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A new measure of youth cigarette smoking.

ABSTRACT: American students' 30-day smoking prevalence has decreased dramatically over the past two decades. The frequency of smoking within the 30-day measure has shifted from heavy smoking (>1/2?pack/day) toward light smoking (<1 to 5?cigarettes/day). 30-day prevalence thus understates the extent of the decline in youth smoking. To capture this shift toward less frequent smoking among the decreasing proportion of students who smoke, I develop a new index: the average number of cigarettes smoked per student per day (ACSD), using data from Monitoring the Future. To calculate ACSD I assign a specific number of cigarettes to each of 7 response options to the question, "How frequently have you smoked cigarettes during the past 30 days?" Response options range from "not at all" (assigned 0 cigarettes) to "two packs or more per day" (assigned 45 cigarettes). I then multiply these estimates by the proportion of students giving each response option. Summing across the 7 categories produces the ACSD for that survey year. I then compare time trends in 30-day prevalence and ACSD. From the mid-1990s to 2016, 30-day smoking prevalence among 12th graders declined 71.3%, while ACSD dropped 83.9% (p?p?p?

SUBMITTER: Warner KE

PROVIDER: S-EPMC6125759 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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A new measure of youth cigarette smoking.

Warner Kenneth E KE

Preventive medicine reports 20180828

American students' 30-day smoking prevalence has decreased dramatically over the past two decades. The frequency of smoking within the 30-day measure has shifted from heavy smoking (>1/2 pack/day) toward light smoking (<1 to 5 cigarettes/day). 30-day prevalence thus understates the extent of the decline in youth smoking. To capture this shift toward less frequent smoking among the decreasing proportion of students who smoke, I develop a new index: the average number of cigarettes smoked per stud ...[more]

PMID: 30191096

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Project description:BackgroundElectronic nicotine delivery systems ("e-cigarettes") are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure.MethodsA focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% Hispanic) in a large Southeastern metropolitan area in the United States.ResultsExploratory Factor Analysis revealed a four factor solution: Negative Consequences (Cronbach's α = .92); Positive Reinforcement (α = .83); Negative Affect Reduction (α = .95); and Weight Control (α = .89). Subscales were significantly correlated with vaping susceptibility and lifetime vaping. Subscales successfully differentiated susceptible adolescents from confirmed non-susceptible adolescents, with susceptible adolescents reporting more positive expectancies, eg, Positive Reinforcement, M = 5.0, SD = 2.0 vs M = 3.0, SD = 2.1, P < .001, η2 = 0.19, and less negative expectancies, M = 5.5, SD = 2.3 vs M = 6.5, SD = 2.6, P = .001, η2 = 0.04. Similar results were found comparing adolescents who have never vaped nicotine with those who have vaped nicotine. Hierarchical linear regression demonstrated subscales were significant predictors of lifetime vaping after controlling for demographics, vaping ad exposure, and peer/family vaping.ConclusionsA preliminary version of an adolescent expectancy measure appears reliable and valid based on expert input and pilot testing with adolescents. Promising results were found in the domains of concurrent validity, discriminant validity, and incremental validity. Future research and evaluation efforts will be able to use this tool to further prevention and treatment goals.

Project description:The first goal of this study was to identify the most appropriate measure of cigarette smoking for identifying unique smoking trajectories among adolescents; the second goal was to describe the resulting trajectories and their characteristics. Using 15 annual waves of smoking data in the National Longitudinal Survey of Youth 1997 (NLSY97), we conducted an exploratory latent class growth analysis to determine the best of four outcome variables for yearly smoking (cigarettes per day on days smoked, days smoked per month, mean cigarettes per day, and total cigarettes per month) among individuals aged 12 to 30 (n = 8,791). Days smoked per month was the best outcome variable for identifying unique longitudinal trajectories of smoking and characteristics of these trajectories that could be used to target different types of smokers for prevention and cessation. Objective statistics were used to identify four trajectories in addition to never smokers (34.1%): experimenters (13.6%), quitters (8.1%), early established smokers (39.0%), and late escalators (5.2%). We identified a quitter and late escalator class not identified in the only other comparable latent class growth analysis. Logistic regressions were used to identify the characteristics of individuals in each trajectory. Compared with never smokers, all trajectories except late escalators were less likely to be black; experimenters were more likely to be out of school and unemployed and drink alcohol in adolescence; quitters were more likely to have a mother with a high school degree/GED or higher (versus none) and to use substances in adolescence and less likely to have ever married as a young adult; early established smokers were more likely to have a mother with a high school diploma or GED, be out of school and unemployed, not live with both parents, have used substances, be depressed, and have peers who smoked in adolescence and to have children as young adults and less likely to be Hispanic and to have ever married as young adults; and late escalators were more likely to be Hispanic, drink alcohol, and break rules in adolescence and less likely to have ever married as young adults. Because of the number of waves of data analyzed, this analysis provided a clearer temporal depiction of smoking behavior and more easily distinguishable smoking trajectories than previous analyses. Tobacco control interventions need to move beyond youth-focused approaches to reach all smokers.

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A new measure of youth cigarette smoking.

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A new measure of youth cigarette smoking.

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