Reasons for Polytobacco Use among Young Adults: Scale Development and Validation

Abstract

INTRODUCTION Limited research has examined reasons for polytobacco use, an increasing public health problem, particularly among young adults. We examined reasons for polytobacco use among users of more than one tobacco product in the past 4 months enrolled in an ongoing sixwave longitudinal study of 3,418 students aged 18-25 from seven US colleges and universities. METHODS An expert panel generated items related to reasons for polytobacco use, included in Wave 3 (administered in Summer 2015). Participants reporting use of more than one tobacco product in the past four months (n=540) were asked to complete the Reasons for Polytobacco Use scale and measures related to tobacco/nicotine use/dependence, use motives, perceptions of tobacco, parental/friend use, other substance use, and mental health. We conducted a factor analysis and then examined convergent and discriminant validity for the derived factors. RESULTS Our sample was an average age of 20.40 (SD=1.84), 48.0% male, and 21.9% Black. Four factors were identified: Instrumentality, Social Context, Displacement, and Experimentation. Instrumentality was the only factor associated with little cigar/cigarillo and marijuana use. Displacement and Social Context showed similar associations; however, Social Context was associated with having friends who used tobacco while Displacement was not. Experimentation was associated with greater perceived addictiveness and harm of using tobacco products as well as greater perceived social acceptability of tobacco use. CONCLUSIONS Each of the four factors identified demonstrated unique convergent and discriminant validity. The use of this scale to characterize polytobacco using young adults may help inform and target cessation or prevention interventions.

Nye bruksmønstre i et tobakksmarked i endring – kombinert bruk av sigaretter, snus og e-sigaretter blant ungdom

“…Dette samsvarer med internasjonale studier som finner at ungdoms flerbruk av tobakksprodukt har sammenheng med eksponering for nære venners tobakksbruk. Assosiasjonen er sterkere for rapportert flerbruk enn for enkelbruk ( Ali et al, 2016 ; Berg et al, 2016 ; Cooper et al, 2016 ). Tobakksprodukter er mer tilgjengelig om en har nære venner som bruker disse, og nære venners bruk kan være en faktor som kan normalisere holdninger til tobakk ( Ali et al., 2016 ; Berg et al., 2016 ).…”

“…Det er vist at det er en sammenheng mellom bruk av flere tobakksprodukt og e-sigaretter og bruk av andre rusmidler, særlig alkohol og cannabis, blant ungdom ( Creamer, Portillo, Clendennen, & Perry, 2016 ; Miech, O’Malley, Johnston, & Patrick, 2015 ). I Sverige er det funnet sammenheng mellom flerbruk av tobakksprodukter, e-sigaretter og alkoholbruk ( Geidne et al, 2016 ) Eksponering for nære venners tobakksbruk har også sammenheng med flerbruk ( Ali, Gray, Martinez, Curry, & Horn, 2016 ; Berg et al, 2016 ; Bombard, Rock, Pederson, & Asman., 2008 ). Gutter er overrepresentert blant flerbrukerne ( Ali et al, 2016 ; Arrazola et al, 2014; Bombard et al, 2008 ) og eldre ungdommer har i større grad dette bruksmønsteret enn de yngre ( Arrazola et al, 2015 ; Miech et al, 2015 ).…”

Ecological momentary assessment of various tobacco product use among young adults

“…82 Additionally, data from Project DECOY examined reasons for polytobacco use (e.g., social context, displacement, experimentation). 83 These associations have also varied based on sex and race/ethnicity. 26,82,83 Another critically important influence on tobacco use is other substance use.…”

“…83 These associations have also varied based on sex and race/ethnicity. 26,82,83 Another critically important influence on tobacco use is other substance use. Young adults are at the greatest risk for using various substances, and the use of any one substance is associated with use of other substances.…”

“…The current study extends previously published findings regarding patterns and reasons for use. 26,82,83 Specifically, this study leveraged Project DECOY 25 and analyzed real-time, naturalistic EMA data in order to examine: 1) patterns of use of the various tobacco products and other substances; and 2) the association of timing, cravings, affect, social context, and other substance use to self-reported tobacco use among young adults. Specifically, we examined predictors of three primary outcomes: cigarette use, ENDS use, and any tobacco product use, respectively.…”