Transcript Document 7481444

Environmental and Social
Influences on Tobacco Use Among
18 to 24 Year-Olds in Idaho
Dr. John Hetherington
Selina Carver
Clearwater Research,
Inc.
Idaho Department of
Health and Welfare
Influences on Young Adult Tobacco Use
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Background – Players and Roles
Idaho Tobacco
Prevention and
Policy
Control Program
 Es/drake
 Clearwater Research

Media
R&E
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Relevance of Young Adult Age Group
Key outcome point in evaluation of
underage education efforts.
 Since 1997, the 18-24 age group had
highest smoking rate nationwide1.
 31.2% smoking rate in 2002 and 31.0%
smoking rate in 20002.

1 Centers for Disease Control. (1999). Tobacco Use – United States, 1900-1999, MMWR, 48, 986-993.
2 Centers for Disease Control. (2002). BRFSS Prevalence Data (http://apps.nccd.cdc.gov/brfss/).
Influences on Young Adult Tobacco Use
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Research on 18-24 Year Olds

National research activity (NIH / CDC)
National College Health Risk Behavior Survey
(1995)
 Harvard School of Public Health’s College
Alcohol Survey (1993 / 1997)
 Monitoring the Future (University of
Michigan)


Individual college surveillance

University of Minnesota, Texas Tech, Yale
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2001 Smoking Rates in Idaho
38%
34%
~ 30%
~ 25%
18 to 24
Age Group
All
Residents
~ 20%
~ 15%
~ 20%
17%
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2002 Study Design Overview

Data Collection


Sampling


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Telephone interview with Idaho young
adults (18-24 years of age).
Probability sample (list assisted RDD).
Stratified disproportionately by health
district.
Analysis

Support answers to RQ about young adult
population.
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Research Questions

What are the general lifestyle characteristics
of the target audience?

What are the characteristics and attitudes of
the 18 to 24 year-old population that affect
their choices on quitting or not starting the
use of tobacco products?
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Data Collection Methodology

Telephone interviews
CATI executed
 11.5 minute interviews


Screening questions
Determine eligibility of HH.
 Enumerate number of young adults in HH.


Questions selected from BRFSS, ATS, and
YTS.
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Questionnaire Topics
Smoker
18%
39%
11%
6%
16% 10%
Non-Smoker
26%
12%
15%
17%
5%
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25%
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Sampling Strategy


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Total of 1,387
interviews
List-assisted
RDD
Health district
stratification
±2.6% C.I. at
95% C.L.
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Data Collection

Fielding period: March 21 to May 23, 2002

Response rate calculations


CASRO response rate:
CASRO Upper Bound:
50.1%
83.1%
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Data Preparation

Case weights:
•
•
Probability of selection (sample frame, young
adults in HH, and phone lines)
Poststratification (sex and age)
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Findings: Current Smoking Status

Overall, 53% had
smoked whole
cigarette
(Q025: n = 730).
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Findings: Current Smoking Status

Of those who had
smoked a whole
cigarette, 68% had
smoked 100 cigarettes
in lifetime
(Q030: n = 495).
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Findings: Current Smoking Status

Three questions were used to categorize
respondents:



Q025: Have you ever smoked a whole cigarette?
Q030: Have you ever smoked 100 cigarettes?
Q035: How many of the past 30 days have you smoked?
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Findings: Current Smoking Status

Of the 52% overall
who had smoked at
least one cigarette:

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
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41% were Frequent
smokers (n = 293)
10% were Occasional
smokers (n = 75)
17% were Former
smokers (n = 119)
33% were Small amount
smokers (n = 233)
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Findings: Smoking Behavior

On average, smoked on 18 of
past 30 days
(n =
480).

On average, smoked 10
cigarettes a day
(n = 359).

33% smoked within 30
minutes of awakening
(n = 119).
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Findings: Cessation

90% have considered reducing number
of cigarettes smoked each day
(n = 335).

38% unsure about being able to refrain
from smoking for at least a month
(n = 141).

70% tried to quit smoking > 1 day in
past 12 months
(n = 340).

69% had tried cold turkey and 10%
nicotine gum/patch
(n = 243, n = 37) .
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Findings: Other Tobacco Use

Overall, 35% had smoked
cigars at some time, and 6%
in past 30 days
(n = 482, n = 81).

Overall, 21% had used
smokeless tobacco at some
time, and 6% in past 30 days
(n = 290, n = 82).
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Findings: Frequent Smokers
More Likely To. . .



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Have a High School degree
or less.
Earn $15-$30K / year.
Agree that They are
addicted to cigarettes.
Agree that Light cigarettes
are safer.
Have a parent or sibling
who smokes.
Have more friends who
smoke.
Allow smoking in their home
or vehicle.
Less Likely To. . .

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Be female, a student, or
exercise.
Have a college degree or attend
college.
Agree that tobacco ads target
youths.
Agree that second hand smoke
harms others.
Have access to the Internet.
Participate in organized sports.
Read an alternative or campus
newspaper.
Have a health club
membership.
Read for inspiration or growth.
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Findings: ETS Exposure

84% overall responded

63% overall indicated that

57% overall indicated that
“Smoking was not allowed anywhere
inside your home” (n = 1157).
“Smoking was not allowed anywhere
inside your vehicle” (n = 849).
“Smoking was not allowed in any
work area” (n = 1157).
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Findings: ETS Exposure

65% overall did not
have an adult
smoking in HH
(n = 903).

61% overall did not
have a sibling who
smoked
(n = 845).

47% overall did not
have any friends
who smoked
(n = 676).
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Predictive Model

Predict smoking status categories:
Current Frequent Smoker
 Current Occasional Smoker
 Small Amount / Former Smoker


Structural Equations Modeling Approach
Unique / common variance components.
 Personal, social, and environmental
characteristics modeled simultaneously.

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Initial Model
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Frequent Smokers

Frequent Smokers
were more likely
to:

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
Model 2 (153) = 503.95
CFI = .83
Use other tobacco
products.
Live with another
smoking adult.
Have friends and
siblings who smoke.
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Frequent Smokers

Frequent Smokers
were less likely to:
•
•
•
•
•
•
•
Agree with general
health / anti-tobacco
statements.
Report good or
excellent general
health.
Be a student.
Exercise, participate in
organized sports, or
have a membership in
a health club.
Have Internet access.
Read campus or
alternative
newspapers.
To not allow smoking
in house or vehicle.
Influences on Young Adult Tobacco Use
Model 2 (153) = 503.95
CFI = .83
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Occasional Smokers

Compared to FSA
and Nonsmoking
groups, Occasional
Smokers were more
likely to:



Model 2 (25) = 143.47
CFI = .79
Use other tobacco
products.
Live with another
smoking adult.
Have friends and
siblings who
smoke.
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Occasional Smokers

Compared to FSA
and Nonsmoking
groups, Occasional
Smokers were less
likely to:

Model 2 (25) = 143.47
CFI = .79
To not allow
smoking in their
vehicle.
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SA / Former Smokers

Compared to the
Nonsmoking group,
Former / Small
Amount Smokers
were more likely to:




Model 2 (58) = 586.17
CFI = .72
Use other tobacco
products.
Live with another
smoking adult.
Have friends and
siblings who smoke.
Be older (given the
18 to 24 age range).
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SA / Former Smokers

Compared to the
Nonsmoking group,
Former / Small
Amount Smokers
were less likely to:




Model 2 (58) = 586.17
CFI = .72
Agree with general
health / antitobacco
statements.
Be a student.
Live with their
parents.
Have a child living
in their household.
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Thanks
John Hetherington, Ph.D.
Clearwater Research
Study Director
1845 S. Federal Way
Boise, ID 83706
(208) 376-3376 x424 1-800-727-5016
http://www.clearwater-research.com
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