title: Social Norms, Perceptions and Dual/Poly Tobacco Use among Texas Youth.
abstract: We assessed risk perceptions and social norms about tobacco use across adolescent non-users of tobacco, single- product users, and dual/poly-product users.
  
  
  
  Use behaviors specific to e-cigarettes, cigarettes, hookah, cigars, and smokeless tobacco were assessed among 6th, 8th and 10th grade students (sample [n] = 3907 from a population of [N] = 461,069 students). Multivariate regression was used to examine differences in these factors across use categories, adjusted for demographic factors.
  
  
  
  Results highlight differences between non-users and single- or dual/poly-product users for most tobacco products. Dual/poly-product users differed from single-product users most notably in their higher perceived use of tobacco products by close friends and dating partners, and a higher proportion of single-product users reported most products were not harmful and not addictive compared to non-users. Few differences were seen between dual/poly-product users and single-product users in their perceptions of harm and addictiveness.
  
  
  
  Findings demonstrate the importance of proximal social influences (ie, close friends and dating partners) for adolescent dual/poly-tobacco product users. Understanding similarities and differences in risk factors between these adolescent groups can guide effective public health prevention and treatment programs.
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX;, Email: maria.r.cooper@uth.tmc.edu.
authors: Maria
authors: M
authors: Cooper
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX.
authors: MeLisa R
authors: MR
authors: Creamer
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX.
authors: Christina
authors: C
authors: Ly
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX.
authors: Brittani
authors: B
authors: Crook
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX.
authors: Melissa B
authors: MB
authors: Harrell
authors: The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX.
authors: Cheryl L
authors: CL
authors: Perry
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D066262:Social Norms; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D064424:Tobacco Use / Q000009:adverse effects / Q000453:epidemiology / Q000523:psychology*; D014030:Tobacco, Smokeless / Q000009:adverse effects / Q000706:statistics & numerical data