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Comparing belief in short-term versus long-term consequences of smoking and vaping as predictors of non-use in a 3-year nationally representative survey study of US youth
  1. Emma Jesch,
  2. Ava Irysa Kikut,
  3. Robert Hornik
  1. Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Ava Irysa Kikut, Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA; ava.kikut{at}asc.upenn.edu

Abstract

Introduction Efforts to prevent youth tobacco use are critical to reducing smoking-related deaths in the USA. Anti-tobacco messaging often focuses on the severe long-term consequences of smoking (eg, fatal lung disease, cancer). It is unclear whether these long-term consequences are more likely to deter youth use than shorter term consequences (eg, headaches, friend disapproval).

Methods A nationally representative 3-year rolling survey of adolescents and young adults (ages 13–26 years) measured belief in potential consequences of two types of tobacco products: combustible cigarettes (n=11 847) and electronic cigarettes (n=4470) as well as intentions and current use. Independent coders classified 23 consequences as either short or long term. Logistic regression tested the associations between short-term (vs long-term) beliefs and current intentions, as well as non-smoking behaviour at 6-month follow-up.

Results Believing in both short-term and long-term consequences was associated with outcomes, but short-term beliefs were more highly associated with anti-smoking (OR=1.40, 95% CI (1.30 to 1.51)) and anti-vaping (OR=2.10, 95% CI (1.75 to 2.52)) intentions and better predicted non-smoking behaviour at follow-up, controlling for prior use (OR=1.75, 95% CI (1.33 to 2.31)).

Conclusions These results support temporal discounting by adolescents and young adults and suggest health communication efforts aiming to reduce youth tobacco use should emphasise shorter term consequences.

  • media
  • electronic nicotine delivery devices
  • prevention
  • cessation

Data availability statement

Data are available upon reasonable request. De-identified survey data are stored on University of Pennsylvania servers. Please contact Robert Hornik (robert.hornik@asc.upenn.edu) to request access.

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Data availability statement

Data are available upon reasonable request. De-identified survey data are stored on University of Pennsylvania servers. Please contact Robert Hornik (robert.hornik@asc.upenn.edu) to request access.

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Footnotes

  • EJ and AIK are joint first authors.

  • Contributors AIK and EJ contributed equally to this work and are listed in random order. Both AIK and EJ directed study design and conducted analysis, writing and reviewing. RH monitored survey instrument development and data collection and contributed to study design, analysis, writing, and critically revising the work. RH is the guarantor.

  • Funding Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and Food and Drug Administration (FDA) Center for Tobacco Products (CTP) under Award Number P50CA179546.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA. The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.