The tobacco control community knows very little about how young adult cigarette smokers form risk perceptions of flavored little cigars and cigarillos (LCC), which researchers believe are key to understanding how to inform regulatory policy as well as prevention methods. In order to accurately determine risk perceptions, sensitive and reliable measures are urgently needed. The long-term goal is to develop health communication interventions that seek to modify risk perceptions of LCC smoking to prevent its initiation among ethnically diverse young adults. The proposed research seeks to fill a knowledge gap by developing a prognostic tool that identifies LCC risk perceptions and predicts LCC initiation behaviors (i.e. susceptibility/intention to smoke) among young adult cigarette smokers. Our preliminary data show that young adult smokers endorse positive attitudes, normative beliefs and self-efficacy toward LCC smoking. We have early indicators that suggest these smokers endorse low perceived risks (i.e., LCC are less harmful than cigarettes) of LCC smoking. Our central hypothesis is that LCC risk perceptions mediate the relationship between attitudes/norms/self-efficacy and susceptibility/intention. We propose 3 specific aims to test our hypothesis: (1) Use qualitative methods to elicit young adult cigarette smokers'beliefs, feelings, and knowledge about flavored LCCs and their risks;(2) To develop a new LCC risk perception scale;and (3) To determine what factors predict LCC susceptibility /intention to smoke. Under the first aim, we will conduct 12 focus groups (n= 8-10/group) to elicit these beliefs, which will inform the scale construction described in Aim 2.
Under Aim 2, we will modify an extant tobacco risk perception scale with qualitative findings from Aim 1 and conduct cognitive testing on the scale among a sample of young adult cigarette smokers. Under 3, we will conduct an online survey among a national probability sample of 18-34 year old cigarette smokers (N=900) and use exploratory structural equation modeling (ESEM) to test our hypotheses. The proposed project will be significant because it is expected to help tobacco control regulatory scientists an policy makers understand the ways in which young adult cigarette smokers think about and respond to risks about flavored LCCs.

Public Health Relevance

The proposed research is relevant to public health because dramatic increases in the consumption of flavored LCC may offset declines seen in cigarette smoking and its associated morbidity and mortality. Thus, the proposed research is relevant to the NIH- FDA's mission of supporting regulation of tobacco products that will reduce the public health toll from tobacco products in the United States.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-HDM-Q (54))
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Kaufman, Annette R
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Georgia State University
Public Health & Prev Medicine
Schools of Public Health
United States
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Sterling, Kymberle L; Majeed, Ban A; Nyman, Amy et al. (2017) Risk Perceptions of Little Cigar and Cigarillo Smoking Among Adult Current Cigarette Smokers. Nicotine Tob Res 19:1351-1358
Sterling, Kymberle L; Fryer, Craig S; Fagan, Pebbles (2016) The Most Natural Tobacco Used: A Qualitative Investigation of Young Adult Smokers' Risk Perceptions of Flavored Little Cigars and Cigarillos. Nicotine Tob Res 18:827-33
Sterling, K; Fryer, C; Pagano, I et al. (2016) Association between menthol-flavoured cigarette smoking and flavoured little cigar and cigarillo use among African-American, Hispanic, and white young and middle-aged adult smokers. Tob Control 25:ii21-ii31
Sterling, Kymberle Landrum; Fryer, Craig S; Pagano, Ian et al. (2016) Little Cigars and Cigarillos Use Among Young Adult Cigarette Smokers in the United States: Understanding Risk of Concomitant Use Subtypes. Nicotine Tob Res 18:2234-2242
Fagan, Pebbles; Pohkrel, Pallav; Herzog, Thaddeus et al. (2015) Comparisons of three nicotine dependence scales in a multiethnic sample of young adult menthol and non-menthol smokers. Drug Alcohol Depend 149:203-11
Sterling, Kymberle L; Fryer, Craig S; Nix, Meghan et al. (2015) Appeal and Impact of Characterizing Flavors on Young Adult Small Cigar Use. Tob Regul Sci 1:42-53
Sterling, Kymberle L; Fryer, Craig S; Majeed, Ban et al. (2015) Promotion of waterpipe tobacco use, its variants and accessories in young adult newspapers: a content analysis of message portrayal. Health Educ Res 30:152-61
Majeed, Ban A; Dube, Shanta R; Sterling, Kymberle et al. (2015) Opinions about electronic cigarette use in smoke-free areas among U.S. Adults, 2012. Nicotine Tob Res 17:675-81