OBJECTIVE-There is no safe level of exposure to tobacco smoke. Thirdhand smoke is residual tobacco smoke contamination that remains after the cigarette is extinguished. Children are uniquely susceptible to thirdhand smoke exposure. The objective of this study was to assess health beliefs of adults regarding thirdhand smoke exposure of children and whether smokers and nonsmokers differ in those beliefs. We hypothesized that beliefs about thirdhand smoke would be associated with household smoking bans.METHODS-Data were collected by a national random-digit-dial telephone survey from September to November 2005. The sample was weighted by race and gender within Census region on the basis of US Census data. The study questions assessed the level of agreement with statements that breathing air in a room today where people smoked yesterday can harm the health of children.RESULTS-Of 2000 eligible respondents contacted, 1510 (87%) completed surveys, 1478 (97.9%) answered all questions pertinent to this analysis, and 273 (18.9%) were smokers. Overall, 95.4% of nonsmokers versus 84.1% of smokers agreed that secondhand smoke harms the health of children, and 65.2% of nonsmokers versus 43.3% of smokers agreed that thirdhand smoke harms children. Strict rules prohibiting smoking in the home were more prevalent among nonsmokers: 88.4% vs 26.7%. In multivariate logistic regression, after controlling for certain variables, belief

ObjectiveTo assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority.MethodsWe conducted a web-based survey of 1596 16–26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30 days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use).ResultsAmong 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed.ConclusionsNearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use.

Aims-This study examines the predictive validity of sensation seeking as a predictor of adolescent substance use, in order to optimize targeting for substance use prevention programmes.Design-Longitudinal study. Setting-Random digit dial telephone survey.Participants-6522 U.S. adolescents aged 10-14 years at baseline, resurveyed at 8-month intervals for 3 subsequent waves.Measurements-Two outcomes were assessed--onset of binge drinking (more than 5 drinks in a short time) and established smoking (>100 cigarettes lifetime). Sensation seeking level was assessed at baseline. Logistic regression was used to predict onset of substance use at any followup wave as a function of sensation seeking. The receiver operating characteristic curve was used to illustrate how well sensation seeking predicted substance use as a function of different cut-off points for defining high sensation seeking, and area under the receiver operating characteristic curve (AROC) was the metric of predictive validity.Findings-Of 5854 participants with one or more follow up assessments, 5634 reported no binge drinking and 5802 were not established smokers at baseline, of whom 717 (12.7% of 5634) reported binge drinking and 144 (2.5% of 5802) reported established smoking at one or more follow up interviews. Sensation seeking predicted binge drinking moderately well (AROC = 0.71 [95% CI 0.69, 0.73]) and was a significantly better predictor of established smoking onset (AROC = 0.80 [0.76, 0.83)). For binge drinking, predictive validity was significantly lower in Blacks; for established smoking it was significantly higher for Hispanics. Implications for two targeting interventions are discussed.Conclusions-Sensation seeking works moderately well at identifying adolescents at risk for onset of binge drinking and established smoking. This study offers a guide for determining the appropriate targeting cut-off value, based on intervention efficacy, costs and risks.

Background Exposure to alcohol marketing is prevalent and is associated with both initiation and progression of alcohol use in underage youth. The mechanism of influence is not well understood, however. This study tests a model that proposes alcohol-specific cognitions as mediators of the relation between alcohol marketing and problematic drinking among experimental underage drinkers. Methods This paper describes a cross-sectional analysis of 1734 U.S. 15–20 year old underage drinkers, recruited for a national study of media and substance use. Subjects were queried about a number of alcohol marketing variables including television time, internet time, favorite alcohol ad, ownership of alcohol branded merchandise (ABM), and exposure to alcohol brands in movies. The relation between these exposures and current (30 day) binge drinking was assessed, as were proposed mediators of this relation, including marketing-specific cognitions (drinker identity and favorite brand to drink), favorable alcohol expectancies and alcohol norms. Paths were tested in a structural equation model that controlled for socio-demographics, personality and peer drinking. Results Almost one-third of this sample of ever drinkers had engaged in 30 day binge drinking. Correlations among mediators were all statistically significant (range 0.16 – 0.47) and all were significantly associated with binge drinking. Statistically significant mediation was found for the association between ABM ownership and binge drinking through both drinker identity and having a favorite brand, which also mediated the path between movie brand exposure and binge drinking. Peer drinking and sensation seeking were associated with binge drinking in paths through all mediators. Conclusions Associations between alcohol marketing and binge drinking were mediated through marketing-specific cognitions that assess drinker identity and brand allegiance, cognitions that marketers aim to cultivate in the consumer.

IMPORTANCE Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults. OBJECTIVE To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted. EXPOSURES Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1. MAIN OUTCOMES AND MEASURES Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2. RESULTS Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95% confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95% CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2