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RK Carey et al Addictive Behaviors Reports 8(2018)95 101 elsewhere in Perez et al.(2017).Active parental consent was obtained cigars,hookah, and cigarettes,with individuals who were non-suscep- for all surveys,for all students. tible to all three products categorized as non-susceptible, those who Baseline data were collected during the 2014-2015 academic year were susceptible to one or more products categorized as susceptible, from 3907 students via web-based surveys administered on tablets in and those who were missing on susceptibility variables for all three the classroom,with three follow-up data collection periods occurring 6, products labeled as missing. 12, and 18 months after baseline via similarly formatted web-based surveys administered outside the classroom. At 6 months 64% were 2.2.2. Ever use retained,at 12 months 70%were retained,and at 18 months 74%were E-cigarette,cigar,hookah,and cigarette ever use were measured at retained. These retention rates are comparable to other cohorts na- 6,12,and 18 months by one item each asking,"Have you ever smoked/ tionwide with similar data collection schedules and incentive structures used [this product], even one or two puffs?" with "Yes" responses (Cantrell et al., 2018). Survey items were adapted from valid and re- classified as ever users of each product and"No"responses classified as liable measures used for state and national tobacco surveillance, like never users.Ever use of any combustible product was measured based the Population Assessment of Tobacco and Health (PATH) study on whether adolescents were classified as ever users of any of the three (Hyland et al., 2017); cognitive interviewing among students, aged combustible products (cigars,hookah,or cigarettes). 11-18, assessed the reliability and content validity of all survey ques- tions. The final survey included over 340 items assessing socio- 2.2.3. Covariates demographic factors, tobacco use behaviors, cognitive and affective Covariates included sex(male or female), grade level(6,8,or 10), factors, and exposure to tobacco marketing. The median number of age (range: 10-18 years), ethnicity, and family SES. Ethnicity was di- questions received by students was 137,with an average administration chotomized as Hispanic versus non-Hispanic, which includes non- time of 45 minutes. The majority of students (58.1%) answered all Hispanic adolescents of white,black, and other races. Family SES was items,and 92%of students answered 96%or more of the items(Delk, measured by one item asking,"In terms of income,what best describes Harrell, Fakhouri,Muir, &Perry, 2017).Active consent from parents/ your family's standard of living in the home where you live most of the guardians and assent from students were obtained for all data collection time?" with response options categorized as high ("very well off'), waves.TATAMS was approved by the University of Texas Health Sci- middle ("living comfortably"), and low ("just getting by," "nearly ence Center at Houston Institutional Review Board(HSC-SPH-13-0377). poor,"and"poor")(Gore,Aseltine Jr.,&Colten,1992;Romero,Cuellar, The population for this study was limited to 2844 adolescents, or &Roberts,2000;Springer,Selwyn,&Kelder,2006). 72.8% of those enrolled at baseline, classified as never users of any product at baseline (i.e., a never user of e-cigarettes, cigars, hookah, 2.3. Analyses and cigarettes)with complete data on all sociodemographic variables. Sampling weights were utilized, allowing the study population to be The distribution of demographic and susceptibility measures across representative of 318,097 students enrolled in 6th,8th,and loth grades the total study population and by ethnicity were examined, and Chi- at baseline in these five Texas counties.As can been seen in Table 1,at square tests assessed statistically significant differences between baseline,sex was equally distributed(51%male),38.3%of adolescents Hispanic and non-Hispanic adolescents across categories of these items. were in grade 6,and mean age was 13.13(SE=0.17).Most adolescents Confirmatory factor analysis(CFA)assessed the fit of the three-item had a middle range family socioeconomic status (SES) (63.1%). His- susceptibility construct for each of the four products among the total panic adolescents represented 52.4%of the study population.Of note, population and by ethnicity, using a robust weighted least squares the Hispanic(n= 1430) and non-Hispanic (n= 1414)youth included approach with mean and variance adjusted estimation. CFA models in this analysis did not differ in terms of susceptibility to any of the four were evaluated based on significance and size of model parameter es- products examined to those excluded from the analysis due to missing timates, and overall goodness-of-fit parameters, including the root covariates (p < 0.05 for all;data not shown). mean square error of approximation (RMSEA, values<0.06 indicate good fit), the comparative fit index (CFI, values>0.95 indicate good 2.2. Measures fit),the Tucker-Lewis index(TLI,values >0.95 indicate good fit),and the weighted root mean square residual(WRMR,values< 1.0 indicate 2.2.1. Susceptibility good fit) (Hu&Bender, 1999;Yu,2002). Susceptibility to four product classes was examined among never Following confirmation that each susceptibility construct fit ap- users of any product: 1)e-cigarettes, 2)cigars (large cigars, cigarillos, propriately across products and ethnicities,the predictive value of each and little filtered cigars),3)hookah,and 4)cigarettes.Susceptibility to derived susceptibility variable on future use of each product was ex- each product was assessed by three items asking,"Have you ever been amined at 6, 12, and 18 months among the total population and by curious about smoking/using [this product]?", "Do you think you will ethnicity using Chi-square tests. Due to low numbers of ever users of use [this product] in the next 12 months?", and "If one of your close combustible products, ever use of cigars,hookah, and cigarettes were friends were to offer you [this product],would you use it?"Response combined as ever use of any combustible product, and logistic regres- options included "Not at all curious," "A little curious," "Somewhat sion models examined the effect of susceptibility to e-cigarettes and any curious," or "Very curious" for the first item and "Definitely not," combustible product, separately, at baseline on ever use of these pro- "Probably not," "Probably yes," or"Definitely yes" for the other two ducts at follow-up, adjusted for sex,age,family SES, and ethnicity. items.These items are adapted from a four item measure that has de- All analyses were conducted using Stata 14.0(College Station,TX) monstrated good internal consistency in prior studies (a=0.74) and Mplus Version 7(Los Angeles,CA),utilizing complete case analysis (Pierce et al., 2005) and is a strong predictor of future cigarette ex- of never users of any product at baseline. Analyses also incorporated perimentation(Pierce et al., 1996,2005). sampling weights and considered clustering within school districts and Adolescents were categorized as non-susceptible to each individual stratification of schools based on proximity to point of sale tobacco item if they responded"Not at all curious"or"Definitely not,"with any outlets to account for complex design(Perez et al., 2017). other response categorized as susceptible. Derived susceptibility vari- ables were created for each product, with individuals who were non- 3. Results susceptible to all three items categorized as non-susceptible,those who were susceptible to one or more items categorized as susceptible, and 3.1. Descriptive statistics those who were missing on any item labeled as missing. Susceptibility to any combustible product was derived based on susceptibility to At baseline (fable 1), the most commonly endorsed susceptibility 97