title: Judgments, awareness, and the use of snus among adults in the United States.
abstract: BACKGROUND
  Alternative tobacco products, such as snus, are emerging in the U.S. market. Understanding correlates of awareness and use, particularly judgments about harm and addictiveness, can inform public health communications about these products.
  
  
  METHODS
  Data were collected from a web panel representative of the U.S. population in March 2013 (N = 2,067). The survey assessed awareness and use of snus among adults. Absolute and comparative snus judgments, intentions, smoking status, and sociodemographic variables were measured. Bivariate and multivariable logistic regression analyses were conducted to examine associations between these variables and snus awareness and use.
  
  
  RESULTS
  Nearly 36% of the population was aware of snus, and 5.2% reported ever using snus. Current cigarette smokers were about 4 times more likely as nonsmokers to report snus awareness and use. Sociodemographic correlates of snus awareness and use included being male, employed full time, and younger. Compared with respondents who perceived snus to be as harmful and as addictive as cigarettes, those who perceived snus to be less harmful and less addictive than cigarettes were more likely to have used snus.
  
  
  CONCLUSIONS
  Current smokers are more likely to be aware of and have used snus. Multiple tobacco product use poses a significant challenge for public health efforts to reduce tobacco-associated morbidity and mortality. Perceptions that snus is less harmful and less addictive compared with cigarettes are associated with snus use. These judgments can inform public health communications about emerging tobacco products and multiple product use.
authors.affiliation: Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD; kaufmana@mail.nih.gov.
authors.forename: Annette R
authors.initials: AR
authors.lastname: Kaufman
authors.affiliation: U.S. Food and Drug Administration, Tobacco Regulatory Science Fellowship Program, Silver Spring, MD; Department of Oncology, Georgetown University Medical Center, Washington, DC;
authors.forename: Darren
authors.initials: D
authors.lastname: Mays
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD.
authors.forename: Amber R
authors.initials: AR
authors.lastname: Koblitz
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD.
authors.forename: David B
authors.initials: DB
authors.lastname: Portnoy
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
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