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OBJECTIVES: This study examined perceptions of factors that influence use and non-use of Alternative Tobacco Products (ATPs) among unaccompanied youth experiencing homelessness. METHODS: Focus groups were conducted with 30 homeless 18-24 year olds (80% men, 50% Hispanic, 30% Black, 17% White, 20% multi-racial/other) recruited from drop-in centers in Los Angeles. Discussion focused on several ATPs (hookah, electronic cigarettes/vaping devices, cigarillos/little cigars, smokeless tobacco, snus, natural cigarettes, clove cigarettes), soliciting participants' experiences using each ATP and motivations for using or not using each ATP. RESULTS: Focus group transcripts were subjected to a rigorous coding procedure and 8 themes relating to the reasons that participants may or may not use ATPs emerged. Each ATP was associated with distinctive characteristics that motivated use and non-use. For example, hookah use was viewed positively with positive sensory and social features dominating the discussion, whereas electronic cigarettes were viewed largely negatively (i.e., that they were expensive and harmful to health). Homelessness characterized participants' responses to the extent that cost was a factor in their choice of ATP. CONCLUSIONS: These data provide important, first look insights into factors that may influence the use and non-use of ATPs among unaccompanied youth experiencing homelessness.
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INTRODUCTION: Adolescents' e-cigarette use is now more prevalent than their combustible cigarette use. Youth are exposed to e-cigarette advertising at retail point-of-sale (POS) locations via the tobacco power wall (TPW), but no studies have assessed whether exposure to the TPW influences susceptibility to future e-cigarette use. METHODS: The study was conducted in the RAND Store Lab (RSL), a life-sized replica of a convenience store developed to experimentally evaluate how POS advertising influences tobacco use risk under simulated shopping conditions. In a between-subjects experiment, 160 adolescents (M age = 13.82; 53% female, 56% white) were randomized to shop in the RSL under one of two conditions: (1) TPW located behind the cashier (n = 80); or (2) TPW hidden behind an opaque wall (n = 80). Youths rated willingness to use e-cigarettes ("If one of your best friends were to offer you an e-cigarette, would you try it?"; 1 = definitely not, 10 = definitely yes) before and after exposure. Linear regression assessed differences in pre-post changes in willingness to use across conditions. RESULTS: Ever-use of e-cigarettes was 5%; use of cigarettes was 8%; use of both e-cigarettes and cigarettes was 4%. There were no differences between TPW conditions on these or other baseline variables (eg, age, gender). Compared to the hidden condition, TPW exposure was associated with greater increases in willingness to use e-cigarettes in the future (B = 1.15, standard error [SE] = 0.50, p = .02). CONCLUSIONS: Efforts to regulate visibility of the TPW at POS may help to reduce youths' susceptibility to initiating e-cigarettes as well as conventional tobacco products like cigarettes. IMPLICATIONS: Past work suggests that exposure to the TPW in common retail settings, like convenience stores, may increase adolescents' susceptibility to smoking cigarettes. This experimental study builds upon prior research to show that exposure to the TPW at retail POS similarly increases adolescents' willingness to use e-cigarettes in the future. Efforts to regulate the visibility of the TPW in retail settings may help to reduce youths' susceptibility to initiating nicotine and tobacco products, including e-cigarettes.
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Comportamento do Adolescente , Publicidade , Vaping , Adolescente , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Vaping/epidemiologia , Vaping/psicologiaRESUMO
OBJECTIVE: China issued a nationwide "Tobacco-Free Campus" Policy (TFCP) in January 2014, but it is unclear how well it was implemented across China's 2138 college campuses. We conducted an Internet survey of Beijing college students to evaluate the implementation of the TFCP in Beijing. METHODS: An Internet survey of 711 students from 37 colleges in Beijing was conducted in May 2015. Respondents reported on secondhand smoking (SHS) exposure on campus, knowledge on and actions taken against SHS, and tobacco marketing exposure on campus. RESULTS: Almost 90% of respondents were exposed to SHS on campus at least once in the past month. Approximately 37% of nonsmokers and 61% of smokers reported seeing a teacher smoking, and the majority of both smokers and nonsmokers reported seeing a classmate smoking in campus buildings. The likelihood and location of SHS exposure depend on the participant's demographics and own smoking behavior. Nonsmokers were more likely to be aware of the health risk of SHS than smokers. Although most participants were aware of the harms, only 13% and 9% tried to stop their last SHS exposure indoors and outdoors, respectively. Forty-seven students from 14 colleges noticed tobacco marketing activities on campus. CONCLUSIONS: The TFCP on Chinese college campuses was only partially enforced, particularly with regard to SHS. IMPLICATIONS: On January 29, 2014, the Chinese Ministry of Education issued the TFCP. A major barrier to effective tobacco control in China is the difficulty in implementing policies issued by the central government. At this point, it is unclear whether the TFCP was successfully implemented on China's college campuses. Major tobacco use monitoring efforts do not include college students. The present research describes the current tobacco control environment on Beijing's college campuses 15 months after the TFCP took effect. To our knowledge, this is the first paper in the English literature on tobacco environment and exposure (rather than a prevalence survey) of college students in China.