One-item susceptibility measure predicts waterpipe and little cigar/cigarillo uptake in a national sample of adolescents and young adults in the United States
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Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, United States
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, United States
Elizabeth N. Orlan   

Department of Health Behavior Gillings School of Global Public Health University of North Carolina, Chapel Hill CBB 7440, Chapel Hill, NC 27599, United States
Publish date: 2019-05-10
Submission date: 2019-02-08
Final revision date: 2019-04-02
Acceptance date: 2019-04-15
Tob. Prev. Cessation 2019;5(May):17
Adolescents and young adults in the United States (US) are increasingly using non-cigarette tobacco products such as waterpipe (WP) and little cigars/cigarillos (LCC). One way to predict which non-user adolescents and young adults are most likely to use these products is through measuring their susceptibility or openness to using the products.

We conducted a national phone survey (baseline) and an internet survey (follow-up) of adolescents and young adults (ages 13–25 years), who, at baseline, had never used WP (N=1002) or LCC (N=990). At baseline, we measured susceptibility using a single item, asking participants whether they would try WP or LCC if their best friend offered it to them, and subsequently measured uptake at follow-up. We conducted multivariate regression analyses to determine whether product-specific susceptibility was a significant predictor of uptake at follow-up.

Participants who were susceptible and participants who had ever used another tobacco product had higher odds of using WP (AOR=3.5, AOR=4.2) and LCC (AOR=3.2, AOR=5.3) at follow-up than those who were not susceptible to those products, and had not ever used tobacco products respectively, controlling for sociodemographic factors. The one-item measure had adequate sensitivity (WP=51.4%, LCC=40.2%) and specificity (WP=84.9%, LCC=87.9%).

Our national study of US adolescents and young adults shows that a one-item susceptibility measure at baseline was a significant predictor of WP and LCC uptake at follow-up, even after controlling for other predictors. Future research should assess the predictive validity of the one-item compared to the multi-item scale.

The authors declare that they have no competing interests, financial or otherwise, related to the current work. E.N. Orlan, T.L. Queen and E.L. Sutfin report grants from the National Cancer Institute and FDA Center for Tobacco Products, during the conduct of the study. K.M. Ribisl reports grants from National Cancer Institute and FDA Center for Tobacco Products, during the conduct of the study; and other from the US Government, outside the submitted work.
Research reported in this publication was supported by P50CA180907 from the National Cancer Institute and the FDA Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.
Not commissioned; externally peer reviewed.
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