title: Patterns of combustible tobacco use in U.S. young adults and potential response to graphic cigarette health warning labels.
abstract: In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as "smokers" (11%); (4) nondaily, light smokers who self-identify as "social or occasional smokers" (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily "smokers," LCC and hookah users (RRR=2.35) and nonusers closed to smoking (RRR=2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function.
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: avillanti@legacyforhealth.org.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Villanti
authors.affiliation: The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Pearson
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Research and Evaluation, Legacy, Washington, DC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cantrell
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Research and Evaluation, Legacy, Washington, DC, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Vallone
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Research and Evaluation, Legacy, Washington, DC, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D011356:Product Labeling; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Models; Population surveillance; Smoking/epidemiology; Statistical; Tobacco