Nicotine Dependence and Motives for Tobacco Use: Nuances Among Alternative Tobacco and Polytobacco Users Público
Wong, Eugene (2016)
Published
Abstract
Background: The growing trend of alternative tobacco product (ATP) and polytobacco use in young adults is concerning. We explored the extent to which the use of ATP in cigarette smokers increases nicotine dependence. We also examined the motives for polytobacco use and motives for the individual use of ATP.
Methods: A mixed-methods longitudinal study was started in the Fall of 2014 using online surveys distributed to 18-25 year-old students of 7 college campuses; analyses focused on data among past 4-month tobacco users from wave 2 (administered in Spring 2015). Variables of interest included: sociodemographics, tobacco use (cigarettes, little cigars/cigarillos, smokeless tobacco, hookah, e-cigarettes), nicotine dependence per an adapted Hooked on Nicotine Checklist, and tobacco use motives per an adapted Tobacco Use Motives Scale (yielding subscales of social, self-enhancement, boredom, and affect regulation).
Results: Of 2,969 participants (retention rate 86.9%), 22.9% smoked cigarettes in the past 4 months (25.9% used one ATP, 13.9% used≥3). The mean age of this subset was 20.5, 45.1% were male, and 24.0% Black. Regression found that, among smokers, past 30-day consumption levels of cigarettes (B=0.14; p<.001), smokeless tobacco (B=0.55; p=.006), and e-cigarettes (B=0.32; p=.004) were associated with higher nicotine dependence. Boredom was associated with polytobacco use versus cigarette only use (OR=1.19; p=.007). Age, female sex, and Black race also significantly predicted polytobacco use (age, OR=.79, p<.001; female, OR=0.39, p<.001; Black, OR=3.79, p=.002). Regression models among single ATP users indicated differences in use motives that predicted past 30-day consumption levels (little cigars/cigarillos: affect regulation, B=0.02, p=.035; smokeless tobacco: social, B=-0.05, p=.003, self-enhancement, B=0.05, p=0.017, boredom, B=0.07, p=.007; hookah: social, B=0.04, p=.002, self-enhancement, B=-0.05, p=.004, boredom, B=0.05, p=.033, affect regulation, B=-0.03, p=.001).
Conclusions: The current research examined the impact of ATP in addition to cigarette use on nicotine dependence as well as differences in tobacco use motives among college student ATP and polytobacco users. Most notably, we found that ATP use does contribute to dependence and that the motives for tobacco use differed between tobacco products, when controlling for age, sex, and race/ethnicity. Findings from this study reveal initial differences in the contextual use of ATP.
Table of Contents
Introduction………………………………………………………1
Literature Review………………………………………………..5
Methods…………………………………………………………..12
Results………………………….…………..……….……..…….17
Discussion…………………………………..…………………...24
Conclusion……………………………………………………….30
References……………………………………………………….33
List of Tables
Table 1……………………………………………………………44
Table 2…………………………………………………………...45
Table 3……………………………………………………………46
Table 4……………………………………………………………47
Table 5……………………………………………………………48
Table 6……………………………………………………………49
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