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Perceived Flavored Smokeless Tobacco Ease-of-use and Youth Susceptibility

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Objectives: Beliefs that flavored smokeless tobacco (ST) is more pleasant, less potent, or otherwise easier to use could contribute to youth initiation. We evaluated associations between perceived ease-of-use of flavored ST (moist snuff and chewing tobacco) and ST initiation susceptibility in a representative sample of US youth. Methods: Among 7718 tobacco never-users in the Population Assessment of Tobacco and Health study (ages 12-17; collected 2013-2014), we compared 4 ST susceptibility items (curiosity, expectation, willingness to try, and a composite) according to whether participants reported flavored ST to be "easier to use" than unflavored ST. We calculated marginal prevalences of ST susceptibility and odds ratios adjusted for socio-demographic characteristics, tobacco advertisement receptivity, warning label exposure, and sensation seeking. Results: ST susceptibility was greatest among tobacco never-users who perceived flavored ST as easier to use. Adjusted odds of potential ST susceptibility (≥1 item) were 1.5-fold higher (95% confidence interval: 1.2, 1.8) among adolescents who perceived flavored ST as easier to use than unflavored ST. Conclusions: ST flavors could contribute to perceptions that facilitate youth initiation. Alternatively, youth susceptible to ST use may perceive flavored varieties differently. Prospective studies are warranted to strengthen causal evidence and measure ST initiation according to perceived ease-of-use.
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Document Type: Research Article

Publication date: 01 July 2017

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  • Tobacco Regulatory Science (Electronic ISSN 2333-9748) is a rigorously peer-reviewed online scientific journal for the dissemination of research relevant to the regulation of tobacco products. The journal content includes a broad array of research domains, including chemistry, biology, behavior, community, and population-level surveillance and epidemiology, as well as knowledge syntheses (eg, meta-analyses or state-of-the-art reviews) and analytic modeling. All articles describe the policy relevance of the research outcomes. Given the global nature of tobacco regulation, particularly as a result of international and national policies, Tobacco Regulatory Science publishes high quality research that is relevant to global regulatory needs and requirements. Tobacco Regulatory Science is published electronically 6 times per year.
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