Browsing by Subject "E-cigarette use"
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Item Progression from e-cigarette use to conventional cigarette smoking among adolescents in the United States(2019-05-08) Owotomo, Olusegun Obafemi; Maslowsky, Julie; Perry, Cheryl; Loukas, Alexandra; Pasch, KerynConventional cigarette smoking remains a major cause of significant morbidity and mortality in the United States. Although adolescent cigarette smoking rates have declined over the past decades, e-cigarette use is an emerging public health threat that can potentially stall or reverse this decline. Currently, e-cigarette use has become a social norm with its prevalence surpassing that of conventional cigarette smoking among adolescents. Adolescent e-cigarette users are at heightened risk of nicotine addiction and progressing to conventional cigarette smoking. However, factors underlying this progression are yet to be fully elucidated. Using the Theory of Planned Behavior as a conceptual framework, I conducted three studies that aimed to identify factors that potentially underlie progression from e-cigarette use to conventional cigarette smoking among US adolescents. With data obtained from two national surveys on adolescent risk behaviors: Monitoring the Future Survey and Population Assessment on Tobacco and Health, I examined smoking-related perceptions that make adolescent e-cigarette users susceptible to conventional cigarette smoking (Study 1); identified subgroups of adolescent e-cigarette users at most risk of exhibiting smoking intention (Study 2); and investigated how e-cigarette use moderates the transition from smoking intention to conventional cigarette smoking (Study 3). These three studies identify actionable predictors of conventional cigarette smoking among adolescent e-cigarette users and highlight potential foci for smoking prevention efforts. Findings suggest that negative attitudes and norms toward conventional cigarette smoking are major factors underlying progression to smoking among adolescent e-cigarette users. Also, three distinct subgroups of adolescent e-cigarette users were identified with each having particular smoking-related characteristics that determine their intention to smoke conventional cigarettes. Finally, transition from smoking intention to smoking initiation is moderated by e-cigarette use status, with smoking intention predicting smoking initiation only among adolescent never e-cigarette users. Adolescent e-cigarette users are at risk of progressing to smoking initiation whether or not they exhibit smoking intention, an indication that the influence of e-cigarette use on cigarette smoking may potentially override the protective effect of lack of smoking intention. Adolescents least likely to initiate conventional cigarette smoking in the current tobacco landscape do not have smoking intention and are abstaining from e-cigarettesItem Using cognitive interviewing to better understand young adult e-cigarette use(2015-08) Hinds, Josephine Taulbee, III; Loukas, Alexandra; Pasch, Keryn EQuestionnaires that assess emerging electronic nicotine delivery systems, or ENDS, are often based on traditional tobacco product surveys. Unique attributes of ENDS makes accurate assessment of their use a challenge for researchers. Cognitive interviews are a way of gaining insight into participants’ interpretations of survey questions and the methods they use in answering survey questions. As part of a larger study, cognitive interviews were used to test a tobacco use survey that included ENDS questions with 25 young adults in Texas. By mapping results from cognitive interviews onto Tourangeau’s four stage model of the survey response process, problems associated with survey questions were revised and then re-tested in multiple rounds of cognitive interviews. The four main areas of identified problems and attempts at question revision lay in improving the participant comprehension of the questions, the answer estimation processes, answer retrieval, and the answer response process. Comprehension issues regarding discernment between ENDS device types appeared to improve when representative pictures were added to the survey showing the vii type of device in question. Question comprehension and answer estimation processes both improved regarding using ENDS only as nicotine delivery systems when specific language that named nicotine cartridges and e-liquid as the content of devices was included in the question text. Regarding the answer retrieval process, results of this study showed that this sample of users had problems quantifying the amount of ENDS products consumed, as well as difficulty reporting the frequency of ENDS product use. The answer response improvement process allowed cognitive interview participants to add their own reasons for trying and using ENDS products to the list of available answer choices in multiple response questions. Cognitive interviews offered insight into the new and rapidly changing landscape of ENDS products through in-depth conversations with users. Future research is needed that allows both users and researchers to quantify ENDS product use. Exploration into the wide array of ENDS devices as well as possible population differences among specific device-type users would be valuable to public health professionals. As a survey-improvement tool, cognitive interviewing provided valuable insight into survey interpretation that was otherwise inaccessible to researchers.