost double that of the full sample (Jordan et al.,
2018; Sears & Mildner, 2015). These findings are supported by the
current study, suggesting that a relatively high proportion of youth
overall and, more specifically, a higher proportion of multicultural
youth, identify with the Hip Hop peer crowd.
5. Conclusions
Findings from this study provide additional evidence that peer
crowd identification is associated with risky behavior. Specifically, re-
sults demonstrate the association between Hip Hop peer crowd iden-
tification and cigarette experimentation. Peer crowd-targeted cam-
paigns such as Fresh Empire have the potential to reach at-risk youth by
focusing on message characteristics relevant to high-risk groups.
Role of funding sources
Funding for this study provided by U.S. Food and Drug
Administration IDIQ Contract HHSF223201210006I. FDA employees
MWW, LH, and MAN were involved in components of the study design,
collection, analysis and interpretation, manuscript drafting, and the
decision to submit the paper for publication. DEW, CAS, and JWJ are
employees of the company receiving the funding (Rescue Agency) and
are co-authors for this study. This publication represents the views of
the authors and does not represent FDA CTP position or policy.
Contributors
Authors DEW, CAS, MWW, and LH designed the study and wrote the
protocol. Authors DEW and CAS implemented the study. Author JWJ
proposed and designed the peer crowd campaign described. Authors
MWW, MAN, and LH conducted the statistical analysis reported. All
authors contributed to the first draft of the manuscript, and all authors
have approved the final manuscript.
Conflict of interest
Authors DEW, CAS, and JWJ are employees of Rescue Agency, the
agency of record for the Fresh Empire campaign funded by the U.S. Food
and Drug Administration and described in this paper. All other authors
declare they have no conflicts of interest.
Acknowledgements
The authors would like to thank the youth who participated in this
study and acknowledge our colleagues at CTP/OHCE including Gem
Benoza, Rashetta Fairnot, Ashley Smith, and Janell Muhammad for
their guidance and direction of the Fresh Empire campaign. We would
also like to acknowledge Connor Lynch, Dina Weldin, Anna Trout, and
Mayo Djakaria from Rescue Agency. Finally, we would like to ac-
knowledge Emily Talbert and April Brubach for their editorial review of
this manuscript and thank Xiaoquan Zhao and Tesfa Alexander.
Disclaimer: This publication represents the views of the author(s)
and does not represent FDA/CTP position or policy.
33
Addictive Behaviors 82 (2018) 28–34
References
Arnett, J. (2007). Emerging adulthood: What is it, and what is it good for? Child
Development Perspectives, 1(2), 68–73. http://dx.doi.org/10.1111/j.1750-8606.2007.
00016.x.
Berkowitz, A. D. (2005). An overview of the social norms approach. In L. C. Lederman, &
L. Stewart (Eds.). Changing the culture of college drinking: a socially situated health
communication campaign (pp. 193–214). Cresskill, NJ: Hampton Press.
Brechwald, W., & Prinstein, M. (2011). Beyond homophily: A decade of advances in
understanding peer influence processes. Journal of Research on Adolescence, 21(1),
166–179. https://doi.org/10.1111/j.1532-7795.2010.00721.x.
Burt, R. D., Dinh, K. T., Peterson, A. V., & Sarason, I. G. (2000). Predicting adolescent
smoking: A prospective study of personality variables. Preventive Medicine, 30(2),
115–125. http://dx.doi.org/10.1006/pmed.1999.0605.
Centers for Disease Control and Prevention (2013). Health disparities and inequalities
report - United States, 2013. Morbidity and Mortality Weekly Report, 62(3), 1–187.
Centers for Disease Control and Prevention (CDC) (2013). Tobacco product use among
middle and high school students—United States, 2011 and 2012. Morbidity and
Mortality Weekly Report, 62(45), 893–897.
Chang, J. (2005). Can't stop Won't stop: A history of the Hip-Hop generation. New York City,
NY: St. Martin's Press.
Chassin, L. (1984). Adolescent substance use and abuse. Advances in Child Behavior
Analysis and Therapy, 3, 99–152. http://dx.doi.org/10.1002/9780471726746.ch21.
Cohen, J. (2001). Defining identification: A theoretical look at the identification of au-
diences with media characters. Mass Communication Society, 4(3), 245–264. http://
dx.doi.org/10.1207/S15327825MCS0403_01.
Cranwell, J., Murray, R., Lewis, S., Leonardi-Bee, J., Dockrell, M., & Britton, J. (2015).
Adolescents' exposure to tobacco and alcohol content in YouTube music videos.
Addiction, 110(4), 703–711. http://dx.doi.org/10.1111/add.12835.
Cruz, T., Wright, L., & Crawford, G. (2010). The menthol marketing mix: Targeted pro-
motions for focus communities in the United States. Nicotine & Tobacco Research,
12(Suppl. 2), S147–S153. http://dx.doi.org/10.1093/ntr/ntq201.
DuRant, R., Rome, E., Rich, M., Allred, E., Emans, S., & Woods, E. (1997). Tobacco and
alcohol use behaviors portrayed in music videos: A content analysis. American Journal
of Public Health, 87(7), 1131–1135. http://dx.doi.org/10.2105/AJPH.87.7.1131.
El-Toukhy, S., Sabado, M., & Choi, K. (2016). Trends in susceptibility to smoking by race
and ethnicity. Pediatrics, 138(5), e20161254. http://dx.doi.org/10.1542/peds.2016-
1254.
Erikson, E. (1994). Identity: Youth and crisis. New York City, NY: Norton.
Fallin, A., Neilands, T., Jordan, J., Hong, J., & Wreaking, L. P. (2015). “Havoc” on
smoking: Social branding to reach young adult “partiers” in Oklahoma. American
Journal of Preventive Medicine, 48(Suppl. 1), S78–S85. http://dx.doi.org/10.1016/j.
amepre.2014.09.008.
Gruber, E., Thau, H., Hill, D., Fisher, D., & Grube, J. (2005). Alcohol, tobacco and illicit
substances in music videos: A content analysis of prevalence and genre. The Journal of
Adolescent Health, 37(1), 81–83. http://dx.doi.org/10.1016/j.jadohealth.2004.02.
034.
Hafez, N., & Ling, P. (2006). Finding the Kool Mixx: How Brown & Williamson used music
marketing to sell cigarettes. Tobacco Control, 15(5), 359–366. http://dx.doi.org/10.
1136/tc.2005.014258.
Haggerty, B. (2016). Prescription for Change: Ending America's Opioid Crisis [video].
Viacom: New York City, NY. https://www.youtube.com/watch?v=2QePuumO31o,
Accessed date: 27 February 2017.
Jordan, J. W., Stalgaitis, C. A., Charles, J., Madden, P. A., Radhakrishnan, A. G., &
Saggese, D. (2018). Peer crowd identification and adolescent health behaviors:
Results from a statewide representative study. Health Education & Behavior (in press).
Jordan, J. W., Turner, S., & Djakaria, M. (2013). Syke: Using social branding to change
culture and reduce teen smoking. In K. Kubacki, & S. Rundle-Thiele (Eds.).
Contemporary issues in social marketing (pp. 195–215). Newcastle Upon Tyne, UK:
Cambridge Scholars Publishing.
Kalkhoran, S., Lisha, N. E., Neilands, T. B., Jordan, J. W., & Ling, P. M. (2016). Evaluation
of bar and nightclub intervention to decrease young adult smoking in New Mexico.
The Journal of Adolescent Health, 59(2), 222–229. http://dx.doi.org/10.1016/j.
jadohealth.2016.04.003.
Keenan, N. L., & Shaw, K. M. (2011). Coronary heart disease and stroke deaths-United
States, 2006. MMWR Surveillance Summaries, 60(Suppl), 62–66.
Kostygina, G., Tran, H., Shi, Y., Kim, Y., & Emery, S. (2016). ‘Sweeter than a swisher’:
Amount and themes of little cigare and cigarillo content on twitter. Tobacco Control,
25, i75–i82. http://dx.doi.org/10.1136/tobaccocontrol-2016-053094.
Lee, Y., Jordan, J., Djakaria, M., & Ling, P. (2014). Using peer crowds to segment Black
youth for smoking intervention. Health Promotion Practice, 15(4), 530–537. http://dx.
doi.org/10.1177/1524839913484470.
Ling, P., Youn Ok, L., Hong, J., Neilands, T., Jordan, J., & Glantz, S. (2014). Social
branding to decrease smoking among young adults in bars. American Journal of Public
Health, 104(4), 751–759. http://dx.doi.org/10.2105/AJPH.2013.301666.
Ling, P. M., Holmes, L. M., Jordan, J. W., Lisha, N. E., & Bibbins-Domingo, K. (2017).
Bars, nightclubs, and cancer prevention: New approaches to reduce young adult ci-
garette smoking. American Journal of Preventive Medicine, 53(3S1), S78–S85. http://
dx.doi.org/10.1016/j.amepre.2017.03.026.
Ling, P. M., & Jordan, J. W. (2011). Psychographic market segmentation in social mar-
keting to reduce smoking among young adults in bars and nightclubs. In J. French, R.
Merritt, & L. Reynolds (Eds.). Social marketing casebook (pp. 113–128). London,
England: Sage Publications.
Lisha, N., Jordan, J., & Ling, P. (2016). Peer crowd affiliation as a segmentation tool for
young adult tobacco use. Tobacco Control, 25(Suppl. 1), i83–i89. http://dx.doi.org/
M.W. Walker et al.
10.1136/tobaccocontrol-2016-053086.
Madden, S. (2016). Jon Connor gives a voice to his city with “fresh water for Flint”
featuring Keke Palmer. XXL. January 28 http://www.xxlmag.com/rap-music/new-
music/2016/01/jon-connor-gives-a-voice-to-his-city-with-fresh-water-for-flint-
featuring-keke-palmer/, Accessed date: 27 February 2017.
Moran, M., & Sussman, S. (2014). Translating the link between social identity and health
behavior into effective health communication strategies: An experimental application
using antismoking advertisements. Health Communication, 29(10), 1057–1066.
http://dx.doi.org/10.1080/10410236.2013.832830.
Moran, M., & Sussman, S. (2015). Changing attitudes toward smoking and smoking
susceptibility through peer crowd targeting: More evidence from a controlled study.
Health Communication, 30(5), 521–524. http://dx.doi.org/10.1080/10410236.2014.
902008.
Moran, M., Walker, M., Alexander, T., Jordan, J., & Wagner, D. (2017). Why peer crowds
matter: Incorporating youth subcultures and values in health education campaigns.
American Journal of Public Health, 107(3), 389–395. http://dx.doi.org/10.2105/
AJPH.2016.303595.
Motley, C., & Henderson, G. (2008). The global hip-hop diaspora: Understanding the
culture. Journal of Business Research, 61(3), 243–253. http://dx.doi.org/10.1016/j.
jbusres.2007.06.020.
Mowery, P. D., Farrelly, M. C., Haviland, M. L., Gable, J. M., & Wells, H. E. (2004).
Progression to established smoking among US youths. American Journal of Public
Health, 94, 331–337. http://dx.doi.org/10.2105/AJPH.94.2.331.
Mulder, J., Ter Bogt, T., Raaijmakers, Q., Gabhainn, S., Monshouwer, K., & Vollebergh, W.
(2009). The soundtrack of substance use: Music preference and adolescent smoking
and drinking. Substance Use & Misuse, 44(4), 514–531. http://dx.doi.org/10.1080/
10826080802347537.
Mulder, J., Ter Bogt, T., Raaijmakers, Q., Gabhainn, S., Monshouwer, K., & Vollebergh, W.
(2010). Is it the music? Peer substance use as a mediator of the link between music
preferences and adolescent substance use. Journal of Adolescence, 33(3), 387–394.
http://dx.doi.org/10.1016/j.adolescence.2009.09.001.
Okoli, C. T., Ratner, P. A., Haines, R. J., Sullivan, K. M., Guo, S. E., & Johnson, J. L.
(2009). Do researcher-derived classifications of youths' smoking behavior correspond
with youths' characterizations of their behavior? Addictive Behaviors, 34, 984–992.
http://dx.doi.org/10.1016/j.addbeh.2009.05.012.
Petraitis, J., Flay, B. R., & Miller, T. Q. (1995). Reviewing theories of adolescent substance
use: Organizing pieces in the puzzle. Psychological Bulletin, 117(1), 67–86. http://dx.
doi.org/10.1037/0033-2909.117.1.67.
34
Addictive Behaviors 82 (2018) 28–34
Pierce, J. P., Choi, W. S., Gilpin, E. A., Farkas, A. J., & Merritt, R. K. (1996). Validation of
susceptibility as a predictor of which adolescents take up smoking in the United
States. Health Psychology, 15, 355–361. http://dx.doi.org/10.1037/0278-6133.15.5.
355.
Pierce, J. P., Farkas, A. J., Evans, N., & Gilpin, E. (1995). An improved surveillance
measure for adolescent smoking? Tobacco Control, 4, S47–S56.
Primack, B., Dalton, M., Carroll, M., Agarwal, A., & Fine, M. (2008). Content analysis of
tobacco, alcohol, and other drugs in popular music. Archives of Pediatrics & Adolescent
Medicine, 162(2), 169–175. http://dx.doi.org/10.1001/archpediatrics.2007.27.
Richardson, A., Ganz, O., & Vallone, D. (2014). The cigar ambassador: How Snoop Dogg
uses Instagram to promote tobacco use. Tobacco Control, 23, 79–80. http://dx.doi.
org/10.1136/tobaccocontrol-2013-051037.
Richardson, C. G., Okoli, C. T., Ratner, P. A., & Johnson, J. L. (2010). Empirical support
for a multi-dimensional model of sensations experienced by youth during their initial
smoking episodes. Addiction, 105, 1827–1834. http://dx.doi.org/10.1111/j.1360-
0443.2010.03041.x.
Rimal, R. N. (2008). Modeling the relationship between descriptive norms and behaviors:
A test and extension of the theory of normative social behavior (TNSB). Health
Communication, 23(2), 103–116. http://dx.doi.org/10.1080/10410230801967791.
Safford, M. M., Brown, T. M., Muntner, P. M., Durant, R. W., Glasser, S., Halanych, J. H.,
... Lewis, C. E. (2012). Association of race and sex with risk of incident acute coronary
heart disease events. JAMA: The Journal of the American Medical Association, 308(17),
1768–1774. http://dx.doi.org/10.1001/jama.2012.14306.
Sears MD, Mildner CA; Market Decisions Research. Virginia I-Base Survey Analysis
Report. http://www.vfhy.org/sites/default/files/research/VA_IBase_Analysis_
Report_PRO.pdf. Published January 16 2015. Accessed February 21, 2017.
Segal, B. M., & Stewart, J. C. (1996). Substance use and abuse in adolescence: An over-
view. Child Psychiatry and Human Development, 26(4), 193–210. http://dx.doi.org/10.
1007/BF02353237.
Sussman, S., Pokhrel, P., Ashmore, R., & Brown, B. (2007). Adolescent peer group iden-
tification and characteristics: A review of the literature. Addictive Behaviors, 32(8),
1602–1627. http://dx.doi.org/10.1016/2Fj.addbeh.2006.11.018.
Terry, D. J., & Hogg, M. A. (1996). Group norms and the attitude–behavior relationship: A
role for group identification. Personality and Social Psychology Bulletin, 22(8),
776–793. http://dx.doi.org/10.1177/2F0146167296228002.
Virginia Department of Health (2015). High school Virginia youth survey. Richmond, VA:
Virginia Department of Health. http://www.vdh.virginia.gov/virginia-youth-survey/
questionnaires-and-documentation/ (Accessed February 21, 2017).