Social Norms, Perceptions and Dual/Poly Tobacco Use among Texas Youth

Abstract

Objectives We assessed risk perceptions and social norms about tobacco use across adolescent non-users of tobacco, single-product users, and dual/poly-product users. Methods Use behaviors specific to e-cigarettes, cigarettes, hookah, cigars, and smokeless tobacco were assessed among 6th, 8th and 10th grade students (sample [n] = 3907 from a population of [N] = 461,069 students). Multivariate regression was used to examine differences in these factors across use categories, adjusted for demographic factors. Results Results highlight differences between non-users and single- or dual/poly-product users for most tobacco products. Dual/poly-product users differed from single-product users most notably in their higher perceived use of tobacco products by close friends and dating partners, and a higher proportion of single-product users reported most products were not harmful and not addictive compared to non-users. Few differences were seen between dual/poly-product users and single-product users in their perceptions of harm and addictiveness. Conclusions Findings demonstrate the importance of proximal social influences (ie, close friends and dating partners) for adolescent dual/poly-tobacco product users. Understanding similarities and differences in risk factors between these adolescent groups can guide effective public health prevention and treatment programs.

Associations Between Risk Perceptions and Cigarette, E-cigarette, and Dual-Product Use Among Canadian Adolescents

“…In contrast, 53% of adolescent multiple-product users reported e-cigarettes as not at all harmful to health, compared to 43% of single-product users in Texas. 17 In addition, 21% of poly-tobacco users reported that cigarettes are not at all harmful, compared to 6% of single-product users. 17 Our findings suggest that those with a high-risk perception of either or both products have a lower likelihood of using cigarettes and e-cigarettes and their own or concurrently.…”

“…Some of these studies have found that perceived risk was negatively associated with dual-use. 16,17 Cooper et al 16 found that college students' perceptions of cigarette and e-cigarette harm were lower among exclusive and dual-users than nonusers. A 2014-2015 study of Texas youth found that 53% of multiple-product users reported e-cigarettes as not at all harmful to health, compared to 43% of single-product users.…”

“…Furthermore, several of the previous studies did not specify which products were being used concurrently, and none have clearly differentiated between perceived risks of multiple products. [16][17][18][19] This study assessed 4 categories of cigarette, e-cigarette risk perception, and their associations with cigarette and e-cigarette use among Canadian adolescents.…”

Measuring perceptions related to e-cigarettes: Important principles and next steps to enhance study validity

“…Consumers have different reasons for using, and varied expectations regarding the perceived benefits and risks of e-cigarettes in general, by product type, and in comparison to conventional cigarettes (Ambrose et al, 2014; Brose et al, 2015; Chaffee et al, 2015; Cooper et al, 2016; Gorukanti et al, 2016; Roditis, Delucchi, et al, 2016). Therefore, researchers should not simply substitute “e-cigarette” or “vaping” into existing cigarette perception measures.…”

“…Cross-sectional studies of youth find that favorable e-cigarette perceptions (e.g., they are “not addictive” or users “look cool”) are associated with youth e-cigarette use (Ambrose et al, 2014; Chaffee et al, 2015; Cooper et al, 2016; Gorukanti, Delucchi, Ling, Fisher-Travis, & Halpern-Felsher, 2016) and intentions (Chaffee et al, 2015). Among youth, favorable perceptions of e-cigarettes are particularly concerning because nicotine may affect adolescent brain development (Dwyer et al, 2009; England et al, 2015; U.S.…”