Reasons for Abstaining from Tobacco Use Among Young Adults: Scale Development and Validation Público

Abstract

Introduction: Research focusing on young adults and the range of reasons for abstaining from tobacco use, particularly in the context of a diversified tobacco market, is critical. Thus, this study aimed to develop and test the internal reliability and convergent and discriminant validity of a scale to assess reasons for tobacco abstinence among young adults reporting no tobacco use in the past 4 months.

Methods: We analyzed data from 2,094 US college students (ages 18-25) enrolled in a two-year, six-wave longitudinal study launched in 2014 who reported no past-4-month tobacco use at Wave 5. The newly developed scale included 10 items and was examined in relation to future tobacco use intentions; measures of perceived addictiveness, health risks, and social acceptability; social influences; and uptake of tobacco use at Wave 6.

Results: The average age of participants was 20.48 years (SD=1.94); 66.8% female, and 66.7% White. Factor analysis identified two factors: Social Concern and Instrumentality. Analyses regarding convergent and discriminant validity indicated that both subscales were associated with lower self-reported likelihood of future tobacco use; greater perceived addictiveness; greater perceived harm to health; and lower likelihood of Wave 6 tobacco use across tobacco products (p’s less than .05). While Social Concern subscale scores were associated with all psychosocial factors as anticipated, Instrumentality subscale scores were neither associated with perceived social acceptability of product use nor with parental tobacco use. Multivariable logistic regression indicated that lower Social Concern subscale scores were predictive of any Wave 6 tobacco use (p=.027) and were marginally predictive of Wave 6 hookah use (p=.094). Lower Instrumentality subscale scores were associated with Wave 6 e-cigarette use (p=.037) and were marginally associated with Wave 6 SLT use (p=.067). Neither Social Concern nor Instrumentality subscale scores predicted cigarette use or LCC use at Wave 6. However, adding the Reasons for Tobacco Abstinence subscale scores to each model significantly increased Nagelkerke R-squares.

Conclusions: This research yielded a quantitative measure regarding reasons for tobacco abstinence that demonstrated validity. Particularly noteworthy, social concern and issues related to instrumentality may be useful intervention targets to prevent tobacco use or promote abstinence among young adults.

Table of Contents

LITERATURE REVIEW............................................................................................................................1

     Background...............................................................................................................................................1

     Predictors of Future Tobacco Use.............................................................................................................1

     Motives for Smoking................................................................................................................................2

     Motives for Tobacco Cessation.................................................................................................................3

     Motives for Tobacco Abstinence..............................................................................................................5

     Theoretical/Conceptual Framework..........................................................................................................5

     Gaps in the Literature................................................................................................................................5

     Research Aims..........................................................................................................................................6

INTRODUCTION........................................................................................................................................7

METHODS...................................................................................................................................................8

     Participants and Procedures......................................................................................................................8

     Measures...................................................................................................................................................9

     Data Analysis..........................................................................................................................................10

RESULTS...................................................................................................................................................11

     Factor Analysis.......................................................................................................................................11

     Participant Characteristics.......................................................................................................................11

     Convergent and Discriminant Validity...................................................................................................12

     Predictors of Wave 6 Tobacco Use for Various Products......................................................................12

DISCUSSION.............................................................................................................................................13

     Implications.............................................................................................................................................15

     Limitations..............................................................................................................................................16

     Conclusions.............................................................................................................................................16

REFERENCES...........................................................................................................................................17

TABLES......................................................................................................................................................21

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Palavra-chave	Risk factors Tobacco use Substance use Young adults Tobacco control
Committee Chair / Thesis Advisor	Berg, Carla, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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