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This study extends the current literature by using cognitive interviews to test ENDS assessment questions in a sample of young adults, a population at elevated risk for ENDS use. Problems encountered when answering ENDS use questions underscore the need to develop easily understood ENDS questions that allow for quantification of ENDS use. Future research examining the nature of ENDS product types and different levels of user experience will yield valuable assessment tools for researchers and tobacco control professionals.

Objectives-We examined patterns of tobacco and electronic cigarette (e-cigarette) use among college students. Differences in sociodemographic characteristics between non-users of these products and 4 mutually exclusive groups of tobacco/e-cigarette users were assessed. Differences in cigarette cessation attempts and dependence between exclusive cigarette smokers and users of cigarettes and at least one alternative tobacco product also were examined. Human Subjects StatementApproval to conduct this research was provided by the University of Texas at Austin IRB [Protocol Number: 2013-06-0034]. Conflict of Interest StatementAll authors of this article declare they have no conflicts of interest. HHS Public AccessAuthor manuscript Am J Health Behav. Author manuscript; available in PMC 2017 July 01. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptMethods-Participants were 5468 18-29 year-old students from 24 colleges in Texas who completed an online survey.Results-Multiple-product use was more prevalent than single-product use. All 4 current tobacco/e-cigarette-user groups were more likely than non-users to be men and older. College students who were younger when they smoked their first cigarette, and those reporting ever needing a cigarette, were more likely to be multiple-product users than cigaretteonly users. There were no group differences in cigarette cessation attempts or any other variables.Conclusions-Using multiple products is associated with some indicators of dependence, but does not seem to aid or deter college students' smoking cessation attempts. Longitudinal research is needed given that transitions in tobacco/e-cigarette use continue throughout young adulthood. Keywordscigarette cessation attempts; cigarette dependence; non-cigarette products; polytobacco use; tobacco use among young adults Whereas cigarette use in the United States (US) has been declining, 1 the use of alternative products, such as cigars and electronic nicotine delivery systems (ENDS, also referred to as e-cigarettes) has been increasing. 2,3 Young adults have the highest prevalence of use of alternative products. 4 Approximately 22% of 18-34 year-olds reported ever using at least one non-combustible product (ie, e-cigarettes, chewing tobacco/dip/snuff, snus or dissolvables) in 2012 and 52% reported ever using at least one combustible non-cigarette product (ie, cigars, pipes, little cigars/cigarillos, bidis, or hookah). 5 Young adults also are more likely than older adults to be concurrent users of multiple products, 6,7 and data from the National Survey on Drug Use and Health showed that multiple-tobacco product use increased significantly from 2002 to 2012 for 18-25 year-olds, but not for those over 25. 8 One group of young adults at elevated risk for multiple-product use is college students. 9,10 The college years, and young adulthood more generally, are characterized by instability and change in multiple domains of behavior, including tobacco and e-cigarette use 11 (hereafter referred to as tobacco...

Objective: Menu labelling has been identified as a potential strategy to help individuals make healthier choices when eating out. Although adolescents eat out often, little research involving menu labelling has been conducted with this population. The objectives of the present study were to: (i) gather qualitative information from adolescents regarding use of menu labels when eating out; (ii) gather adolescents' suggestions for optimal ways to design menu labels; and (iii) examine differences between adolescents living in communities of different socio-economic status. Design: Qualitative. Five focus groups of five to ten participants.

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