title: Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts.
abstract: OBJECTIVE
  Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts.
  
  
  METHODS
  Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use.
  
  
  RESULTS
  Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status.
  
  
  CONCLUSIONS
  Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status.
authors.affiliation: Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA; School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Hong Kong. Electronic address: nanjiang@hku.hk.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.affiliation: Public Health and Environment Division, RTI International, Research Triangle Park, NC 27709, USA. Electronic address: younlee@rti.org.
authors.forename: Youn O
authors.initials: YO
authors.lastname: Lee
authors.affiliation: Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94143, USA. Electronic address: pling@medicine.ucsf.edu.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Ling
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D001290:Attitude; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D012147:Restaurants; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D040241:Social Marketing; D055815:Young Adult; D014026:Nicotiana
keywords: Alcohol use; Cigarette smoking; Smoking cessation; Tobacco; Young adult