Background:
Young adulthood is critical both for tobacco initiation and cessation. This study evaluated the effectiveness of an innovative Social Branding intervention to decrease smoking among high risk “Hipster” young adults in bars and nightclubs. The intervention included an anti-tobacco Social Brand to compete with cigarette brands, sponsored social events in bars/clubs, anti-tobacco messaging created by local young adult artists, branded clothing and promotional items, website, social media and direct mail promotions.

Methods:
Quasi-experimental controlled study of young adult bar patrons in two intervention cities (San Diego and San Francisco, CA) and one comparison community (Los Angeles, CA), surveyed at baseline and two years follow-up (approximately 1200 each time point per city) between January, 2012, and October, 2016. Cross-sectional surveys were collected using randomized time-location sampling of venues in each city. The outcome was current (past 30 day) smoking. Logistic regressions controlling for age, sex and race/ethnicity with interactions between location and time were conducted.

Results:
Current smoking prevalence among bar patrons was 41-50%, higher than the general California smoking prevalence of 12%. In San Diego, where the intervention was established for several years, cigarette smoking was significantly lower (42% baseline, 38% follow up) than in Los Angeles (LA, 45% baseline and 45% follow up) throughout the study. In San Francisco, where the intervention was new, cigarette smoking decreased significantly (51% baseline, 44% follow up), compared to LA where there was no change.

Conclusions:
An innovative Social Branding intervention was associated with a sustained lower smoking prevalence in San Diego and a significantly decreased smoking prevalence in San Francisco, compared to the control community. While these data are limited to California, this segmentation strategy can be used across the US and among young adults in many other countries. This approach could also build a global anti-tobacco brand for young adults.