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Sam Fahmy
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School of Public Health
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Suggests that increased regulation of electronic and direct mail coupons could improve public health
ATLANTA—A new study led by researchers at the Georgia State University School of Public Health finds that direct mail and electronic coupons influence former smokers when they’re most vulnerable to relapse.
Researchers examined data from a nationally representative survey of more than 5,000 former smokers and found that those who received cigarette coupons through direct mail or email were twice as likely to relapse. The findings appear in the September edition of the American Journal of Preventive Medicine.
“We hypothesized that people who received coupons would be more likely to relapse, but we were surprised by the magnitude of the effect,” said lead author Jidong Huang, Professor in the Department of Health Policy and Behavioral Sciences. “It really shows that smokers who have quit within the past year are the most vulnerable to relapse, and it implies that policies that prohibit the distribution of tobacco coupons could help more people succeed in quitting.”
Huang emphasized that despite significant progress in reducing tobacco use, smoking remains America’s leading cause of preventable death and results in nearly half a million annual deaths in the U.S. Approximately 35 million American adults smoke, and nearly 70% of smokers are interested in quitting.
Huang credits strong tobacco prevention and control policies—such as raising tobacco taxes, adopting comprehensive smoke free policies, conducting hard-hitting anti-tobacco media campaigns and implementing restrictions on tobacco advertising—with helping push cigarette smoking in the U.S. to all-time lows but said his study highlights the need for additional regulation. In addition, he said that physicians and smoking cessation counselors should warn people who have recently quit about the impact that marketing materials can have on their efforts to quit.
“Most people aren’t aware that direct mail and email marketing are among the most important ways for tobacco companies to reach current and potential smokers, but it’s still a very important public health issue,” Huang said. “In addition to interventions and treatments that help people manage nicotine cravings, polices that prohibit the distribution of tobacco coupons could help more people successfully quit.”
Additional Georgia State School of Public Health authors on the study are former doctoral student Yu Wang, now a CDC Steven M. Teutsch Prevention Effectiveness Fellow, Assistant Professor Zongshuan Duan, Research Associate Professor Scott Weaver, Professor Shannon Self-Brown, Research Professor David Ashley and Professor Terry Pechacek, as well as Senior Fellow of Public Health Sherry Emery of NORC at the University of Chicago.
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Research reported in this news release was supported by the National Cancer Institute of the National Institutes of Health under award number R01CA194681. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Writer: Sam Fahmy, [email protected]
Featured Researcher

Jidong Huang
Professor
Department of Health Policy and Behavioral Sciences
School of Public Health
Huang’s research primarily focuses on three key areas. Firstly, his work involves the evaluation of the health equity and economic impact of public policies regulating health behaviors and products, with an emphasis on use of tobacco, alcohol and cannabis products. Secondly, Dr. Huang’s research delves into the epidemiology of diverse health behaviors. This involves an examination of their prevalence, distribution, temporal trends, patterns of usage and their multifaceted determinants that encompass social, economic and commercial factors. To achieve this, a wide array of data sources is harnessed, ranging from surveys to extensive big data repositories. The third research area involves employing experimental methodologies and other causal inference approaches to identify and evaluate health behavioral interventions that hold the potential to improve health outcomes and contribute notably to areas such as cancer prevention and control.