RESEARCH PAPER
One-item susceptibility measure predicts waterpipe and little cigar/cigarillo uptake in a national sample of adolescents and young adults in the United States
 
More details
Hide details
1
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, United States
2
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, United States
3
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, United States
CORRESPONDING AUTHOR
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
KEYWORDS
TOPICS
ABSTRACT
Introduction:
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.

Methods:
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.

Results:
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%).

Conclusions:
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.

CONFLICTS OF INTEREST
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.
FUNDING
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.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (53)
1.
Jamal A, Gentzke A, Hu S, et al. Tobacco Use Among Middle and High School Students—United States, 2011–2016. MMWR Morb Mortal Wkly Rep. 2017;66(23):567-603. doi:10.15585/mmwr.mm6623a1
 
2.
Jamal A, Phillips E, Gentzke AS, et al. Current Cigarette Smoking Among Adults—United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(2):53. doi:10.15585/mmwr.mm6702a1
 
3.
Phillips E, Wang TW, Husten CG, et al. Tobacco product use among adults—United States, 2015. MMWR Morbidity and mortality weekly report. 2017;66(44):1209. https://www.cdc.gov/mmwr/volum.... Accessed February 8th, 2019.
 
4.
Wang TW, Gentzke A, Sharapova S, Cullen KA, Ambrose BK, Jamal A. Tobacco Product Use Among Middle and High School Students-United States, 2011–2017. MMWR Morb Mortal Wkly Rep. 2018;67(22):629-633. doi:10.15585/mmwr.mm6722a3
 
5.
Montazeri Z, Nyiraneza C, El-Katerji H, Little J. Waterpipe smoking and cancer: systematic review and meta-analysis. Tob Control. 2016;26(1):92-97. doi:10.1136/tobaccocontrol-2015-052758
 
6.
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014. https://www.ncbi.nlm.nih.gov/p.... Accessed February 8, 2019.
 
7.
Chang CM, Corey CG, Rostron BL, Apelberg BJ. Systematic review of cigar smoking and all cause and smoking related mortality. BMC Public Health. 2015;15(1):390. doi:10.1186/s12889-015-1617-5
 
8.
Waziry R, Jawad M, Ballout RA, Al Akel M, Akl EA. The effects of waterpipe tobacco smoking on health outcomes: an updated systematic review and meta-analysis. Int J Epidemiol. 2017;46(1):32-43. doi:10.1093/ije/dyw021
 
9.
Maziak W. The waterpipe: an emerging global risk for cancer. J Cancer Epidemiol. 2013;37(1):1-4. doi:10.1016/j.canep.2012.10.013
 
10.
Sterling KL, Fryer CS, Fagan P. The most natural tobacco used: a qualitative investigation of young adult smokers’ risk perceptions of flavored little cigars and cigarillos. Nicotine Tob Res. 2015;18(5):827-833. doi:10.1093/ntr/ntv151
 
11.
Martinasek MP, McDermott RJ, Martini L. Waterpipe (hookah) tobacco smoking among youth. Curr Probl Pediatr Adolesc Health Care. 2011;41(2):34-57. doi:10.1016/j.cppeds.2010.10.001
 
12.
Ambrose BK, Day HR, Rostron B, Conway KP, Borek N, Hyland A, Villanti AC. Flavored tobacco product use among US youth aged 12-17 years, 2013-2014. JAMA. 2015;314(17):1871-1873. doi:10.1001/jama.2015.13802
 
13.
Corey CG, Ambrose BK, Apelberg BJ, King BA. Flavored tobacco product use among middle and high school students—United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(38):1066-1070. doi:10.15585/mmwr.mm6438a2
 
14.
Villanti AC, Johnson AL, Ambrose BK, et al. Flavored Tobacco Product Use in Youth and Adults: Findings From the First Wave of the PATH Study (2013-2014). Am J Prev Med. 2017;53(2):139-151. doi:10.1016/j.amepre.2017.01.026
 
15.
Feirman SP, Lock D, Cohen JE, Holtgrave DR, Li T. Flavored tobacco products in the United States: a systematic review assessing use and attitudes. Nicotine Tob Res. 2015;18(5):739-749. doi:10.1093/ntr/ntv176
 
16.
Soneji S, Sargent J, Tanski S. Multiple tobacco product use among US adolescents and young adults. Tob Control. 2016;25(2):174-180. doi:10.1136/tobaccocontrol-2014-051638
 
17.
Watkins SL, Glantz SA, Chaffee BW. Association of noncigarette tobacco product use with future cigarette smoking among youth in the Population Assessment of Tobacco and Health (PATH) study, 2013-2015. JAMA Pediatr. 2018;172(2):181-187. doi:10.1001/jamapediatrics.2017.4173
 
18.
Mzayek F, Khader Y, Eissenberg T, Al Ali R, Ward KD, Maziak W. Patterns of water-pipe and cigarette smoking initiation in schoolchildren: Irbid longitudinal smoking study. Nicotine Tob Res. 2011;14(4):448-454. doi:10.1093/ntr/ntr234
 
19.
Jensen PD, Cortes R, Engholm G, Kremers S, Gislum M. Waterpipe use predicts progression to regular cigarette smoking among Danish youth. Subst Use Misuse. 2010;45(7-8):1245-1261. doi:10.3109/10826081003682909
 
20.
Jaber R, Madhivanan P, Veledar E, Khader Y, Mzayek F, Maziak W. Waterpipe a gateway to cigarette smoking initiation among adolescents in Irbid, Jordan: a longitudinal study. Int J Tuberc Lung Dis. 2015;19(4):481-487. doi:10.5588/ijtld.14.0869
 
21.
Hampson SE, Andrews JA, Severson HH, Barckley M. Prospective predictors of novel tobacco and nicotine product use in emerging adulthood. J Adolesc Health. 2015;57(2):186-191. doi:10.1016/j.jadohealth.2015.04.015
 
22.
Richardson A, Williams V, Rath J, Villanti AC, Vallone D. The next generation of users: prevalence and longitudinal patterns of tobacco use among US young adults. Am J Public Health. 2014;104(8):1429-1436. doi:10.2105/ajph.2013.301802
 
23.
Pierce JP, Choi WS, Gilpin EA, Farkas AJ, Merritt RK. Validation of susceptibility as a predictor of which adolescents take up smoking in the United States. Health Psychol. 1996;15(5):355-361. doi:10.1037//0278-6133.15.5.355
 
24.
Lipkus IM, Reboussin BA, Wolfson M, Sutfin EL. Assessing and predicting susceptibility to waterpipe tobacco use among college students. Nicotine Tob Res. 2014;17(9):1120-1125. doi:10.1093/ntr/ntu336
 
25.
Strong DR, Hartman SJ, Nodora J, et al. Predictive Validity of the Expanded Susceptibility to Smoke Index. Nicotine Tob Res. 2015;17(7):862-869. doi:10.1093/ntr/ntu254
 
26.
Choi WS, Gilpin EA, Farkas AJ, Pierce JP. Determining the probability of future smoking among adolescents. Addiction. 2001;96(2):313-323. doi:10.1046/j.1360-0443.2001.96231315.x
 
27.
Gritz ER, Prokhorov AV, Hudmon KS, et al. Predictors of susceptibility to smoking and ever smoking: a longitudinal study in a triethnic sample of adolescents. Nicotine Tob Res. 2003;5(4):493-506. doi:10.1080/14622200307242
 
28.
Unger JB, Rohrbach LA, Howard-Pitney B, Ritt-Olson A, Mouttapa M. Peer influences and susceptibility to smoking among California adolescents. Subst Use Misuse. 2001;36(5):551-571. doi:10.1081/ja-100103560
 
29.
Primack BA, Soneji S, Stoolmiller M, Fine MJ, Sargent JD. Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults. JAMA Pediatr. 2015;169(11):1018-1023. doi:10.1001/jamapediatrics.2015.1742
 
30.
Trinidad DR, Pierce JP, Sargent JD, et al. Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study. Prev Med. 2017;101:8-14. doi:10.1016/j.ypmed.2017.05.010
 
31.
Cole AG, Kennedy RD, Chaurasia A, Leatherdale ST. Exploring the Predictive Validity of the Susceptibility to Smoking Construct for Tobacco Cigarettes, Alternative Tobacco Products, and E-Cigarettes. Nicotine Tob Res. 2017;21(3):323-330. doi:10.1093/ntr/ntx265
 
32.
Pierce JP, Distefan JM, Kaplan RM, Gilpin EA. The role of curiosity in smoking initiation. Addict Behav. 2005;30(4):685-696. doi:10.1016/j.addbeh.2004.08.014
 
33.
Maxwell KA. Friends: The role of peer influence across adolescent risk behaviors. J Youth Adolesc. 2002;31(4):267-277. doi:10.1023/a:1015493316865
 
34.
Castrucci BC, Gerlach KK, Kaufman NJ, Orleans CT. The association among adolescents' tobacco use, their beliefs and attitudes, and friends' and parents' opinions of smoking. Matern Child Health J. 2002;6(3):159-167. doi:10.1023/A:1019774028526
 
35.
Hundleby JD, Mercer GW. Family and friends as social environments and their relationship to young adolescents' use of alcohol, tobacco, and marijuana. J Marriage Fam. 1987:151-164. doi:10.2307/352679
 
36.
Lundborg P. Having the wrong friends? Peer effects in adolescent substance use. J Health Econ. 2006;25(2):214-233. doi:10.1016/j.jhealeco.2005.02.001
 
37.
de Vries H, Engels R, Kremers S, Wetzels J, Mudde A. Parents’ and friends’ smoking status as predictors of smoking onset: findings from six European countries. Health Educ Res. 2003;18(5):627-636. doi:10.1093/her/cyg032
 
38.
Jawad M, Wilson A, Lee JT, Jawad S, Hamilton FL, Millett C. Prevalence and predictors of water pipe and cigarette smoking among secondary school students in London. Nicotine Tob Res. 2013;15(12):2069-2075. doi:10.1093/ntr/ntt103
 
39.
Sidani JE, Shensa A, Yabes J, Fertman C, Primack BA. Waterpipe tobacco use in college and non-college young adults in the USA. Fam Pract. 2018;36(2):103-109. doi:10.1093/fampra/cmy037
 
40.
Ward KD, Eissenberg T, Gray JN, Srinivas V, Wilson N, Maziak W. Characteristics of US waterpipe users: a preliminary report. Nicotine Tob Res. 2007;9(12):1339-1346. doi:10.1080/14622200701705019
 
41.
Boynton MH, Agans RP, Bowling JM, et al. Understanding how perceptions of tobacco constituents and the FDA relate to effective and credible tobacco risk messaging: A national phone survey of US adults, 2014–2015. BMC Public Health. 2016;16(1):516. doi:10.1186/s12889-016-3151-5
 
42.
Brewer NT, Morgan JC, Baig SA, et al. Public understanding of cigarette smoke constituents: three US surveys. Tob Control. 2017;26(5):592-599. doi:10.1136/tobaccocontrol-2015-052897
 
43.
Jeong M, Noar SM, Zhang D, et al. Public understanding of cigarette smoke chemicals: Longitudinal study of US adults and adolescents. Nicotine Tob Res. 2019. doi:10.1093/ntr/ntz035
 
44.
Baig SA, Byron MJ, Lazard AJ, Brewer NT. “Organic,”“natural,” and “additive-free” cigarettes: Comparing the effects of advertising claims and disclaimers on perceptions of harm. Nicotine Tob Res. 2018;1:7. doi:10.1093/ntr/nty036
 
45.
Biener L, Siegel M. Tobacco marketing and adolescent smoking: more support for a causal inference. Am J Public Health. 2000;90(3):407. doi:10.2105/ajph.90.3.407
 
46.
King JL, Reboussin BA, Spangler J, Ross JC, Sutfin EL. Tobacco product use and mental health status among young adults. Addict Behav. 2018;77:67-72. doi:10.1016/j.addbeh.2017.09.012
 
47.
Juon HS, Ensminger ME, Sydnor KD. A longitudinal study of developmental trajectories to young adult cigarette smoking. Drug Alcohol Depend. 2002;66(3):303-314. doi:10.1016/s0376-8716(02)00008-x
 
48.
O'Loughlin JL, Dugas EN, O'Loughlin EK, Karp I, Sylvestre MP. Incidence and determinants of cigarette smoking initiation in young adults. J Adolesc Health. 2014;54(1):26-32.e4. doi:10.1016/j.jadohealth.2013.07.009
 
49.
Ennett ST, Bauman KE, Foshee VA, Pemberton M, Hicks KA. Parent‐child communication about adolescent tobacco and alcohol use: What do parents say and does it affect youth behavior? J Marriage Fam. 2001;63(1):48-62. doi:10.1111/j.1741-3737.2001.00048.x
 
50.
Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700-707. doi:10.1001/jama.2015.8950
 
51.
Nodora J, Hartman SJ, Strong DR, et al. Curiosity predicts smoking experimentation independent of susceptibility in a US national sample. Addict Behav. 2014;39(12):1695-1700. doi:10.1016/j.addbeh.2014.06.002
 
52.
Food and Drug Administration, HHS. Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products. Final rule. Fed Regist. 2016;81(90):28973-9106. https://www.ncbi.nlm.nih.gov/p.... Accessed February 8, 2019.
 
53.
Gottlieb S. Statement from FDA Commissioner Scott Gottlieb, M.D., on Proposed New Steps to Protect Youth by Preventing Access to Flavored Tobacco Products and Banning Menthol in Cigarettes. https://www.fda.gov/news-event.... Published November 15, 2018. Accessed February 8, 2019.
 
eISSN:2459-3087