Personality, motivational and situational determinants of regular and occasional use of smokeless tobacco

Analysis of motivating factors for smokeless tobacco use in two Indian states

BACKGROUND

This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation and continuation of smokeless tobacco vary by age, gender, and education.

MATERIALS AND METHODS

We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/ non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education).

RESULTS

Initiation-women were less likely than men to report "peer pressure", "fashion statement", and "stress/coping" as relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing "peer pressure" than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report "stress/coping" than those with no education (OR: 2.82, CI: 1.06-7.48). Continuation-women were less likely than men to choose "relaxation", and "distance from family" as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose "stimulation" as a factor than the youngest group.

CONCLUSIONS

Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.

Psychological predictors of male smokeless tobacco use initiation and cessation: a 16-year longitudinal study

AIMS

To test whether psychological factors predict male smokeless tobacco (SLT) initiation and cessation longitudinally.

DESIGN

Sixteen-year longitudinal design with 95% retention at year 6 and 82% at year 16.

SETTING

Forty Washington State school districts.

PARTICIPANTS

SLT use data were gathered on a cohort of adolescents (91% Caucasian). For SLT initiation, the sample size was 2468. For SLT cessation, sample sizes were 219 (age 20 outcome) and 192 (age 28 outcome).

MEASUREMENTS

Self-reported psychological measures of parental disobedience ('parent non-compliance'), peer influence ('friend compliance'), rebelliousness and thrill-seeking were taken at ages 12 and 18. SLT use was measured at ages 12, 18, 20 and 28 years.

FINDINGS

For SLT initiation, scoring highly on the following psychological factors at age 12 at least doubled the odds of daily SLT use at age 18 (P < 0.001): friend compliance [odds ratio (OR): 2.56, 95% confidence interval (CI): 1.78-3.68), rebelliousness (OR: 2.16, 95% CI: 1.46-3.19) and thrill-seeking (OR: 2.33, 95% CI: 1.45-3.75). For SLT cessation, none of the psychological factors at age 18 predicted SLT cessation at age 20 or 28 (P value range: 0.06-0.84).

CONCLUSION

Peer influence, rebelliousness, and thrill-seeking appear to predict smokeless tobacco initiation strongly among male youth in the United States.

Health, masculinity and smokeless tobacco use among college-aged men

Existing work on smokeless tobacco (SLT) often focuses on correlates and predictors of use, ignoring the social and cultural context surrounding initiation and continued use of SLT products. The current study takes a qualitative approach using guided focus groups to examine this unexplored context. The findings show that male SLT users gain social rewards from dipping with other men, and usage is initiated and continued in spite of known potential health consequences. For the men participating in this study SLT use was primarily initiated at social or athletic events with the encouragement of other men and continued for relational maintenance and bonding. Additionally, the men reported that the social rewards received from using SLT far outweighed any potential health consequences or negative social repercussions they might also experience. Implications for future research and health interventions targeting SLT use are discussed.

Prevalence and correlates of lifetime smokeless tobacco use in female military recruits

Although considerable research has been conducted on smokeless tobacco (ST) use in males, much less is known about the characteristics of female ST users. The present study examined the prevalence and correlates of lifetime ST use among female Air Force recruits (N=9,087). Participants were surveyed during Basic Military Training regarding their history of tobacco use and other health risk behaviors. Although the prevalence of current ST use was low (<1%; n=34), 6.6% (n=599) had tried ST. Multivariate logistic regression analysis indicated that lifetime ST use was related to ethnicity, with Native Americans and Whites being most likely to have tried ST. Additional correlates of lifetime ST use included post-high-school education (OR=1.26, 95% CI=1.03-1.55); weekly acts of road rage (OR=1.48, 95% CI=1.06-2.06); frequent arguing (OR=1.71, 95% CI=1.18-2.48); daily or near-daily alcohol consumption (OR=1.71, 95% CI=1.03-2.82); current cigarette use (OR=3.80, 95% CI=2.42-5.94); and experimental use of cigars (OR=4.01, 95% CI=3.22-5.01), pipes (OR=2.23, 95% CI=1.64-3.03), and clove cigarettes (OR=1.23, 95% CI=1.01-1.49), all of which were associated with an increased likelihood of ST use. Results suggest that female recruits who have ever used ST engage in a variety of risk behaviors including use of other tobacco products and alcohol, as well as additional harmful behaviors.