The social image of smokeless tobacco use in three different types of teenagers

The acceptability of smokeless tobacco products depends on nicotine levels

Understanding the role nicotine plays in initiating and sustaining addiction has been of interest for the scientific community and general population, with the idea that low levels of nicotine will reduce abuse liability associated with smokeless tobacco products. Previously, research has relied on subjective assessments to determine consumer acceptability, but these measures cannot provide a characterization of the physiological responses associated with nicotine use. Consumer acceptability arises from psychological and neurophysiological factors, thus establishing the need to use subjective and objective measurements in conjunction. This study provides a comprehensive characterization of the subjective and objective effects of smokeless tobacco product use with varying levels of nicotine. EEG data were recorded before and after the use of four different smokeless tobacco products and one control product over five separate visits, with participants arriving to each visit after 12 h of tobacco abstinence. These products have distinct consumer acceptability levels and patterns of use characteristics ranging from starter products to those used primarily by established users. Subjective results showed that smokeless tobacco products with higher levels of nicotine were more successful in reducing craving and more reinforcing than those with lower levels. These results were concordant with the activity present in the EEG recordings where products with high nicotine levels produced larger changes in the amplitude of the event-related signal than those with low levels. This study is fundamental in understanding the relationship between subjective and objective smokeless tobacco acceptability measurements, as mediated by the different levels of nicotine in each product.

A Positive Response to Teen Smoking: Why N-O-T?

Most young people who smoke will continue smoking into adulthood, increasing their risk for premature disease and death. N-O-T's early intervention program for students who are regular smokers can be a means to prevent debilitating or chronic disease and early death.

Risk and protective factors of adolescent exclusive snus users compared to non-users of tobacco, exclusive smokers and dual users of snus and cigarettes

The use of snus is increasing in Norway. In this study we examined differences between adolescents who were exclusive snus users, and adolescent non-users, smokers and dual users of snus and cigarettes on a number of psychosocial factors, categorized as risk variables and protective variables associated with involvement in health compromising behavior. We applied separate logistic regression models, where exclusive snus users (n=740) were compared with non-users (n=904), smokers (n=219), and dual users (n=367). Compared to non-users, the group of exclusive snus users was associated with variables traditionally predicting health risk behavior, such as smoking friends (OR=1.74, SD 1.27-2.38) and truancy (OR=2.12, SD 1.65-2.78). Compared to smokers, exclusive snus users were related to variables traditionally associated with protection against involvement in health risk behavior, e.g. higher academic orientation (OR=1.66, SD 1.12-2.45). Associations with protective factors were also observed when exclusive snus users were compared with dual users. While the group of exclusive snus users was associated with a pattern of psychosocial risk compared to non-users, they showed a more conventional pattern when compared to smokers and dual users. The group of exclusive snus users may be described on a continuum varying from psychosocial risk factors to protective factors of risk involvement depending on the group of comparison.

Perceptions of smokers influence nonsmoker attitudes and preferences for interactions

In two studies, we examined nonsmokers' perceptions of smokers and consequences of the perceptions. In Study 1, smokers answered questions about their sense of self, dependence on smoking, and motivation to quit. Nonsmokers answered questions about their perceptions of these characteristics. Differences between smokers' self-descriptions and nonsmokers' perceptions were observed. Study 2 asked nonsmokers to judge two types of smokers for which the descriptions were based on Study 1 findings. Results showed that nonsmokers held a more negative attitude about and were less willing to engage in different close relationships with the smoker who was described in terms of nonsmokers' perceptions rather than smokers' reports. Attitude mediated the relationship between type of smoker and willingness to date a smoker.

Images of smokers and willingness to smoke among African American pre-adolescents: an application of the prototype/willingness model of adolescent health risk behavior to smoking initiation

OBJECTIVE

This study used the prototype/willingness model of adolescent health risk behavior to examine factors related to onset of smoking.

METHODS

Two waves of data were collected from a panel of 742 African American children (mean age=10.5 at Wave 1) and their primary caregivers. Measures included cognitions outlined by the prototype model as well as self-reports of smoking by the parent and child.

RESULTS

Structural equation modeling revealed a pattern consistent with expectations generated by the prototype model. The relation between contextual, familial, and dispositional factors-including neighborhood risk, parental smoking, and children's academic orientation-and the initiation of smoking at Wave 2, two years later, was mediated by the children's cognitions. Primary among these cognitions were the children's images of smokers and children's willingness to smoke.

CONCLUSIONS

Smoking cognitions mediate the impact of important distal factors (such as context, family environment, and disposition) on the onset of smoking in children. Perhaps more important, it is possible to predict onset of smoking in African American children as young as age 10 by assessing the cognitive factors suggested by the prototype model.

Social imagery, tobacco independence, and the truthsm campaign

OBJECTIVES

This study investigated relationships among exposure to the truthsm campaign, differences in social imagery about not smoking and related measures, and smoking behavior. We asked, "How does truthsm work? Through what psychological mechanisms does it affect smoking behavior?" We developed a framework to explain how receptivity to truthsm ads might influence youth cognitive states and subsequent effects on progression to established smoking. The main hypotheses were that social imagery about not smoking and related beliefs and attitudes about tobacco use mediate the relationship between truthsm exposure and smoking status.

METHODS

The study was based on data from the Legacy Media Tracking Survey (LMTS), waves I-III, which were conducted at three time points from 1999 through 2001. A nationally representative sample of 20,058 respondents aged 12-24 from the three time points was used in the analysis. We developed a structural equation model (SEM) based on constructs drawn from the LMTS. We investigated the model and tested our hypotheses about the psychological and behavioral effects of campaign exposure.

RESULTS

We tested our constructs and model using a two-stage structural equation modeling approach. We first conducted a confirmatory factor analysis (CFA) to test the measurement model. Our model achieved satisfactory fit, and we conducted the SEM to test our hypotheses. We found that social imagery and perceived tobacco independence mediate the relationship between truthsm exposure and smoking status. We found meaningful differences between paths for segmented samples based on age, gender, and race/ethnicity subgroups and over time.

CONCLUSIONS

The truthsm campaign operates through individuals'sense of tobacco independence and social imagery about not smoking. This study indicates that the campaign's strategy has worked as predicted and represents an effective model for social marketing to change youth risk behaviors. Future studies should further investigate subgroup differences in campaign reactions and utilize contextual information about the truthsm campaign's evolution to explain changes in reactions over time.

Favourite movie stars, their tobacco use in contemporary movies, and its association with adolescent smoking

OBJECTIVE

To assess the relation between adolescents' favourite movie stars, the portrayal of tobacco use by those stars in contemporary motion pictures, and adolescent smoking.

DESIGN AND SETTING

632 students (sixth to 12th grade, ages 10-19 years) from five rural New England public schools completed a voluntary, self administered survey in October 1996. The survey assessed tobacco use, other variables associated with adolescent smoking, and favourite movie star. In addition, tobacco use by 43 selected movie stars was measured in films between 1994 and 1996.

OUTCOME MEASURES

Students were categorised into an ordinal five point index (tobacco status) based on their smoking behaviour and their smoking susceptibility: non-susceptible never smokers, susceptible never smokers, non-current experimenters, current experimenters, and smokers. We determined the adjusted cumulative odds of having advanced smoking status based on the amount of on-screen tobacco use by their favourite film star.

RESULTS

Of the 43 stars, 65% used tobacco at least once, and 42% portrayed smoking as an essential character trait in one or more films. Stars who smoked more than twice in a film were considered smokers. For adolescents whose favourite stars smoked in only one film, the odds of being higher on the smoking index was 0.78 (95% confidence interval (CI) 0.53 to 1.15). For adolescents whose favourite stars smoked in two films, the odds of being higher on the smoking index was 1.5 (95% CI 1.01 to 2.32). For adolescents whose favourite stars smoked in three or more films (Leonardo DiCaprio, Sharon Stone, John Travolta), the odds of being higher on the smoking index was 3.1 (95% CI 1.34 to 7.12). Among never smokers (n = 281), those who chose stars who were smokers in three or more films were much more likely to have favourable attitudes toward smoking (adjusted odds ratio 16.2, 95% CI 2.3 to 112).

CONCLUSIONS

Adolescents who choose movie stars who use tobacco on-screen are significantly more likely to have an advanced smoking status and more favourable attitudes toward smoking than adolescents who choose non-smoking stars. This finding supports the proposition that the portrayal of tobacco use in contemporary motion pictures, particularly by stars who are admired by adolescents, contributes to adolescent smoking.

Evidence that smokeless tobacco use is a gateway for smoking initiation in young adult males

BACKGROUND

This study was designed to test the hypothesis that smokeless tobacco (SLT) serves as a gateway drug for smoking among young adult males. Methods. A cohort (n = 7,865) of U.S. Air Force recruits who claimed to have never smoked cigarettes was followed prospectively for 1 year. The participants were male, 32.9% were ethnic minorities, and their average age was 19.84 years (SD = 2.29). Among recruits entering basic military training, 403 (5.1%) reported current SLT use and 198 (2.5%) reported a past history of SLT use.

RESULTS

At the 1-year follow-up current SLT users were 233% more likely to have initiated smoking than nonusers (odds ratio = 2.33, 95% CI = 1.84-2.94). Similarly, recruits who reported past SLT use were 227% more likely to begin smoking than participants who had never used SLT (odds ratio = 2.27, 95% CI = 1.64-3.15). SLT use remained a potent predictor of smoking initiation in a multivariate logistic model that included demographic factors and other risk factors for initiation.

CONCLUSIONS

SLT use appears to be an important predictor of smoking initiation among young adult males. This study suggests that smoking prevention and cessation programs should also include strategies related to SLT use.

Oral spit tobacco: addiction, prevention and treatment

The prevalence of smokeless tobacco is significant and reaches as high as 17% past month use in white males aged 18-25. Smokeless tobacco use is of concern because of the potential for addiction and the associated negative health consequences. This article reviews the basis for addiction to smokeless tobacco, examining the nicotine content in smokeless tobacco products, pharmacokinetics, psychoactive effects, tolerance, and withdrawal. It also explores the negative health consequences which include a number of oral pathologies and increased cardiovascular risk factors. Furthermore, it examines the factors associated with the initiation of smokeless tobacco use, and the current prevention programs that address these factors. Current smokeless tobacco treatment approaches are also discussed as well as predictors for abstinence. Finally, the future directions are discussed in light of the limited amount of research that has been conducted in the smokeless tobacco area, particularly related to prevention and treatment.

Smokeless tobacco and cigarettes: differential attitudes and behavioral intentions of young adolescents toward a hypothetical new peer

Examined adolescents' perceptions of cigarette smokers and smokeless tobacco users. Participants were 562 middle school students in rural Florida who viewed 1 of 6 videotapes of a hypothetical peer (i.e., actor) who would soon be attending their school. The videotapes differed only as a function of sex (boy or girl) and tobacco condition (no tobacco, cigarette, smokeless tobacco). After viewing the videotape, participants completed 2 measures designed to assess attitudes and behavioral intentions toward the peer. Results indicated that (a) the actor in the no-tobacco condition was rated more favorably than actors in the other two conditions, although the actor in the smokeless-tobacco condition was rated more favorably than the actor in the cigarette condition; (b) girls viewed the actor in smokeless-tobacco condition more favorably than did boys; (c) compared to nonsmokers, adolescents with a cigarette use history provided more favorable ratings for the actor in the cigarette condition. Taken together, results suggest that different types of tobacco use may have a different impact on social image within the young adolescent population.

Prevalence, patterns, and correlates of spit tobacco use in a college athlete population

We surveyed varsity athletes (N = 1,328) in 16 California colleges about their patterns of spit (smokeless) tobacco (ST) use, related habits, reasons for use, and preferred methods for quitting. Prevalence of use was analyzed by sport and demographic characteristics, and patterns of use in players using snuff exclusively, using chewing tobacco exclusively, and those using both were compared. Odds ratios and 95% confidence intervals were calculated, adjusting for ethnic group. Prevalence was highest in Whites (44%) and Native Americans (48%) and lowest in African Americans (11%), and higher in varsity baseball (52%) than varsity football players (26%), in players attending rural colleges, and among those who ever smoked cigarettes or used alcohol. Forty-one percent of ST users initiated regular use during their high school years. Athletes who used snuff exclusively used it more intensively and for more years than those who used chewing tobacco exclusively. Snuff users indicated a greater perceived need for ST, but also were more ready to quit. These data suggest ST programs with prevention and cessation components are appropriate for high school as well as college athletes. Such interventions should focus on baseball players, distinguish snuff from chewing tobacco users in planning quit strategies, integrate intervention programs for cigarette smoking and alcohol consumption, provide training in refusal skills, and attempt to change social norms in support of ST use by integrating popular peers and significant others (e.g., wives/girlfriends) to endorse nonuse of ST.

Psychological profile of college students who use smokeless tobacco

The purpose of this study was to develop a psychological profile of smokeless tobacco users. We surveyed 1991 college students regarding their use of tobacco products. Twenty-one percent of the white males used smokeless tobacco compared to only 10.4% of blacks, 5.4% of Hispanics, and 5.4% of others, primarily Asians. Although the prevalence of smokeless tobacco use reported by Asians was relatively low, their rate of reported smoking was over twice as high as any other ethnic group, 43.6%. The most important reasons for beginning to use smokeless tobacco were to "see if I would enjoy it," "most friends used it," and "try something new." The personality profile of the smokeless tobacco users differed from that of smokers and non-users of tobacco. College students with the highest probability of being a smokeless tobacco user were white males who scored higher in extraversion and neuroticism but lower on state anxiety than non-users.

A comparison of smokeless tobacco and smoking practices of university varsity and intramural baseball players

To examine the smokeless tobacco (ST) and smoking practices of collegiate varsity and intramural baseball players, 284 undergraduate athletes at two major Southwestern universities were surveyed using a questionnaire previously developed to measure use among this population. About one-fourth of all athletes were current ST users and 4% smokers. Over half of varsity players (53%) compared to 25.9% of intramural players used one or both forms of ST. Varsity players were about 20 times more likely to use ST as to smoke, while intramural players were about five times as likely to use ST than to smoke. On both teams, use of chewing tobacco was associated with use of snuff. Smoking was not associated with ST use in either group. Mean ages for initiation for all products was 15, and for quitting, 18. There was no evidence that one form of tobacco served as a gateway for the other among these young adult athletes. Over a fourth of all users started after age 17, suggesting that college is an appropriate locus for both ST prevention and cessation programming. Such programs for this population must address the unique characteristics of the social environment in collegiate baseball.

Smokeless tobacco use among Ontario students

The use of smokeless tobacco among adolescents has emerged as a public health concern. We report here estimates of use and characteristics of users among a probability sample of 4,267 Ontario (Canada) students aged thirteen to nineteen years. The results indicated that smokeless tobacco use was not common, varying from 1 percent to 3 percent depending upon age and gender, but was more likely to occur among smokers (10% to 32%). The group most prone to use was young smoking males.