Tara Elton-Marshall1, Pete Driezen2, Geoffrey T Fong3, K Michael Cummings4, Alexander Persoskie5, Olivia Wackowski6, Kelvin Choi7, Annette Kaufman8, David Strong9, Shannon Gravely2, Kristie Taylor10, Jonathan Kwan5, Maansi Bansal-Travers11, Mark Travers11, Andrew Hyland11. 1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Ontario Tobacco Research Unit, Toronto, Ontario, Canada. Electronic address: Tara.EltonMarshall@camh.ca. 2. Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada. 3. Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada. 4. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. 5. United States Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, USA. 6. Rutgers School of Public Health, Center for Tobacco Studies, Piscataway, NJ, USA. 7. Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA. 8. Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA. 9. Cancer Prevention Program, Moores Cancer Center, University of California, San Diego, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, San Diego, CA, USA. 10. Westat, Rockville, MD, USA. 11. Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY, USA.
Abstract
OBJECTIVES: To examine: (1) How perceptions of harm for seven non-cigarette tobacco products predict subsequent use; (2) How change in use is associated with changes in perceptions of product harm; (3) Whether sociodemographic variables moderate the association between perceptions and use. METHODS: Data are from the adult sample (18+) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort survey conducted September 2013-December 2014 (Wave 1 (W1) n = 32,320) and October 2014-October 2015 (Wave 2 (W2) n = 28,362). RESULTS: Wave 1 users and non-users of e-cigarettes, filtered cigars, cigarillos, and pipes, who perceived these products as less harmful had greater odds of using the product at W2. For the other products, there was an interaction between W1 perceived harm and W1 use status in predicting W2 product use. At W2, a smaller percentage of U.S. adults rated e-cigarettes as less harmful than cigarettes compared to W1 (41.2% W1, 29.0% W2). Believing non-cigarette products to be less harmful than cigarettes was more strongly associated with subsequent product use in the oldest age group (55+ years) while weaker effects were observed in the youngest age group (18-24 years). This moderating effect of age was significant for e-cigarettes, hookah, traditional cigars, and cigarillos. CONCLUSIONS: Strategies to prevent initiation and promote cessation of these products may benefit from understanding and addressing perceptions of these products.
OBJECTIVES: To examine: (1) How perceptions of harm for seven non-cigarette tobacco products predict subsequent use; (2) How change in use is associated with changes in perceptions of product harm; (3) Whether sociodemographic variables moderate the association between perceptions and use. METHODS: Data are from the adult sample (18+) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort survey conducted September 2013-December 2014 (Wave 1 (W1) n = 32,320) and October 2014-October 2015 (Wave 2 (W2) n = 28,362). RESULTS: Wave 1 users and non-users of e-cigarettes, filtered cigars, cigarillos, and pipes, who perceived these products as less harmful had greater odds of using the product at W2. For the other products, there was an interaction between W1 perceived harm and W1 use status in predicting W2 product use. At W2, a smaller percentage of U.S. adults rated e-cigarettes as less harmful than cigarettes compared to W1 (41.2% W1, 29.0% W2). Believing non-cigarette products to be less harmful than cigarettes was more strongly associated with subsequent product use in the oldest age group (55+ years) while weaker effects were observed in the youngest age group (18-24 years). This moderating effect of age was significant for e-cigarettes, hookah, traditional cigars, and cigarillos. CONCLUSIONS: Strategies to prevent initiation and promote cessation of these products may benefit from understanding and addressing perceptions of these products.
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