Factors associated with initiation and use of snus among adolescents

Aim: We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents’ own educational plans, the parents’ educational level(s) and tobacco habits were estimated. Methods: In this cross-sectional questionnaire-based study, 1465 patients aged 18–20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. Results: Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. Conclusions: These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents’ influence on their children’s tobacco use.

Development of the UNC Perceived Message Effectiveness Scale for Youth

PurposeTobacco prevention media campaigns are an important tool to address youth tobacco use. We developed a theory-based perceived message effectiveness (PME) Scale to use when vetting messages for campaigns.MethodsParticipants were a national sample of N=623 US adolescents (ages 13–17 years) recruited from a national probability-based panel. In an online experiment, we randomised adolescents to view tobacco prevention ads. All participants viewed an ad on smoking or vaping from the US Food and Drug Administration’s The Real Cost campaign and a control video, in a random order. After ad exposure, we assessed PME using nine candidate items and constructs for convergent and criterion validity analyses. We used confirmatory factor analysis and examined information curves to select the scale items.ResultsA brief PME scale with three items (α=0.95) worked equally well for demographically diverse adolescents with different patterns of tobacco use. The Real Cost ads generated higher PME scores than the control videos for both vaping and smoking (convergent validity; p<0.05). Higher PME scores were associated with greater attention, fear, cognitive elaboration and anticipated social interactions (convergent validity; r=0.31–0.66), as well as more negative attitudes toward and lower susceptibility to vaping and smoking (criterion validity; r=−0.14 to −0.37). A single-item PME measure performed similarly to the three-item version.ConclusionsThe University of North Carolina PME Scale for Youth is a reliable and valid measure of the potential effectiveness of vaping and smoking prevention ads. Employing PME scales during message development and selection may help youth tobacco prevention campaigns deploy more effective ads.

Assessment of Action Plans as a Guide for Equity-Focused Coalition Work

Collaborative capacity within coalitions is required to promote healthy communities and create systemic change. The purpose of this study was to evaluate the quality of three Tobacco Prevention and Control Coalitions’ action plans for their likely ability to address health equity through tobacco cessation efforts. To do this, the Butterfoss State Plan Index was adapted for relevance to community-oriented coalitions, with a focus on health disparities and tobacco control. This study compares three tobacco control coalitions in Texas to quantify their efforts on addressing health disparities through a standardized measurement process. The results of this assessment indicate that there are gaps in existing coalition assessment tools, and action plan norms and requirements, specifically as it pertains to addressing health disparities in a systematic way. Through a systematic analysis of coalition action plans and supporting documents, it is clear that there is a need for more standard inclusion of disparities-focused work within action plans. Community health researchers, coalition members, and coalition funders should consider action plans to be living, iterative documents that are subject to adjustments. Systems-thinking perspective should be used to develop action plans adapted to environmental, community, policy, and other changes. Lessons learned from this study can provide an example of how to incorporate strategies for reducing health disparities within coalition action planning.

Tobacco Prevention Using Social Skills Education and Puppet Scripts in an After-School Program

The purpose of this study was to explore the feasibility of implementing a tobacco use prevention intervention using social skills education and puppet scripts in an afterschool program. A total of 75 K-2 students attending an afterschool program in a rural Midwest area participated in a 4-lesson youth development tobacco prevention curriculum and completed a pre-post tobacco knowledge quiz. Additionally, 10 program mentors completed a pre-post program strengths and difficulties (SDQ) questionnaire on their assigned students. A series of t-tests were computed to examine differences in the pre and post scores of participants on the SDQ subscales, and total scales and descriptive statistics were computed on the tobacco knowledge quiz. Statistically significant differences were noted on 4 pre–post subscales scores of the SDQ and the total SDQ. Use of youth development curriculum using interactive puppet-based strategies implemented in afterschool settings may be a feasible health education strategy.

Integrating Alzheimer's Messages into Chronic Disease Programs

The number of people in the United States with dementia is increasing, with nearly six million people living with Alzheimer’s disease and related dementias. It is the fifth leading cause of death for those aged ≥65 years. Over 95% of people with dementia have another comorbid chronic condition. The Healthy Brain Initiative’s State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map notes that public health agencies should raise awareness of the link between brain health and physical health, and specifically calls out tobacco prevention and control, cardiovascular health management diabetes prevention and management, obesity prevention and control, and injury prevention as intervention points. The National Association of Chronic Disease Directors developed brain health messages targeted to reduce risk for cognitive decline through the prevention and control of comorbid chronic conditions. These messages can be leveraged for public health action by integrating them into existing chronic disease programs.

Evaluation and Impact of ASPIRE: An Interactive Tobacco Prevention Curriculum, among University Students in India

Online education approach provides innovative opportunities for engaging youths. Web-based, multimedia smoking prevention programs have been tested in high-income countries; however, efficacy of such programs is not well-investigated in low- and middle-income countries. The aim of this study was to evaluate the impact of A Smoking Prevention Interactive Experience (ASPIRE), an interactive tobacco prevention curriculum, among university students in India.A single-subject cohort study where each subject serves as their own control was conducted among university student participants engaged in ASPIRE, 60 minutes per week for five consecutive weeks during July to August of 2019. Assessments were conducted at baseline and immediately after exposure to ASPIRE. To evaluate the program, a structured instrument was specifically designed to measure the outcomes.A total of 103 university students participated voluntarily. Average age of the participants was 18.3±0.9 ranging from 17 to 20 years. Eighteen percent of students were curious to know about the various smoking products. More males were more susceptible to cigarette smoking as compared to females. The majority of participants felt that ASPIRE was culturally appropriate for young adults in India, but a modified version targeted toward Indian youth would be more acceptable. Pre- to postintervention knowledge of tobacco-related hazards increased from 70 to 97% (p < 0.001).ASPIRE, a multimedia interactive program, demonstrated its considerable potential to discourage smoking initiation among Indian youth.

Longitudinal Impact of Depressive Symptoms and Peer Tobacco Use on the Number of Tobacco Products Used by Young Adults

We examined the role of depressive symptoms in the longitudinal trajectory of the number of tobacco products used across young adulthood, ages 18–30 years, and whether peer tobacco use exacerbated the effects of the depressive symptoms. Participants were 4534 initially 18–25-year-old young adults in the Marketing and Promotions Across Colleges in Texas project (Project M-PACT), which collected data across a 4.5-year period from 2014 to 2019. Growth curve modeling within an accelerated design was used to test study hypotheses. Elevated depressive symptoms were associated with a greater number of tobacco products used concurrently and at least six months later. The number of tobacco-using peers moderated the association between depressive symptoms and the number of tobacco products trajectory. Young adults with elevated depressive symptoms used a greater number of tobacco products but only when they had a greater number of tobacco-using peers. Findings indicate that not all young adults with depressive symptoms use tobacco. Having a greater number of tobacco-using peers may facilitate a context that both models and encourages tobacco use. Therefore, tobacco prevention programs should aim to include peer components, especially for young adults.

Gender Differences in the Prevalence of Electronic Nicotine Product Use Among College Students in the U.S. - Analyses of the 2017 Population Assessment of Tobacco and Health (PATH) Study

The objective of this study was to analyze, among a nationally representative sample of college students in the U.S., gender differences in the lifetime, past 12-months, and past 30-day prevalence of e-nicotine products (ENPs) use, reasons for use, and susceptibility to ENP use among never users. We analyzed data from the Population Assessment of Tobacco and Health (PATH) Study. The study population included college-aged individuals (18-24 years old) enrolled in a degree program. The results of the study revealed that males were more likely to use ENPs than females. Both males and females reported a high proportion of misconception about ENPs, particularly with regards to ENPs being less harmful to the user than cigarettes. It also indicated that 36% of male and 32% of female college students were susceptible to start using ENPs. Our results highlight the need to provide comprehensive, tobacco-prevention education among U.S. youth.

Study on the Learning Effectiveness of the Tobacco Control Window Design Course in Line with the Visual Marketing Standards of the World Skills Competition

Objectives: Almost all smokers started smoking cigarettes before the age of 18 then became addicted to tobacco. Therefore, tobacco prevention education must be carried out throughout high school and university. Shunde Polytechnic integrates tobacco control health education into the window design curriculum, which allows students to complete and display tobacco control window design works on campus to cause discussion, thus achieving the promotion of tobacco control publicity and education. Based on the competition standards of the Visual Merchandising project of World Skills Competition, the original teaching methods were reformed in this research and the nine standards of the competition were divided into four modules for teaching. The required knowledge, specific skill requirements, and workflow were well integrated into the teaching of smoke control window design tasks to foster students’ abilities to display innovative design, window production, installation and operation, and teamwork. And the teaching results were verified according to World Skills Competition scoring methods and standards. The results showed that with the import of the Visual Merchandising project competition standard of World Skills Competition into the original window design course, on the one hand, the effects of students’ works and their self-satisfaction with their works have shown a significant improvement. On the other hand, although this kind of teaching method does not relieve the students’ mental, physical, time, and frustration pressure, it has stimulated and cultivated students’ good professional qualities. However, this research focuses on the assessment of professional skills and professionalism. Therefore, future research will more focus on evaluating the effectiveness of window design courses under the new teaching model in preventing youngsters from smoking or encouraging students to quit smoking, popularizing correct knowledge about the health hazards of tobacco, and establishing positive life beliefs.

Predicting Electronic Cigarette Use Among Adults in the Philippines

Background: The Philippines has one of the highest cigarette smoking rates in Southeast Asia. Tobacco prevention and control efforts should not be a one-size-fits-all approach. One of the most recent and highly marketed way of cutting down smoking is the use of E-cigarettes. But its use may also have potential harmful effects which would be similar to cigarette smoking. Purpose: This study aimed to determine the factors predicting electronic cigarette use among adults in a large metropolitan area in the Philippines. Methods:The study used a descriptive-correlational multivariate research design. Adults who are at least 18 years of age, who are electronic cigarettes users, dual users (electronic cigarette and cigarette users), and non-smokers were chosen for this study. The researchers utilized a researcher- made questionnaire based on the Theory of Planned Behavior (TPB) in gathering the data. Results: Multiple regression analysis suggests that positive attitude and high perceived behavioral control significantly predict intent to use electronic cigarettes. Moreover, intent to use is a significant predictor of actual e-cigarette use. Conclusion: People who have positive attitudes and high perceived behavioral control towards e-cigarette use are most likely to have higher intent to use e-cigarettes. Further, people who have high intent to use e-cigarettes will most likely use e-cigarettes. With reverence to the findings of this study, health managers and professionals should look into how e-cigarettes are being marketed to the public which may shape their attitude and behavior. Lastly, further studies should be conducted on other variables that may predict electronic cigarette use and measure health outcomes.