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Addictive Behaviors Reports 8(2018)95-101
<br />Contents lists available at ienceDirect
<br />Addictive Behaviors Reports
<br />ELSMER journal homepage: www.elsevier.com/locate/abrep
<br />Measurement and predictive value of susceptibility to cigarettes,
<br />e-cigarettes, cigars, and hookah among Texas adolescents pdates
<br />Felicia R. Carey, Anna V. Wilkinson, Melissa B. Harrell% Elisabeth A. Cohn, Cheryl L. Perry
<br />Michael&Susan Dell Center for Healthy Living,University of Texas Health Science Center at Houston,School of Public Health in Austin,1616 Guadalupe S4 Suite 6.300,
<br />Austin,TX 78701,United States of America
<br />ABSTRACT
<br />Susceptibility to cigarette smoking,defined as the lack of a firm commitment not to smoke in the future,begins in childhood and is a phase in the transition from
<br />never to ever use of cigarettes.While a consistent and validated predictor of cigarette use,little research has assessed whether the susceptibility construct applies
<br />equally well across other tobacco products.Baseline data were collected in 2014-2015 from a representative sample of(n=2844)middle and high school students in
<br />five counties surrounding the four largest cities in Texas,(49%female and mean age 13.13 years,with subsequent waves at 6,12,and 18 months.Confirmatory factor
<br />analysis examined the appropriateness of a three-item susceptibility measure(product-specific curiosity,intention to use,and peer influence)across product types
<br />and ethnic groups (Hispanic versus non-Hispanic). Logistic regression examined whether product specific susceptibility at baseline predicted future product in-
<br />itiation. At baseline, 11.5%, 17.0%, 17.4% and 29.4%, of adolescent never users were susceptible to cigars, cigarettes,hookah and e-cigarettes, respectively;
<br />significantly more Hispanic than non-Hispanic adolescents were susceptible to e-cigarettes (32.4%versus 26%,p < 0.01) and cigarettes (19.9%versus 13.9%,
<br />p < 0.05).Product-specific items were significantly and consistently associated with the respective underlying susceptibility product construct and across ethnic
<br />groups(p < 0.001 for all).Susceptibility to e-cigarettes(AOR=2.28-6.64)or any combustible product(cigarettes,hookah,cigars;AOR=3.38-5.20)significantly
<br />predicted subsequent ever use.This study confirms the appropriateness of the susceptibility construct across four tobacco product types and ethnic groups,and the
<br />utility of susceptibility in predicting future product use among adolescents.
<br />1. Introduction use tobacco products in the future,is a critical construct,predictive of
<br />tobacco use and amenable to intervention. Research examining the
<br />Use of conventional tobacco products,like cigarettes and cigars,has initial susceptibility construct based on behavioral intentions,peer in-
<br />decreased in recent years among adolescents, while use of tobacco fluence, and self-efficacy(Pierce et al., 1996) demonstrated that com-
<br />products, like e-cigarettes and hookah, continues to increase (Singh prehensive community anti-smoking media programs, are effective in
<br />et al., 2016).These trends and the growing popularity of specific pro- altering and suppressing adolescents' susceptibility to smoking
<br />ducts call for identifying risk factors that predict product use initiation. (Meshack et al., 2004). A revised measure of the susceptibility con-
<br />Numerous studies have demonstrated susceptibility to cigarettes among struct, which incorporated curiosity with behavioral intentions and
<br />never smoking adolescents is associated with increased risk of experi- peer influence, demonstrated little loss in internal consistency, but a
<br />mentation with cigarettes and becoming an established smoker reduction in predictive validity and accuracy (Pierce et al., 2005). To
<br />Jackson,1998;Jackson&Dickinson,2004;Nodora et al.,2014;Pierce, date,a few studies have assessed whether the original susceptibility to
<br />Choi,Gilpin,Farkas,&Merritt,1996;Pierce,Distefan,Kaplan,&Gilpin, cigarettes construct(Pierce et al.,1996)also can be adapted to measure
<br />2005; Spelman et al., 2009; Strong et al., 2015; Unger, Johnson, susceptibility to other products, like e-cigarettes, hookah, and cigars
<br />Stoddard, Nezami, &Chou, 1997). Limited research suggests that sus- (e.g.,Bold et al.,2017;Lechner et al.,2018),and none have examined
<br />ceptibility to e-cigarettes or hookah independently predicts future e- the susceptibility construct that includes curiosity. Yet, recent survey
<br />cigarette (Bold, Kong, Cavallo, Camenga, & Krishnan-Sarin, 2017) or data suggest that the most common reason for adolescents to try e-
<br />hookah use(Lipkus,Reboussin,Wolfson,&Sutfin,2015),respectively, cigarettes is out of curiosity (Kong, Morean, Cavallo, Camenga, &
<br />and that susceptibility to cigarettes predicts future e-cigarette and cigar Krishnan-Sarin, 2015; Patrick et al., 2016). Thus, utilizing a suscept-
<br />use(Cole,Kennedy,Chaurasia,&Leatherdale, 2017).Still,few studies ibility construct that includes curiosity might be particularly useful to
<br />have examined product-specific susceptibility measures in predicting our understanding of susceptibility to non-cigarette tobacco products.
<br />future use of products other than cigarettes. Additionally, no studies have assessed whether the susceptibility
<br />Susceptibility,which reflects the lack of a firm commitment not to construct (Pierce et al., 2005) functions equally across ethnic groups.
<br />Corresponding author.
<br />E-mail address:Melissa.B.Harrell@uth.tmc.edu(M.B.Harrell).
<br />https://doi.org/10.1016/j.abrep.2018.08.005
<br />Received 17 April 2018;Received in revised form 3 August 2018;Accepted 16 August 2018
<br />Available online 18 August 2018
<br />2352-8532/©2018 The Authors.Published by Elsevier Ltd.This is an open access article under the CC BY-NC-ND license
<br />http://creativeco mmo ns.orgAicenses/BY-NC-ND/4.O/).
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