Positive Outcome Expectations and Tobacco Product Use Behaviors in Youth

ABSTRACT

Background: Outcome expectations are an important determinant of health behavior, according to Social Cognitive Theory; yet recent literature has not examined the relationship between outcome expectations and tobacco product use (e.g., use of cigarettes, cigars, hookah, e-cigarettes, or smokeless tobacco). Objectives: This study examines if outcome expectations at baseline, among an adolescent cohort of never users of tobacco products, predicts tobacco product use (i.e., cigarettes, hookah, e-cigarette, cigar, or smokeless tobacco) or susceptibility to use at 6-month follow-up. Methods: Data are from the first two waves of a Texas cohort study of urban middle school and high school students, which were collected in 2014–2015. Logistic regression analyses were used; these adjusted for socio-demographic variables. Analyses were limited to never users of any tobacco product at baseline (n = 1999, N = 357,035). Results: Outcome expectations related to stress relief predicted ever use of (AOR: 4.21, 95% CI 1.84–9.60) and susceptibility (AOR: 2.97, 95% CI 1.01–8.70) to tobacco products. Additional outcome expectations (e.g., relaxation, concentration, slimness, etc.) were not associated with ever use or susceptibility. Conclusions/Importance: This study extends the literature regarding outcome expectations among adolescents regarding tobacco products. It is important that interventions offer alternative solutions to stress relief that do not include tobacco products.

KEYWORDS:

• Adolescence
• adolescent health
• social cognitive theory
• smoking and tobacco use
• tobacco control and policy

Acknowledgment

Research reported in this publication was supported by grant number [1 P50 CA180906] from the National Cancer Institute and the FDA's Center for Tobacco Products (CTP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.