title: Phantom smoking among young adult bar patrons.
abstract: To explore the prevalence and sociodemographic makeup of smokers who do not self-identify as smokers (ie, phantom smokers) compared with self-identifying smokers in a sample of bar-going young adults aged 18-30 years to more accurately assess young adult prevalence of smoking and inform cessation message targeting.
  
  
  
  Cross-sectional surveys of smokers (n=3089) were conducted in randomly selected bars/nightclubs in seven US cities. Logistic regression models assessed associations between phantom smoking (past 30-day smoking and denial of being a smoker), tobacco and alcohol use behaviours (eg, social smoking, nicotine dependence, smoking while drinking, past 30-day alcohol use) and demographics.
  
  
  
  Compared with smokers, phantom smokers were more likely to be college graduates (OR=1.43, 95% CI 1.03 to 1.98) and to identify themselves as social smokers (OR=1.60, 95% CI 1.27 to 2.12). Phantom smokers had lower odds of smoking while drinking (OR=0.28, 95% CI 0.25 to 0.32), being nicotine dependent (OR=0.36, 95% CI 0.22 to 0.76) and having quit for at least 1 day in the last year (OR=0.46, 95% CI 0.36 to 0.69) compared with smokers.
  
  
  
  This research extends phantom smoking literature on college students to provide a broader picture of phantom smoking among young adults in high-risk contexts and of varying levels of educational attainment. Phantom smokers may be particularly sensitive to social pressures against smoking, suggesting the importance of identifying smoking as a behaviour (rather than identity) in cessation messaging to ensure that phantom smokers are reached.
authors.affiliation: RTI International, Research Triangle Park, North Carolina, USA.
authors.forename: Jamie
authors.identifier: 0000-0001-9765-2299
authors.initials: J
authors.lastname: Guillory
authors.affiliation: Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Nadra
authors.initials: N
authors.lastname: Lisha
authors.affiliation: RTI International, Research Triangle Park, North Carolina, USA.
authors.forename: Youn Ok
authors.initials: YO
authors.lastname: Lee
authors.affiliation: Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012147:Restaurants; D000074285:Smokers / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Denormalization; Priority/special populations; Surveillance and monitoring