Measuring susceptibility to use tobacco in an increasingly complex consumer marketplace: How many questions do we really need?

Objective: Predicting which young people are likely to use tobacco in the future is critical for prevention and intervention. Although measures for assessing susceptibility to using tobacco have fulfilled this goal for decades, there is almost no standard for the number of items that should be administered, or which items should be administered for which products. This study explored whether brief but psychometrically sound versions of commonly used susceptibility measures can adequately capture the construct relative to longer measures.

Does Reducing the Size of the Tobacco Power Wall Affect Young People's Risk of Future Use of Tobacco Products? An Experimental Investigation.

Objective: A ban on tobacco power walls (in-store package displays) is unlikely in the United States because of concerns that such bans violate commercial free speech rights. This experiment evaluated the effectiveness of a more measured strategy for mitigating the influence of the power wall on young people's susceptibility to tobacco use: limiting its size.

Method: The experiment took place in the RAND StoreLab, a life-sized replica of a convenience store.

Doing more with less: A proposal to advance cigarette packaging regulations in the United States.

Cigarette packages are potent marketing tools. Following guidance from the WHO Framework Convention on Tobacco Control, many countries have sought to diminish this marketing power by mandating that (1) large graphic health warnings be affixed to the packages (i.e.

Does removing menthol cigarettes in convenience stores reduce susceptibility to cigarette smoking? An experimental investigation in young people.

Background: Evidence for the effectiveness of menthol cigarette bans comes mostly from studies of adults that smoke. This experiment evaluated whether the absence of menthol products from a convenience store influenced young people's susceptibility to cigarette smoking after they shopped in the store.

Methods: This experiment took place in the RAND StoreLab (RSL), a life-sized research convenience store.

An experimental evaluation of the effects of banning the sale of flavored tobacco products on adolescents' and young adults' future nicotine vaping intentions.

Background: Some U.S. states and municipalities have banned the sale of flavored tobacco products to help curb youth vaping.

Additive impact of multiple point-of-sale tobacco control policies on youth tobacco-related outcomes.

Objectives: The tobacco industry utilizes tactics to increase youth awareness, exposure, access and use of tobacco. To address these tactics, municipalities in Massachusetts have passed point-of-sale policies including: 1) restricting flavored tobacco (FTR), 2) restricting cigar package sizes and prices (CPPR), 3) banning tobacco in pharmacies (PB), and 4) raising the minimum legal sales age of tobacco to 21 (MLSA 21). This study evaluated whether more policies, and a combination of policies addressing all three industry tactics, are associated with more favorable youth tobacco-related outcomes.

Substance Use and Mental Health Outcomes from a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness.

Introduction: Cigarette smoking and associated high-risk behaviors are prevalent among youth experiencing homelessness (YEH), making appropriately tailored interventions targeting smoking behavior important for this group. We pilot tested a brief text-messaging intervention (TMI) as an adjunct to standard care for YEH who smoke and found promising preliminary effects of the intervention on smoking cessation. The purpose of the present study was to test the TMI's effect on the secondary outcomes of other substance use (including use of other tobacco/nicotine devices) and mental health symptoms.

Longer-Term Impact of the Flavored Tobacco Restriction in Two Massachusetts Communities: A Mixed-Methods Study.

Introduction: In response to high rates of youth tobacco use, many states and localities are considering regulations on flavored tobacco products. The purpose of this study was to assess whether flavored tobacco restrictions (FTRs) in Massachusetts curb youth tobacco use over time and whether a dose-response effect of length of policy implementation on tobacco-related outcomes exists.

Aims And Methods: Using a quasiexperimental design, two municipalities with a FTR (adopting municipalities) were matched to a comparison municipality without a FTR.

Pilot Randomized Clinical Trial of a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness.

Introduction: Smoking rates are alarmingly high among young people experiencing homelessness (YEH), yet there are no evidence-based cessation programs for this population. This paper presents results from a pilot evaluation of a text messaging-based smoking cessation treatment, as an adjunct to brief group cessation counseling, to improve abstinence rates among 18-25-year-old smokers experiencing homelessness. The goal of this study was to estimate effect sizes for a larger trial and it was not powered to detect group differences.

A text message intervention for quitting cigarette smoking among young adults experiencing homelessness: study protocol for a pilot randomized controlled trial.

Background: Cigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults. Although many young homeless smokers are motivated to quit, there are no empirically-evaluated smoking cessation programs for this population. It is important that any such program address the factors known to be associated with quitting-related outcomes among homeless young people, to provide ongoing support in a way that accommodates the mobility of this population, and does not rely on scarce service provider resources for its delivery.

Co-use of tobacco and marijuana among young people experiencing homelessness in Los Angeles County.

Introduction: Tobacco and marijuana co-use among young people in the U.S. is a public health concern that deserves greater attention.

Health, Homelessness Severity, and Substance Use among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth.

Lesbian, gay, bisexual, and questioning (LGBQ) youth are overrepresented among youth experiencing homelessness (YEH), and health disparities among LGBQ youth are well-documented. LGBQ youth are typically aggregated as a single sexual minority group; however, research suggests that bisexual youth may have greater mental health, substance use, and physical health risks relative to their gay and lesbian peers. In a probability sample of LGBQ YEH in Los Angeles County (n = 183), we examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth due to the small subsample of questioning youth.

Roll-your-own cigarette smoking among youth experiencing homelessness.

Introduction: Roll-your-own (RYO) cigarette smoking is uncommon among young smokers in the U.S. but may be more widespread among those experiencing homelessness as it is a less expensive source of cigarettes.

Short-Term Impact of a Flavored Tobacco Restriction: Changes in Youth Tobacco Use in a Massachusetts Community.

Introduction: To counter the high prevalence of flavored tobacco use among youth, many U.S. localities have passed policies that restrict youth access to these products.

Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness.

Purpose: Virtually nothing is known about the potential effects of tobacco advertising on tobacco use among youth experiencing homelessness, a vulnerable population with high tobacco use rates. This study examines associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated any level of lifetime use.

Design: A cross-sectional design was used.

Patterns of alternative tobacco product use among youth experiencing homelessness.

Introduction: Identifying distinct patterns of tobacco product use can inform efforts to reduce poly-tobacco use among young people, but little is known regarding patterns of use among youth experiencing homelessness. This study identified patterns of using tobacco/nicotine products among youth experiencing homelessness, and assessed whether certain subgroups of youth were more likely than others to engage in specific patterns of use.

Methods: Data were collected from a probability sample of 469 homeless youth who used tobacco in the past month, recruited from 25 service and street sites in Los Angeles County.

Graphic health warning posters increase some adolescents' future cigarette use susceptibility by changing normative perceptions of smoking: A case of mediated moderation.

Prior work suggests that exposure to graphic health warning posters (GWPs) at retail point-of-sale may increase future cigarette smoking susceptibility in adolescents who are already at risk for future smoking, but not among committed never-smokers. However, little is known about what psychological mechanisms may account for this effect of GWPs on at-risk youths. Participants ( = 441) aged 11-17 years were randomized to experimental shopping conditions in a life-sized model convenience store, in which GWPs were absent ("status quo"; = 107) or visibly displayed near the check-out area ( = 334).

Motivation to quit cigarettes and alternative tobacco products: prevalence and correlates among youth experiencing homelessness.

Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product. Unaccompanied homeless youth were sampled from 25 street and service sites in Los Angeles County (N = 469).

Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention.

Background And Objectives: The primary care (PC) setting provides an opportunity to address adolescent alcohol and marijuana use. We examined moderators of effectiveness for a PC brief motivational intervention on adolescents' alcohol and marijuana use and consequences 1 year later.

Methods: We conducted a randomized controlled trial in 4 PC clinics from April 2013 to November 2015 and followed adolescents using Web-based surveys.

Knowledge of Alternative Tobacco Products in Unaccompanied Homeless Youth.

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.

An exponential effect persistence model for intensive longitudinal data.

We develop an effect persistence model for intensive longitudinal data under a general assumption of an exponential loss of association between exposure and outcome over time. The working model proposed may be useful for understanding the complexity of phenomena for which subjects can be repeatedly exposed to an intervention or a naturally occurring event, while, the effect of any one exposure is expected to diminish over time. Under the main assumption, we specify a semilinear model with extensions to generalized linear models.

Do graphic health warning labels on cigarette packages deter purchases at point-of-sale? An experiment with adult smokers.

This experiment tested whether the presence of graphic health warning labels on cigarette packages deterred adult smokers from purchasing cigarettes at retail point-of-sale (POS), and whether individual difference variables moderated this relationship. The study was conducted in the RAND StoreLab (RSL), a life-sized replica of a convenience store that was developed to evaluate how changing POS tobacco advertising influences tobacco use outcomes during simulated shopping experiences. Adult smokers (n = 294; 65% female; 59% African-American; 35% White) were assigned randomly to shop in the RSL under one of two experimental conditions: graphic health warning labels present on cigarette packages versus absent on cigarette packages.

Correlates of cigarette and alternative tobacco product use among young tobacco users experiencing homelessness.

Introduction: Most young people experiencing homelessness smoke cigarettes, but little is known about use of alternative tobacco products (ATPs) such as e-cigarettes or other electronic nicotine delivery systems (ENDS) and little cigars/cigarillos (LCCs). This study examines past month use and correlates of cigarettes and ATP among young tobacco users experiencing homelessness.

Methods: We surveyed a probability sample of N = 469 unaccompanied homeless 13-25 year olds (mean age = 22; 71% male), who reported past month use of any type of tobacco product, from 25 service and street sites in Los Angeles County.

Adolescents with better mental health have less problem alcohol use six months later.

Purpose: Adolescents who report having mental health problems, including depression and anxiety, are at greater risk of alcohol use. We examined the longitudinal association between mental health and alcohol use six months later in a diverse adolescent sample attending a primary care appointment. The primary care setting provides a unique opportunity to reach this younger age group and address risk factors, including mental health problems and substance use.

Is the National Institute on Alcohol Abuse and Alcoholism Screening Guide Useful for Identifying Adolescents at Risk for Later Cigarette Smoking? A Prospective Study in Primary Care Clinics.

Objectives: This paper evaluated whether a 2-item assessment of alcohol use risk, developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA SG), prospectively predicted smoking status among a sample of adolescents visiting their primary care physician.

Methods: We analyzed a sample of 651 adolescents (57.80% female; 56.