Predictive Validity of the Expanded Susceptibility to Smoke Index

Abstract

Objectives: The susceptibility to smoking index can be improved as it only identifies one third of future adult smokers. Adding curiosity to this index may increase the identification of future smokers and improve the identification of effective prevention messages. Methods: Analyses used data from the California Longitudinal Study of Smoking Transitions in Youth, for whom tobacco use behaviors, attitudes, and beliefs were assessed at 3 time points from age 12 through early adulthood. Logistic regressions were used to evaluate whether baseline curiosity about smoking was predictive of smoking during the 6-year follow-up period and whether curiosity about smoking provided evidence of incremental validity over existing measures of susceptibility to smoking. Results: Compared to those who were classified as definitely not curious about smoking, teens who were classified as probably not curious (OR adj = 1.90, 95% CI = 1.28-2.81) and those classified as definitely curious (OR adj = 2.38, 95% CI= 1.49-3.79) had an increase in the odds of becoming a young adult smoker. Adding curiosity to the original susceptibility to smoking index increased the sensitivity of the enhanced susceptibility index to 78.9% compared to 62.2% identified by the original susceptibility index. However, a loss of specificity meant there was no improvement in the positive predictive value. Conclusions: The enhanced susceptibility index significantly improves identification of teens at risk for becoming young adult smokers. Thus, this enhanced index is preferred for identifying and testing potentially effective prevention messages.

E-Cigarettes and Future Cigarette Use

“…[7][8][9][10][11][12][13] E-cigarette users, representing several age groups and geographic locations, had 2 to 4 times the odds of indicating an intention to use cigarettes as never users, 7,8 results consistent with those we reported in the CHS. 9 To date there have been 3 reports from prospective cohort studies examining the relationship between e-cigarette use and subsequent initiation of combustible cigarette use in adolescence, including a study of 9th-grade students (mean age 14.1), 14 a second study of 9th and 10th-grade students (mean age 14.7), 15 and another small study of 16-to 26-year-olds, with few never-smoking e-cigarette users at baseline that was not able to examine associations within specific developmental periods in this age range.…”

“…10,11,13 In the current study, susceptibility to future cigarette use was assessed using validated measures (see Supplemental Material). Adolescents were classified as having no susceptibility if they responded "definitely not" to questions about intention to initiate use of cigarettes in the future.…”

“…[1][2][3][4][5][6] Among high school students in the National Youth Tobacco Survey, 13.4% of adolescents reported past 30-day use of e-cigarettes in 2014, compared with 9.2% of adolescents who reported past 30-day use of cigarettes. 1 Among high school students participating in the Southern California Children's Health Study (CHS), we found that 24.0% had ever tried e-cigarettes (including 9.6% who reported use in the past 30 days), compared with 18.7% who had tried cigarettes (5.7% in the past 30 days); >40% of e-cigarette users had never smoked a combustible cigarette.…”

The relationships between sensation seeking and a spectrum of e-cigarette use behaviors: Cross-sectional and longitudinal analyses specific to Texas adolescents

“…Susceptibility to e-cigarette use was measured using the following three questions: “Do you think you will use the following products (e-cigarettes) in the next 12 months?”; “If one of your close friends were to offer you one of the following products (e-cigarettes), would you use it?”; and “Have you ever been curious about using an e-cigarette?”(Pierce, Distefan, Kaplan, & Gilpin, 2005; Strong et al, 2014). Response options were “definitely not (1),” “probably not (2),” “probably yes (3),” and “definitely yes (4).” Susceptibility to e-cigarette use was restricted to never users of e-cigarettes at baseline.…”

Depression and cigarette smoking behavior: A critical review of population-based studies

“…Susceptibility to smoking has been linked to smoking initiation (63,64) and is measured by asking whether persons, typically adolescents, think they will smoke in the future. A study of 18,870 adolescents in Malaysia in the Global School-Based Student Health Survey (65) found that significantly more adolescents with depression (9.1%) reported susceptibility to smoking compared to adolescents without depression (5.4%; p = 0.001).…”