The Relationship Between Young Adult Smokers' Beliefs About Nicotine Addiction and Smoking-Related Affect and Cognitions

E-Cigarette Use: The Effects of Psychological Vulnerabilities, Perceptions, and Intentions to Use E-Cigarettes

Little research has examined the effects that psychological vulnerabilities (i.e., difficulty with emotion regulation, depressed mood, distress tolerance) have on the perceptions of e-cigarettes, intent to use e-cigarettes, and actual e-cigarette use. Data were collected via an online survey from 837 adults (55.6% male, Mage = 29.2, 71.7% Caucasian). The two path analytic models predicting lifetime and current use fit the data well. Difficulty with emotion regulation was positively associated with depressed mood and negatively associated with distress tolerance, while distress tolerance was negatively associated with depressed mood. Depressed mood was positively associated with perceived benefits of e-cigarette use, and perceived benefits was positively associated with intent to use. Perceived benefits and intent to use were significantly associated with both lifetime and current use. Findings enhance our understanding of the effects that mood and emotion-related factors have on perceptions of, intent to use, and actual use of e-cigarettes, which may have important implications for prevention and cessation.

Associations of Daily Versus Nondaily Smoking, Tobacco-Related Risk Perception, and Cancer Diagnosis Among Adults in the Population Assessment of Tobacco and Health (PATH) Study

INTRODUCTION

Nondaily smoking has become increasingly common among cigarette smokers. Our objective was to determine whether current daily versus nondaily smoking differed by tobacco-related risk perceptions (TRRPs), demographic factors, and cancer history.

METHODS

Participants were all adults in Waves 1-3 of the longitudinal cohort Population Assessment of Tobacco and Health Study who were current smokers at Wave 3 (N = 8307). The primary analysis was weighted logistic regression of daily versus nondaily smoking at Wave 3. TRRP measures were cigarette harm perception, worry that tobacco products will damage one's health, belief that smoking cigarettes causes [lung/bladder/mouth/liver] cancer, and nondaily cigarette harm perception (Likert-type scale). Other measures included demographic factors, other tobacco product use, minor at time of first cigarette, and cancer survivor status (yes/no).

RESULTS

Among current smokers, daily versus nondaily smoking was significantly associated with being a minor at time of first cigarette (OR = 1.54, p < .001), TRRPs (OR = 0.83, p < .001; OR = 1.40, p < .001; and OR = 1.17, p = .009 [harm perception, worry, and nondaily cigarette harm perception, respectively]), and interaction between cancer survivor status and belief that smoking causes cancer (p < .001). TRRPs among current smokers did not differ significantly between cancer survivors and respondents without a cancer history.

CONCLUSIONS

Respondents with lower harm perception, higher worry, and higher nondaily cigarette harm perception were more likely to be daily versus nondaily smokers. Respondents with higher belief that smoking causes cancer or who were cancer survivors were less likely to be daily (versus nondaily) smokers compared to respondents with low belief and no cancer history.

IMPLICATIONS

This study is unique in that it examined associations of smoking cigarettes daily versus nondaily with tobacco-related risk perceptions and cancer survivorship-comparing cancer survivors to those without a cancer history. Given the increasing prevalence of nondaily smoking as compared with daily smoking in the general population, and the prognostic significance of smoking after cancer diagnosis, these findings fill a clinically important gap in the literature and provide a foundation for further research.

Measuring Cigarette Smoking Risk Perceptions

Risk perception is an important construct in many health behavior theories. Smoking risk perceptions are thoughts and feelings about the harms associated with cigarette smoking. Wide variation in the terminology, definition, and assessment of this construct makes it difficult to draw conclusions about the associations of risk perceptions with smoking behaviors. To understand optimal methods of assessing adults' cigarette smoking risk perceptions (among both smokers and nonsmokers), we reviewed best practices from the tobacco control literature, and where gaps were identified, we looked more broadly to the research on risk perceptions in other health domains. Based on this review, we suggest assessments of risk perceptions (1) about multiple smoking-related health harms, (2) about harms over a specific timeframe, and (3) for the person affected by the harm. For the measurement of perceived likelihood in particular (ie, the perceived chance of harm from smoking based largely on deliberative thought), we suggest including (4) unconditional and conditional items (stipulating smoking behavior) and (5) absolute and comparative items and including (6) comparisons to specific populations through (7) direct and indirect assessments. We also suggest including (8) experiential (ostensibly automatic, somatic perceptions of vulnerability to a harm) and affective (emotional reactions to a potential harm) risk perception items. We also offer suggestions for (9) response options and (10) the assessment of risk perception at multiple time points. Researchers can use this resource to inform the selection, use, and future development of smoking risk perception measures.

IMPLICATIONS

Incorporating the measurement suggestions for cigarette smoking risk perceptions that are presented will help researchers select items most appropriate for their research questions and will contribute to greater consistency in the assessment of smoking risk perceptions among adults.

Dependence, plans to quit, quitting self-efficacy and past cessation behaviours among menthol and other flavoured cigarette users in Europe: The EUREST-PLUS ITC Europe Surveys

INTRODUCTION

This study characterises smoking and cessation-related behaviours among menthol and other flavoured cigarette users in Europe prior to the implementation of the European Tobacco Products Directive (TPD) ban on the sale of flavoured cigarettes.

METHODS

An analysis of cross-sectional data from the 2016 EUREST-PLUS ITC Europe Surveys was conducted among a sample of 10760 adult smokers from eight European Union Member States. Respondents were classified as menthol, other flavoured, unflavoured, or no usual flavour cigarette users and compared on smoking and cessation behaviours and characteristics. Data were analysed in SPSS Complex Samples Package using bivariate and multivariate regression analyses adjusted for sociodemographic characteristics, dependence, and country.

RESULTS

In bivariate analyses, cigarette flavour was significantly associated with all outcomes (p<0.001). After adjusting for sociodemographic characteristics, these associations attenuated but remained significant and in the same direction for dependence, self-efficacy, plans to quit, past quit attempts, and ever e-cigarette use. In fully adjusted models, compared to smokers of non-flavoured cigarettes, menthol smokers were less likely to smoke daily (AOR=0.47, 95% CI: 0.32-0.71), smoke within 30 min of waking (0.52,0.43-0.64), consider themselves addicted (0.74,0.59-0.94), and more likely to have ever used e-cigarettes (1.26,1.00-1.57); other flavoured cigarette smokers were less likely to smoke daily (0.33,0.15-0.77), and have higher self-efficacy (1.82,1.20-2.77); no usual flavour smokers were less likely to smoke daily (0.34,0.22-0.51), smoke within 30 min of waking (0.66,0.55-0.80), consider themselves addicted (0.65,0.52-0.78), have ever made a quit attempt (0.69,0.58-0.84), have ever used e-cigarettes (0.66,0.54-0.82), and had higher self-efficacy (1.46,1.19-1.80).

CONCLUSIONS

Smokers of different cigarette flavours in Europe differ on smoking and cessation characteristics. The lower dependence of menthol cigarette smokers could lead to greater success rates if quit attempts are made, however cross-country differences in smoking behaviours and quitting intentions could lead to the TPD ban on cigarette flavours having differential impact if not accompanied by additional measures, such as smoking cessation support.

Flavors and Risk: Perceptions of Flavors in Little Cigars and Cigarillos Among U.S. Adults, 2015

Introduction

Flavored little cigars, cigarillos, and filtered cigars (LCCs) are popular and pose unique health risks. This study explored risk perceptions of flavors in LCCs and the relationship between perceptions and use among U.S. adults.

Methods

Data were from the 2015 Tobacco Products and Risk Perceptions Survey of a national probability sample of 6051 adults, conducted online, August-September, 2015. The analytic sample consisted of 5105 adults aware of LCCs and 2174 who had ever used any type of LCCs.

Results

Just over half of adults reported flavors in LCCs as "very" or "somewhat" risky, while more than one-third of adults reported they did not know the risks of flavors in LCCs. Younger adults, males, and users of any LCCs were more likely than older adults, females and non-users, respectively, to perceive LCC flavors as less risky. Those who perceived LCC flavors as "not at all risky" or "a little risky" were roughly twice as likely to have ever used flavored LCCs compared to those who reported not knowing the risks (AOR = 2.07, 95% CI = 1.16 to 3.69 and AOR = 1.96, 95% CI = 1.26 to 3.06). Those who reported LCC flavors as "very risky" were also more likely to have ever used flavored LCCs than those who reported not knowing the risks (AOR = 1.50, 95% CI = 1.13 to 1.98).

Conclusions

Though the proportion of adults assigning low risk to flavors in LCCs is small, these adults are more likely to use flavored LCCs. The association of use with risk perceptions of flavors in LCCs should be addressed in health risk campaigns.

Implications

Flavored LCCs are popular, particularly among young adults. While understanding the impact of flavors is an FDA research priority, little is currently known about perceptions of risk associated with flavors in LCCs. This study explores the nature of risk perceptions of flavors in LCCs, and the relationship between perceptions and flavored LCC use. We conclude that perception of risk of flavors in LCCs is related to use of these products, particularly perception of less risk. Considering the relationship between use and risk perceptions would be helpful in constructing health risk messaging.

Correlates of unsuccessful smoking cessation among adults in Bangladesh

Having 21.9 million adult smokers, Bangladesh ranks among the top ten heaviest smoking countries in the world. Correlates of unsuccessful smoking cessation remain unknown. We aimed to identify the correlates of unsuccessful smoking cessation among adults in Bangladesh.

We used data from the 2009 Global Adult Tobacco Survey (GATS) for Bangladesh. We compared socio-demographic, belief about health effect of smoking, and environmental characteristics of current smokers who had a recent failed quit attempt during the past 12 months of the survey (unsuccessful quitters) with those former smokers who had quit ≥ 12 months earlier of the survey and had not relapsed (successful quitters). Data were analyzed using logistic regression model and generalized estimating equations.

A total of 1552 smokers (1058 unsuccessful quitters and 494 successful quitters) aged 15 years and older who participated in the survey was included in this study. Among the smokers, 1058 (68%) were unsuccessful quitters. Our analysis showed that older aged, female, and higher educated smokers were less likely to quit unsuccessfully. Moreover, who believed that smoking causes serious illness were also less likely to quit unsuccessfully. For the interaction between place of residence and smoking rules inside home, we found that among the smoker's, in those house smoking was allowed, and who lived in urban place were less likely to be unsuccessful in quitting than those who lived in rural place.

Our findings suggest a cessation program that requires integrated approach with a view to considering these findings in setting up.

•

The interaction effects for smoking cessation has been rarely investigated.

•

Almost 70% of adult smokers were unsuccessful quitters.

•

Older aged, female, and educated smokers were less likely to quit unsuccessfully.

•

Belief about harmful effect of smoking associated with unsuccessful smoking cessation

•

Interaction between smoking rules inside home and place of residence was observed.

Optimistic bias in young adults for cancer, cardiovascular and respiratory diseases: A pilot study on smokers and drinkers

Optimistic bias defines the tendency for human beings to underrate risk when it pertains to themselves compared with their view of risk pertaining to other people in the same conditions. The aim of this work is to investigate the optimistic bias in risk perception and health-related behaviours for three specific conditions in a young adult sample: cancer, respiratory disorders and cardiovascular diseases. Young adults showed an optimistic bias related to cancer, and to cardiovascular diseases. Our findings suggest that optimistic bias is linked to specific behavioural patterns, largely widespread in young adults, such as tobacco cigarette smoking and alcohol consumption.