title: Reasons for Polytobacco Use among Young Adults: Scale Development and Validation.
abstract: BACKGROUND
  Limited research has examined reasons for polytobacco use, an increasing public health problem, particularly among young adults. We examined reasons for polytobacco use among users of more than one tobacco product in the past 4 months enrolled in an ongoing six-wave longitudinal study of 3,418 students aged 18-25 from seven US colleges and universities.
  
  
  METHODS
  An expert panel generated items related to reasons for polytobacco use, included in Wave 3 (administered in Summer 2015). Participants reporting use of more than one tobacco product in the past four months (n=540) were asked to complete the Reasons for Polytobacco Use scale and measures related to tobacco/nicotine use/dependence, use motives, perceptions of tobacco, parental/friend use, other substance use, and mental health. We conducted a factor analysis and then examined convergent and discriminant validity for the derived factors.
  
  
  RESULTS
  Our sample was an average age of 20.40 (SD=1.84), 48.0% male, and 21.9% Black. Four factors were identified: Instrumentality, Social Context, Displacement, and Experimentation. Instrumentality was the only factor associated with little cigar/cigarillo and marijuana use. Displacement and Social Context showed similar associations; however, Social Context was associated with having friends who used tobacco while Displacement was not. Experimentation was associated with greater perceived addictiveness and harm of using tobacco products as well as greater perceived social acceptability of tobacco use.
  
  
  CONCLUSIONS
  Each of the four factors identified demonstrated unique convergent and discriminant validity. The use of this scale to characterize polytobacco using young adults may help inform and target cessation or prevention interventions.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Regine
authors.initials: R
authors.lastname: Haardörfer
authors.affiliation: Battelle Public Health Center for Tobacco Research, 1100 Dexter Avenue North, Suite 400 Seattle, WA 98109-3598.
authors.forename: Gillian
authors.initials: G
authors.lastname: Schauer
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Getachew
authors.initials: G
authors.lastname: Betelihem
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Matthew
authors.initials: M
authors.lastname: Masters
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Bennett
authors.initials: B
authors.lastname: McDonald
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Jill
authors.initials: J
authors.lastname: Shah
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Jackelyn
authors.initials: J
authors.lastname: Payne
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Raina
authors.initials: R
authors.lastname: Sarmah
authors.affiliation: ICF Macro, 1725 I (Eye) Street NW, 10th Floor, International, Washington, DC 20006.
authors.forename: Matthew
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
authors.forename: Michael
authors.initials: M
authors.lastname: Windle
keywords: Risk factors; Substance use; Tobacco use; Young adults