Peer crowd affiliation as a segmentation tool for young adult tobacco use.

BackgroundIn California, young adult tobacco prevention is of prime importance; 63% of smokers start by the age of 18 years, and 97% start by the age of 26 years. We examined social affiliation with 'peer crowd' (eg, Hipsters) as an innovative way to identify high-risk tobacco users.MethodsCross-sectional surveys were conducted in 2014 (N=3368) among young adult bar patrons in 3 California cities. We examined use rates of five products (cigarettes, e-cigarettes, hookah, cigars and smokeless tobacco) by five race/ethnicity categories. Peer crowd affiliation was scored based on respondents' selecting pictures of young adults representing those most and least likely to be in their friend group. Respondents were classified into categories based on the highest score; the peer crowd score was also examined as a continuous predictor. Logistic regression models with each tobacco product as the outcome tested the unique contribution of peer crowd affiliation, controlling for race/ethnicity, age, sex, sexual orientation and city.ResultsRespondents affiliating with Hip Hop and Hipster peer crowds reported significantly higher rates of tobacco use. As a categorical predictor, peer crowd was related to tobacco use, independent of associations with race/ethnicity. As a continuous predictor, Hip Hop peer crowd affiliation was also associated with tobacco use, and Young Professional affiliation was negatively associated, independent of demographic factors.ConclusionsTobacco product use is not the same across racial/ethnic groups or peer crowds, and peer crowd predicts tobacco use independent of race/ethnicity. Antitobacco interventions targeting peer crowds may be an effective way to reach young adult tobacco users.Trial registration numberNCT01686178, Pre-results

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined. Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and snus) and sexual minority status, adjusting for demographics and comparing LB women and GB men with their heterosexual counterparts. Results—LGB bar/nightclub patrons used all OTPs more than their heterosexual counterparts. LB women were more likely than heterosexual women to use cigarillos, electronic cigarettes, hookah, chew, and snus. GB men were more likely than heterosexual men to smoke cigarillos, electronic cigarettes, hookah, and use chew and snus. Past-year quit attempt was associated with increased odds of electronic cigarette use in men and women, and increased odds of dual use (cigarettes and OTPs) among men. Intention to quit was negatively associated with dual use among women. Binge drinking was associated with increased use of all OTPs across genders. Conclusions—LGB bar-going young adults are at higher risk for OTP use than their heterosexual counterparts. Bar-based interventions are needed to address all forms of tobacco use in this high-risk group

Bars, Nightclubs, and Cancer Prevention: New Approaches to Reduce Young Adult Cigarette Smoking.

IntroductionTobacco contributes to multiple cancers, and it is largely preventable. As overall smoking prevalence in California declines, smoking has become concentrated among high-risk groups. Targeting social/cultural groups (i.e., "peer crowds") that share common values, aspirations, and activities in social venues like bars and nightclubs may reach high-risk young adult smokers. Lack of population data on young adult peer crowds limits the ability to assess the potential reach of such interventions.MethodsThis multimodal population-based household survey included young adults residing in San Francisco and Alameda counties. Data were collected in 2014 and analyzed in 2016. Multivariable logistic regressions assessed smoking by sociodemographic factors, attitudes, self-rated health, peer crowd affiliation, and bar/nightclub attendance.ResultsSmoking prevalence was 15.1% overall; 35.3% of respondents sometimes or frequently attended bars. In controlled analyses, bar attendance (AOR=2.13, 95% CI=1.00, 4.53) and binge drinking (AOR=3.17, 95% CI=1.59, 6.32) were associated with greater odds of smoking, as was affiliation with "Hip Hop" (AOR=4.32, 95% CI=1.48, 12.67) and "Country" (AOR=3.13, 95% CI=1.21, 8.09) peer crowds. Multivariable models controlling for demographics estimated a high probability of smoking among bar patrons affiliating with Hip Hop (47%) and Country (52%) peer crowds.ConclusionsBar attendance and affiliation with certain peer crowds confers significantly higher smoking risk. Interventions targeting Hip Hop and Country peer crowds could efficiently reach smokers, and peer crowd-tailored interventions have been associated with decreased smoking and binge drinking. Targeted interventions in bars and nightclubs may be an efficient way to address these cancer risks

Comparing Asian American Women's Knowledge, Self-Efficacy, and Perceived Risk of Heart Attack to Other Racial and Ethnic Groups: The mPED Trial

ObjectiveThe aim of the study was to compare knowledge and awareness of heart attacks/heart disease and perceived risk for future heart attack in Asian/Pacific Islander women, compared to other racial and ethnic groups.Materials and methodsIn this cross-sectional study, 318 women enrolled in a mobile phone-based physical activity education trial were analyzed. Heart attack knowledge, self-efficacy for recognizing and responding to heart attack symptoms, and perceived risk for a future heart attack were measured. Analyses were conducted using logistic, proportional odds, and linear regression models, depending on the outcome and adjusting for age. Pairwise differences between Asian/Pacific Islanders and the other four groups were assessed using a Bonferroni correction (p < 0.0125).ResultsAsian/Pacific Islander women had significantly lower total scores for knowledge of heart attack and self-efficacy for heart attack recognition and care seeking behavior compared to the Caucasian women (p = 0.001 and p = 0.002, respectively). However, perceived risk did not differ among the groups. Forty-six percent of the Asian American women, compared to 25% of Caucasian women, falsely believed "breast cancer is the number one cause of death for women (p = 0.002)." In addition, Asian/Pacific Islander women were less likely to report "arm pain, numbness, tingling, or radiating" as one of the heart attack symptoms compared to the Caucasian and the multiracial group (34%, 63% [p < 0.001], and 66% [p = 0.004], respectively).ConclusionsThese findings highlight the urgent need to develop effective, tailored campaigns to close the knowledge gap between Asian/Pacific Islander women and Caucasian women

Tobacco Marketing Receptivity and Other Tobacco Product Use Among Young Adult Bar Patrons

PurposeUse of other tobacco products (smokeless tobacco, hookah, cigarillo, and e-cigarettes) is increasing, particularly among young adults, and there are few regulations on marketing for these products. We examined the associations between tobacco marketing receptivity and other tobacco product (OTP) use among young adult bar patrons (aged 18-26 years).MethodsTime-location sampling was used to collect cross-sectional surveys from 7,540 young adult bar patrons from January 2012 through March of 2014. Multivariable logistic regression analyses in 2015 examined if tobacco marketing receptivity was associated (1) with current (past 30 day) OTP use controlling for demographic factors and (2) with dual/poly use among current cigarette smokers (n = 3,045), controlling for demographics and nicotine dependence.ResultsAmong the entire sample of young adult bar patrons (Meanage = 23.7, standard deviation = 1.8; 48.1% female), marketing receptivity was consistently associated with current use of all OTP including smokeless tobacco (adjusted odds ratio [AOR]= 2.56, 95% confidence interval [CI] 2.08-3.16, p < .001), hookah (AOR = 1.97, 95% CI 1.58-2.43, p < .001), cigarillos (AOR = 3.00, 95% CI 2.21-4.08, p < .001), electronic cigarettes (AOR = 2.43, 95% CI 1.93-3.04, p < .001), and multiple tobacco products (AOR = 2.93, 95% CI 2.45-3.51, p < .001). Among current smokers, marketing receptivity was significantly associated with use of smokeless tobacco (AOR = 1.63, 95% CI 1.22-2.18, p < .01), cigarillos (AOR = 1.81, 95% CI 1.22-2.70, p < .01), and multiple tobacco products (AOR = 1.58, 95% CI 1.27-1.97, p < .001).ConclusionsOTP use is common among young adult bar patrons, and it is associated with tobacco marketing receptivity. Efforts to limit tobacco marketing should address OTP in addition to cigarettes

Latent Class Analysis to Examine Patterns of Smoking and Other Tobacco Products in Young Adult Bar Patrons

PurposeUse of multiple tobacco products is increasing, particularly among young adults. Latent class analysis of substance-use patterns provides a framework for understanding the heterogeneity of use. We sought to identify different patterns of cigarette, e-cigarette, hookah, cigarillo, and smokeless tobacco use among young adult bar patrons.MethodsWe conducted repeated cross-sectional surveys of randomized time location samples of young adult California bar patrons in 2013 and 2014. Latent class analysis was used to examine patterns of use among current (past 30-day) tobacco users. Classes were compared on demographic characteristics and tobacco use correlates.ResultsOverall 84.4% of the current tobacco users were cigarette smokers, 38.7% used electronic cigarettes, 35.9% used hookah, 30.1% smoked cigars/cigarillos, and 15.4% used smokeless tobacco in the past 30 days. We extracted six latent classes: "Cigarette only" (n = 1690), "Hookah mostly" (n = 479), "High overall use" (n = 528), "Smokeless mostly" (n = 95), "E-cigarette mostly" (n = 439), "Cigars mostly" (n = 435). These classes differed in their risk profiles on both current use compared to no use, and number of days they used each tobacco product. Differences between classes emerged on demographics (age, sex, race/ethnicity) and tobacco correlates including perceived peer smoking, antitobacco industry attitudes, prioritizing social activities, and advertising receptivity.ConclusionsUnderstanding different patterns of multiple tobacco product use may inform both prevention and cessation programming for young adults. It may be efficient to tailor messages to different latent classes and address the distinct demographic and attitudinal profiles of groups of multiple tobacco product users