Risk Perceptions of Smokeless Tobacco Among Adolescent and Adult Users and Nonusers

Liu, Sherry T.; Nemeth, Julianna M.; Klein, Elizabeth G.; Ferketich, Amy K.; Kwan, Mei‐Po; Wewers, Mary Ellen

doi:10.1080/10810730.2015.1012237

Cited by 26 publications

(25 citation statements)

References 36 publications

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“…Similar perceptions of reduced risk relative to cigarettes have been reported in other rural populations (14; 18), and differences in perceived harm between tobacco products by youth has been associated with tobacco use nationally (19). While ST use does not involve inhalation of toxic combustion products, objectively quantifying harm relative to cigarettes is difficult.…”

Section: Discussionsupporting

confidence: 56%

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Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California

et al. 2016

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Smokeless tobacco (ST) use among US high school males living in rural areas exceeds national levels. Subgroups at heightened risk of ST use have been identified, but less is known regarding ST decision-making within high-risk groups. The study objective was to describe rural adolescent males' perceived ST acceptability, health risks, and social implications and how those perceptions differ between ST users and never-users. Methods Semi-structured individual interviews were conducted with a purposeful sample of 55 male students (32 ST ever-users) at three rural California high schools. Interviews were audio recorded and professionally transcribed. Investigators collaboratively developed a codebook based on thematic content and then independently coded transcripts, reconvening frequently to achieve consensus. Coded text was systematically organized into themes following a general inductive approach. ST users and non-users shared multiple ST-related perceptions, including: that ST is a common, normative way of life in rural "country" culture among certain groups; that ST use conveys oral health risks; and that the decision to use (or not to use) is rooted in personal choice. ST users' and never-users' perceptions differed regarding the immediacy, severity, and inevitability of health risks, particularly relative to cigarette smoking. Other differences included perceived parental permissiveness and the expected social benefits of ST use, such as peer acceptance and conveying maturity. Within this population of rural male adolescents, ST users emphasized the social benefits of ST use, while acknowledging but discounting health risks. Differences and similarities in tobacco perceptions among adolescents living in similar environments may inform effective health communication.

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Section: Discussionsupporting

confidence: 56%

“…Youth who perceive little or no risk of harm from ST are more likely to be ST-users (10; 13). However, in one study, both ST-users and non-users held diverse views about the health risks of ST relative to cigarettes (14). …”

Section: Introductionmentioning

confidence: 99%

Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California

et al. 2016

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“…33 We measured absolute harm perceptions in our study, which are independent from harm perceptions that are compared to cigarettes (relative harm). Relative harm perceptions have been a common measure used in past research 7,8,11–17 ; however, comparison to a referent product can influence harm perceptions due to contextual effects of message framing. 18 For example, research on snus 34 and e-cigarettes 35 has assessed the differences between direct (relative/comparative) and indirect (absolute) risk perceptions.…”

Section: Discussionmentioning

confidence: 99%

“…3–6 Past research has assessed relative harm perceptions to gauge harm perceptions compared to combusted cigarettes. This research suggests that smokeless tobacco, 7–10 electronic cigarettes (e-cigarettes), 8,11 hookah/waterpipes, 12–14 cigars and cigarillos, 12,15,16 and roll-your-own tobacco (RYO) 17 are all perceived as less harmful than combusted cigarettes.…”

Section: Introductionmentioning

confidence: 99%

US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products

Bernat

Ferrer

Margolis

et al. 2017

Addictive Behaviors

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Introduction Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions. Methods We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute’s Health Information National Trends Survey (N=3376). Results Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco. Conclusions This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products.

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“…The data indicate that, although smokeless tobacco is not considered completely risk-free in an absolute sense, some individuals believe that using smokeless tobacco is safer than smoking conventional cigarettes (Liu et al, 2015). …”

Section: Introductionmentioning

confidence: 99%

Perceived Harms and Social Norms in the Use of Electronic Cigarettes and Smokeless Tobacco

Waters

Mueller-Luckey

LeVault

et al. 2017

Journal of Health Communication

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Background Perceptions of harms and social norms influence the use of conventional tobacco cigarettes, but little research is available about their combined relationship with e-cigarette and smokeless tobacco use. Methods We conducted a cross sectional survey of 309 individuals from central Illinois. We explored (1) demographic predictors of perceived harms and social norms related to e-cigarette and smokeless tobacco use, and (2) whether perceived harms, social norms, or both were important predictors of e-cigarette and smokeless tobacco use. Results E-cigarette perceptions of harm were consistent across all demographic characteristics. Smokeless tobacco perceptions of harm were unrelated to age, race, and sex, but lower education and income were associated with lower perceived harm (p<.05). E-cigarette social norms were less favorable among non-whites (p<.05) but did not vary by other demographic characteristics. Only less education was associated with more favorable social norms of smokeless tobacco (p<.05). Higher perceived harms were related to lower use of e-cigarettes and smokeless tobacco (p<.05). Perceived social norms were not associated with product use. Conclusions This study provides preliminary support for implementing broad-based health messaging efforts that focus more on the potential harms of e-cigarette and smokeless tobacco use than on social norms.

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Risk Perceptions of Smokeless Tobacco Among Adolescent and Adult Users and Nonusers

Cited by 26 publications

References 36 publications

Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California

Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California

US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products

Perceived Harms and Social Norms in the Use of Electronic Cigarettes and Smokeless Tobacco

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