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Mbotwa CH, Rweyemamu LP. Tobacco Use and Associated Factors Among Men in Tanzania: Further Analysis of the 2022 Tanzania Demographic and Health Survey Data. Tob Use Insights 2024; 17:1179173X241259605. [PMID: 38831862 PMCID: PMC11145999 DOI: 10.1177/1179173x241259605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
Background: Tobacco use is a significant public health challenge, contributing to preventable diseases and premature deaths globally. We aimed to determine the prevalence of tobacco use and associated factors among men in Tanzania. Methods: This was a cross-sectional analysis of data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey. The study population comprised men aged 15-49 years. Weighted logistic regression was performed to identify factors associated with tobacco use. Results: A total of 5763 men with a mean age of 28.6 ± 10 years were included in the analysis. The overall prevalence of tobacco use was 11.1%, with 95% of users consuming smoked products, 17.1% using smokeless products, and 12.1% using both smoked and smokeless products. Older age was associated with increased odds of tobacco use, with odds of tobacco use increasing with each higher age group. Similarly, alcohol consumption was associated with greater odds of tobacco use. On the other hand, having a secondary education or higher, lack of occupation, being the head of the household, and owning a mobile telephone were associated with lower odds of tobacco use. Geographically, men from the Eastern zone and Zanzibar exhibited greater odds of tobacco use, while those from the Southern highlands zone had lower odds. Conclusion: This study revealed a significant prevalence of tobacco use among Tanzanian men and was associated with different individual, interpersonal, and community factors. The findings underscore the need for targeted interventions considering age-specific risk factors and geographical variations.
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Affiliation(s)
- Christopher Hariri Mbotwa
- Department of Social Sciences, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
| | - Linus Paul Rweyemamu
- Department of Biochemistry and Pharmacology, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
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Prokhorov AV, Calabro KS, Arya A, Russell S, Czerniak KW, Botello GC, Chen M, Yuan Y, Perez A, Vidrine DJ, Perry CL, Khalil GE. Mobile Text Messaging for Tobacco Risk Communication Among Young Adult Community College Students: Randomized Trial of Project Debunk. JMIR Mhealth Uhealth 2021; 9:e25618. [PMID: 34822339 PMCID: PMC8663493 DOI: 10.2196/25618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/19/2021] [Accepted: 10/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The use of new and emerging tobacco products (NETPs) and conventional tobacco products (CTPs) has been linked to several alarming medical conditions among young adults (YAs). Considering that 96% of YAs own mobile phones, SMS text messaging may be an effective strategy for tobacco risk communication. OBJECTIVE Project Debunk is a community-based randomized trial aiming to identify specific types of messages that effectively improve perceived NETP and CTP risk among YAs in community colleges. METHODS With YAs recruited offline from 3 campuses at the Houston Community College (September 2016 to July 2017), we conducted a 6-month randomized trial with 8 arms based on the combination of 3 message categories: framing (gain-framed vs loss-framed), depth (simple vs complex), and appeal (emotional vs rational). Participants received fully automated web-based SMS text messages in two 30-day campaigns (2 messages per day). We conducted repeated-measures mixed-effect models stratified by message type received, predicting perceived CTP and NETP risks. Owing to multiple testing with 7 models, an association was deemed significant for P<.007 (.05 divided by 7). RESULTS A total of 636 participants completed the baseline survey, were randomized to 1 of 8 conditions (between 73 and 86 participants per condition), and received messages from both campaigns. By the 2-month post campaign 2 assessment point, 70.1% (446/636) completed all outcome measures. By the end of both campaigns, participants had a significant increase in perceived NETP risk over time (P<.001); however, participants had a marginal increase in perceived CTP risk (P=.008). Separately for each group, there was a significant increase in perceived NETP risk among participants who received rational messages (P=.005), those who received emotional messages (P=.006), those who received simple messages (P=.003), and those who received gain-framed messages (P=.003). CONCLUSIONS In this trial, YAs had an increase in perceived NETP risk. However, with stratification, we observed a significant increase in perceived NETP risk upon exposure to rational, emotional, simple, and gain-framed messages. In addition, YAs generally had an increase in perceived CTP risk and presented nonsignificant but observable improvement upon exposure to emotional, complex, and loss-framed messages. With the results of this study, researchers and practitioners implementing mobile health programs may take advantage of our tailored messages through larger technology-based programs such as smartphone apps and social media campaigns. TRIAL REGISTRATION ClinicalTrials.gov NCT03457480; https://clinicaltrials.gov/ct2/show/NCT03457480. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/10977.
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Affiliation(s)
- Alexander V Prokhorov
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Karen Sue Calabro
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Ashish Arya
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sophia Russell
- Department of Health Disparities, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Katarzyna W Czerniak
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Gabrielle C Botello
- Department of Health Services Research, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Minxing Chen
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Ying Yuan
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Adriana Perez
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Austin, TX, United States
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Cheryl L Perry
- School of Public Health, Health Science Center, University of Texas, Austin, TX, United States
| | - Georges Elias Khalil
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
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Divdar M, Araban M, Heydarabadi AB, Cheraghian B, Stein LAR. Effectiveness of message-framing to improve oral health behaviors and dental plaque among pregnant women. Arch Public Health 2021; 79:117. [PMID: 34183061 PMCID: PMC8237427 DOI: 10.1186/s13690-021-00640-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Oral health is considered a prominent factor that contributes to quality of life. Hormonal changes during pregnancy can influence oral health. Message framing can play an important role in oral health. The aim of the present study was to investigate the effect of message framing on oral health and dental plaque among pregnant women. METHODS The study was conducted in 2017 on 108 pregnant women in Izeh county, Iran. Participants were randomly assigned to gain-framed, loss-framed, and control groups. The research instrument included a two part questionnaire containing demographic information and oral health knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque index. Gain-and loss-framed messages were sent to the intervention groups via cell phone texts, but the control group did not receive any messages. Participant dental plaque was clinically assessed. Analysis of covariance with follow-up tests were performed using SPSS version, 23.0 with p-value set at 0.01 for significance. RESULTS Intervention groups had better oral health (knowledge, atttitude, intention, efficacy, practices and plaque) scores compared to the control group (p < 0.001), but intervention (gain- vs loss-framed) groups did not differ on outcomes. CONCLUSION Text message intervention improved knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque among pregnant women. While differences between control and both intervention groups indicated text messaging had an impact on oral health outcomes, message framing (i.e., gain vs loss) had no discernable impact on oral health outcomes.
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Affiliation(s)
- Masoumeh Divdar
- Department of Health Education and Health Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- Social determinants of health research center, Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Akbar Babaei Heydarabadi
- Department of Health Education and Health Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - L. A. R. Stein
- Department of Psychology, University of RI, Kingston, RI USA
- Social/ Behavioral Sciences and Center for Alc/ Addic Studies, Brown University School of Public Health, Providence, RI USA
- Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, Cranston, RI USA
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Perry CL, Creamer MR, Chaffee BW, Unger JB, Sutfin EL, Kong G, Shang C, Clendennen SL, Krishnan-Sarin S, Pentz MA. Research on Youth and Young Adult Tobacco Use, 2013-2018, From the Food and Drug Administration-National Institutes of Health Tobacco Centers of Regulatory Science. Nicotine Tob Res 2020; 22:1063-1076. [PMID: 31127298 PMCID: PMC7457341 DOI: 10.1093/ntr/ntz059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
Abstract
The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior. IMPLICATIONS The Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.
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Affiliation(s)
- Cheryl L Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | - MeLisa R Creamer
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Jennifer B Unger
- Keck School of Medicine,University of Southern California, Los Angeles, CA
| | | | | | - Ce Shang
- Oklahoma Tobacco Research Center, Stephenson Cancer Center
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stephanie L Clendennen
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Mary Ann Pentz
- Keck School of Medicine,University of Southern California, Los Angeles, CA
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Calabro KS, Khalil GE, Chen M, Perry CL, Prokhorov AV. Pilot study to inform young adults about the risks of electronic cigarettes through text messaging. Addict Behav Rep 2019; 10:100224. [PMID: 31828203 PMCID: PMC6889374 DOI: 10.1016/j.abrep.2019.100224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 09/10/2019] [Accepted: 09/22/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Young adults are rapidly adopting electronic cigarette (e-cigarette) use. The popularity of e-cigarettes among young people can be attributed to heavy industry advertising and misleading health claims. Data indicate that young e-cigarette users who have never used conventional cigarettes may transition toward smoking combustible cigarettes. Communicating e-cigarette risks via text messaging is limited. This pilot study assessed the impact of exposure to 16 text messages on e-cigarette knowledge and risk perception. The short text messages delivered to participants conveyed e-cigarette use may lead to addiction to nicotine and explained the latest health-related findings. METHODS A two-group randomized pretest and posttest study was conducted among 95 racially, ethnically diverse young adults recruited from vocational training programs. Fifty percent of participants were randomized to receive either gain- or loss-framed messages. Knowledge and risk perceptions about e-cigarettes and tobacco use were assessed pre- and post-message exposure. RESULTS Participants had a mean age of 20.8 years, SD = 1.7. Current use of e-cigarettes was reported by 10.5% (10/95) and 27.4% (26/95) used a variety of other tobacco products. Findings revealed significant increases in knowledge about e-cigarettes after exposure to the messages (range for ps: p < 04 to p < 0.0001). A statistically significant increase in perceived e-cigarette risk was found post-exposure (p = 0.002). Participants randomized to gain-framed messages reported a significantly higher perceived risk of using e-cigarettes post-exposure than did those who received loss-framed messages (p = 0.02). CONCLUSIONS This was a small-scale pilot requiring additional evidence to support the effectiveness of text messaging for increasing e-cigarette knowledge and risk perception. Future research may apply text messages to test new ways to educate young populations about tobacco use and consider addressing these messages to specific subgroups at high risk of use such as non-college bound young adults.
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Affiliation(s)
- Karen S. Calabro
- Department of Behavioral Science, The University of Texas (UT) MD Anderson Cancer Center, Houston, TX, United States
| | - Georges E. Khalil
- Department of Behavioral Science, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Minxing Chen
- Department of Biostatistics, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Cheryl L. Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX, United States
| | - Alexander V. Prokhorov
- Department of Behavioral Science, UT MD Anderson Cancer Center, Houston, TX, United States
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Wotring A, Paprzycki P, Wagner-Green V, Wygonik QR, Blavos AA, Kruger J, Castor T, Diehr AJ, Glassman TJ. Primary versus secondary prevention messages: College students' perceptions of effectiveness by marijuana user status. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:743-752. [PMID: 30240330 DOI: 10.1080/07448481.2018.1506790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/04/2018] [Accepted: 07/26/2018] [Indexed: 06/08/2023]
Abstract
Objective: With medical and recreational marijuana legislation expanding throughout the country, the need to educate high-risk populations is evident. The purpose of this study was to assess college students' perceptions of health communication messages comparing primary and secondary prevention messages concerning marijuana. Participants: Participants (n = 487) included college students, ages 18-25, enrolled in a Midwestern University. Methods: Participants assessed messages based on likeability, creativity, believability, persuasiveness, relevance, and usefulness using an online questionnaire that also included open-end comments. Results: Rasch analyses indicate that nonmarijuana users rated primary prevention messages higher than secondary prevention messages, whereas marijuana users ranked secondary prevention messages more favorably than primary prevention messages. Conclusion: Interventions designed to address marijuana use among college students may be more effective if tailored toward user status. Specifically, primary prevention materials should be designed for abstainers, while secondary prevention messages that focus on harm reduction strategies should be used with marijuana users.
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Affiliation(s)
- Amy Wotring
- University of Toledo, School of Population Health, College of Health & Human Services, Toledo, Ohio, USA
| | - Peter Paprzycki
- Department of Educational Research and Administration, Dissertation Research Support Center, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Victoria Wagner-Green
- University of Toledo, School of Population Health, College of Health & Human Services, Toledo, Ohio, USA
| | - Quri R Wygonik
- University of Toledo, School of Population Health, College of Health & Human Services, Toledo, Ohio, USA
| | | | - Jessica Kruger
- SUNY at Buffalo, Community Health and Health Behavior, Buffalo, New York, USA
| | - Tom Castor
- University of Toledo, School of Population Health, College of Health & Human Services, Toledo, Ohio, USA
| | - Aaron J Diehr
- Department of Public Health & Recreation Professions, Southern Illinois University, Carbondale, Illinois, USA
| | - Tavis J Glassman
- University of Toledo, School of Population Health, College of Health & Human Services, Toledo, Ohio, USA
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Prokhorov AV, Khalil GE, Calabro KS, Machado TC, Russell S, Czerniak KW, Botello GC, Chen M, Perez A, Vidrine DJ, Perry CL. Mobile Phone Text Messaging for Tobacco Risk Communication Among Young Adult Community College Students: Protocol and Baseline Overview for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e10977. [PMID: 30322833 PMCID: PMC6231779 DOI: 10.2196/10977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/18/2022] Open
Abstract
Background Community-college students are at high risk for tobacco use. Because the use of mobile phone text messaging is nearly ubiquitous today, short message service (SMS) may be an effective strategy for tobacco risk communication in this population. Little is known, however, concerning the message structure significantly influencing perceived tobacco risk. Objective We aim to outline the rationale and design of Project Debunk, a randomized trial comparing the effects of different SMS text message structures. Methods We conducted a 6-month randomized trial comparing 8 arms, based on the combination of the 3 message structures delivered to young adults in a 2×2×2 study design: framing (gain-framed or loss-framed), depth (simple or complex), and appeal (emotional or rational). Participants were invited to participate from 3 community colleges in Houston from September 2016 to July 2017. Participants were randomized to 1 arm and received text messages in 2 separate campaigns. Each campaign consisted of 2 text messages per day for 30 days. Perceived tobacco risk was assessed at baseline, 2 months after the first campaign, and 2 months after the second campaign. We assessed the perceived risk of using conventional products (eg, combustible cigarettes) and new and emerging products (eg, electronic cigarettes). The validity of message structures was assessed weekly for each campaign. A 1-week follow-up assessment was also conducted to understand immediate reactions from participants. Results We completed data collection for the baseline survey on a rolling basis during this time and assessed the validity of the message structure after 1 week of SMS text messages. For the entire sample (N=636), the average age was 20.92 years (SD 2.52), about two-thirds were male (430/636, 67.6%), and most were black or African American (259/636, 40.7%) or white (236/636, 37.1%). After 1 week of receiving text messages, the following was noted: (a) loss-framed messages were more likely to be perceived as presenting a loss than gain-framed messages (F7,522=13.13, P<.001), (b) complex messages were perceived to be more complex than simple messages (F7,520=2.04, P=.05), and (c) emotional messages were perceived to be more emotionally involving than rational messages (F7,520=6.46, P<.001). Conclusions This study confirms that the recruitment, randomization, and message composition have been successfully implemented. Further analyses will identify specific types of messages that are more effective than others in increasing the perceived risk of tobacco use. If our results suggest that any of the 8 specific message structures are more effective for helping young adults understand tobacco risk, this would provide evidence to include such messages as part of a larger technology-based campaign such as mobile phone apps, entertainment-based campaigns, and social media. Trial Registration ClinicalTrials.gov NCT03457480; https://clinicaltrials.gov/ct2/show/NCT03457480 (Archived by WebCite at http://www.webcitation.org/6ykd4IIap) Registered Report Identifier RR1-10.2196/10977
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Affiliation(s)
- Alexander V Prokhorov
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Georges Elias Khalil
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Karen Sue Calabro
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Tamara Costello Machado
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sophia Russell
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Katarzyna W Czerniak
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Gabrielle C Botello
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Minxing Chen
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Adriana Perez
- Department of Biostatistics and Data Science, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, United States
| | - Damon J Vidrine
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, OK, United States
| | - Cheryl L Perry
- School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, United States
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Khalil GE, Calabro KS, Crook B, Machado TC, Perry CL, Prokhorov AV. Validation of mobile phone text messages for nicotine and tobacco risk communication among college students: A content analysis. Tob Prev Cessat 2018; 4. [PMID: 29888338 PMCID: PMC5989570 DOI: 10.18332/tpc/84866] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In the United States, young adults have the highest prevalence of tobacco use. The dissemination of mobile phone text messages is a growing strategy for tobacco risk communication among young adults. However, little has been done concerning the design and validation of such text messages. The Texas Tobacco Center of Regulatory Science (Texas-TCORS) has developed a library of messages based on framing (gain- or loss-framed), depth (simple or complex) and appeal (emotional or rational). This study validated the library based on depth and appeal, identified text messages that may need improvement, and explored new themes. METHODS The library formed the study sample (N=976 messages). The Linguistic Inquiry and Word Count (LIWC) software of 2015 was used to code for word count, word length and frequency of emotional and cognitive words. Analyses of variance, logistic regression and scatter plots were conducted for validation. RESULTS In all, 874 messages agreed with LIWC-coding. Several messages did not agree with LIWC. Ten messages designed to be complex indicated simplicity, while 51 messages designed to be rational exhibited no cognitive words. New relevant themes were identified, such as health (e.g. ‘diagnosis’, ‘cancer’), death (e.g. ‘dead’, ‘lethal’) and social connotations (e.g. ‘parents’, ‘friends’). CONCLUSIONS Nicotine and tobacco researchers can safely use, for young adults, messages from the Texas-TCORS library to convey information in the intended style. Future work may expand upon the new themes. Findings will be utilized to develop new campaigns, so that risks of nicotine and tobacco products can be widely disseminated.
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Affiliation(s)
- Georges E Khalil
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Karen S Calabro
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Brittani Crook
- The University of Texas Health Science Center, School of Public Health, Texas, United States
| | - Tamara C Machado
- The University of Texas MD Anderson Cancer Center, Texas, United States
| | - Cheryl L Perry
- The University of Texas Health Science Center, School of Public Health, Texas, United States
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Ly C, Nicksic NE, Loukas A, Prokhorov AV, Perry CL. Receptivity of Young Adult Hookah Users to Health Warning Labels. TOB REGUL SCI 2018; 4:536-547. [PMID: 31656827 PMCID: PMC6813791 DOI: 10.18001/trs.4.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We examined the receptivity of non-college young adult hookah users to health warning labels. METHODS We conducted in-person qualitative interviews with 23 hookah users, aged 18-29 in Austin, Texas, who were not currently enrolled in college/university. Data were transcribed, coded, and thematically analyzed using NVivo Pro, version 11. RESULTS Gaps in knowledge were evident regarding the level of chemical exposure, cancer risks, and negative health consequences of hookah use. Respondents preferred warning labels that factually listed health consequences rather than labels that used "sensationalistic" wording (eg, "kills") or technical terms. Participants thought placement of hookah warning labels would be most effective on product packaging or on the door of establishments selling hookah. Respondents thought most of the warning labels would be effective in deterring hookah use; however, the majority stated they would likely continue to use hookah over the next year. CONCLUSIONS Non-college-attending young adult hookah users preferred hookah health warning labels that are simple, factual, informative, and non-sensationalistic. These results may inform regulations regarding the packaging of tobacco products, specifically in the design and placement of warning labels, which may result in better user message receptivity.
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Affiliation(s)
- Christina Ly
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX
| | - Nicole E Nicksic
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX
| | - Alexandra Loukas
- The University of Texas at Austin, Department of Kinesiology and Health Education, College of Education, Austin, TX
| | | | - Cheryl L Perry
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX
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