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Protocol - Social Norms about Tobacco - Youth

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Description

This protocol includes two questions from the Wave 7 Youth Population Assessment of Tobacco and Health (PATH) Survey and one question from the "Changes in Peer and Parent Influence During Adolescence: Longitudinal Versus Cross-Sectional Perspectives on Smoking Initiation" publication (Chassin et al., 1986). Question one assesses household descriptive norms (i.e., others’ use of tobacco) by asking whether or not a respondent resides with one or more users of tobacco products. Question two assesses descriptive norms by asking the respondent how many of their friends smoke. Questions three assesses injunctive norms (i.e., others’ approval of tobacco use) by asking the respondent about the opinions regarding tobacco use among close network members.

Specific Instructions

This protocol was systematically updated to reflect the Wave 7 data collection of the Population Assessment of Tobacco and Health (PATH) Study. This protocol will be formally reviewed by a TRR Content Expert Panel early in 2024.

The WG recommends that investigators provide the descriptions included in the protocol text section of this data sheet to respondents while the questions are being administered. 

In addition, the WG recommends that investigators consider clearly defining "tobacco products" by noting whether that definition includes or excludes certain types of related products based on these criteria: products that are intended for human consumption; made or derived from tobacco; typically contain nicotine, but sometimes do not; and are not Food and Drug Administration-approved tobacco-cessation products.

The WG notes that an additional indicator of descriptive norms could be constructed by determining the prevalence of smoking or other tobacco use within a particular social group. The Powell et al publication (2005) includes an approach that has been used for school-based studies, where school-level prevalence of smoking has been assessed. 

School-based prevalence of smoking can be assessed for the individual student’s school, not including the given individual in the calculation. That is, for each student the prevalence of school-based peer smoking is the prevalence of smoking among all other respondents at their school.

Availability

Available

Protocol

Electronic Nicotine Products

Electronic nicotine products include e-cigarettes, pod devices, vape pens, tank systems, mods, e-cigars, e-pipes, e-hookahs, and hookah pens. Using these devices is often referred to as “vaping.” They are battery-powered and product vapor or aerosol instead of smoke. They typically use a nicotine liquid called “e-liquid”, although the amount of nicotine can vary and some may not contain any nicotine at all.

Some common brands include JUUL, Vuse, Blu, NJOY, eGo, Suorin, Bo, Smok, Phix, and Puff, but there are many others.

[SHOW GENERIC IMAGE OF E-PRODUCTS]

Cigars

Traditional cigars, cigarillos, and filtered cigars go by lots of different names, so please use these descriptions and photos to understand what they are.

Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Some common brands of cigars include Macanudo®, Romeo y Julieta®, Arturo Fuente®, and Cohiba, but there are many others.

[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]

Cigarillos and filtered cigars are smaller than traditional cigars. They are usually brown. Some are the same size as cigarettes, and some come with filters or with plastic or wooden tips. Some common brands are Black & Mild®, Swisher Sweets®, Dutch Masters®, Phillies Blunts®, Zig Zag, and Cheyenne.

[SHOW GENERIC IMAGE OF CIGARILLOS AND FILTERED CIGARS]

Pipe Tobacco 

There are many different types of pipes. They all have a bowl that holds the tobacco and a stem.

[SHOW GENERIC IMAGE OF PIPE]

Hookah and Shisha 

hookah is a type of water pipe. It is sometimes also called a "narghile" pipe. There are many types of hookahs. People often smoke tobacco in hookahs in groups at cafes or in hookah bars. 

[SHOW GENERIC IMAGE OF HOOKAH]

Smokeless Tobacco 

Smokeless tobacco is a type of tobacco which you put in your mouth and chew, suck or spit. It may be loose or packaged in small pouches that you can place directly in your mouth. There are many kinds of smokeless tobacco, such as dip, spit, moist snuff, pouches, and chewing tobacco. Common brands include Redman®, Levi Garrett®, Skoal®, Grizzly®,and Copenhagen®.

[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS, EXCLUDING SNUS]

Snus

Snus is a type of smokeless tobacco. Snus usually comes in small pouches, although some snus may be sold as loose snus. Typically, with most kinds of smokeless tobacco, you spit, but you do not need to spit when using snus. Common brands of snus include Camel Snus, Marlboro Snus, and General Snus.

[SHOW GENERIC IMAGE OF SNUS – BOTH LOOSE AND POUCHES]

IQOS

IQOS is a battery-powered device that uses Marlboro HeatSticks – tobacco sticks that look like cigarettes but can only be used in IQOS. The device heats tobacco instead of burning it to product a heated tobacco vapor that is inhaled. IQOS does not contain any liquid.

[SHOW GENERIC IMAGE OF IQOS]

Oral Nicotine Products

Oral nicotine products are products that you put in your mouth, other than nicotine pouches. This includes lozenges, discs, tablets, gum, toothpicks, dissolvable tobacco, and related products. Common brands include Velo Nicotine Lozenges, Verve Nicotine Discs, Rogue Nicotine Tablets, Lucy Nicotine Gum, Pixotine Nicotine Toothpicks, and Stonewall Dissolvable Tobacco. These products do not include nicotine replacement therapy products (such as Nicorette lozenges, Nicorette gum, or NicoDerm patches.)

Nicotine Pouches

Nicotine pouches are small, white pouches that contain nicotine which users place in their mouth. Nicotine pouches are different from other smokeless tobacco products such as snus, dip, or chew, because they do not contain any ground tobacco lead. Common brands include Zyn, On!, or Velo, but there are many others.

[SHOW GENERIC IMAGE OF NICOTINE POUCHES]

1. Not including yourself does anyone who lives with you now do any of the following? Choose all that apply.

1[ ]Smoke cigarettes

2[ ]Use e-cigarettes or other electronic nicotine products

5[ ]Smoke traditional cigars, cigarillos, or filtered cigars

6[ ]Smoke hookah

3[ ]Use snus

4[ ]Use smokeless tobacco (such as moist snuff, dip, spit, or chew)

7[ ]Use IQOS

10[ ]Use nicotine pouches (such as Zyn, on!, or Velo)

11[ ]Use other types of oral nicotine products (such as Velo lozenges, Rogue tablets, Lucy gum, or Pixotine toothpicks)

8[ ]Use any other form of tobacco

9[ ]No one who lives with me now uses any form of tobacco

-8[ ]DON’T KNOW

-7[ ]REFUSED

2. How many of your five closest friends smoke cigarettes?

[ ] None

1[ ]friend

2[ ]friends

3[ ]friends

4[ ]friends

5[ ]friends 

3. Thinking about the people who are important to you, how would you describe their views on using tobacco in general?

1[ ]Very positive

2[ ]Positive

3[ ]Neither positive nor negative

4[ ]Negative

5[ ]Very negative

-8[ ]DON’T KNOW

-7[ ]REFUSED

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered or interviewer-administered questionnaire

Lifestage

Child, Adolescent

Participants

Youth (12-17)

Selection Rationale

The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative, in-person longitudinal cohort study of non-users and users of tobacco products and those at risk for tobacco use across the United States. Respondents 12 years old and up are asked questions on tobacco use, attitudes, and health, and biospecimens (buccal cell, urine, and blood) are collected from adults. The PATH Study was implemented to provide an evidence base for assessing and monitoring the U.S. Food and Drug Administration’s regulatory actions in meeting its mandate under the Family Smoking Prevention and Tobacco Control Act. Regulatory domains include product standards, new and modified risk products, health warnings, and health education campaigns. Recommended measures primarily come from PATH because they have undergone extensive pretesting and will allow comparison with this larger study.

Language

English, Other languages available at source

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

Population Assessment of Tobacco and Health (PATH) Study, Wave 7, Youth Survey

Source

National Institutes of Health, U.S. Food and Drug Administration. (2023). Population Assessment of Tobacco and Health (PATH) Study: Final Youth Interview, Wave 7 (January 2022 – December 2022), English Data Collection Instrument. Bethesda, MD: National Institutes of Health. [https://www.icpsr.umich.edu/files/NAHDAP/pathstudy/Final%20PATH%20Wave%207%20English%20Youth%20Questionnaire.pdf]. Items YX0671, YX0071.

Chassin, L., Presson, C. C., Sherman, S. J., Montello, D., & McGrew, J. (1986). Changes in peer and parent influence during adolescence: Longitudinal versus cross-sectional perspectives on smoking initiation. Developmental Psychology, 22(3), 327-334.

General References

National Institutes of Health, U.S. Food and Drug Administration. (2023). Population Assessment of Tobacco and Health (PATH) Study: Final Youth Interview, Wave 7 (January 2022 – December 2022), English Data Collection Instrument. Bethesda, MD: National Institutes of Health. [https://www.icpsr.umich.edu/files/NAHDAP/pathstudy/Final%20PATH%20Wave%207%20English%20Youth%20Questionnaire.pdf] .

Powell LM, Taurasb JA, Ross H. (2005) The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior. Journal of Health Economics, 24(5): 950-968.

Protocol ID

750304

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX750304_Social_Norms_About_Tobacco___Youth_Friend_Views_On_Use
PX750304030000 Thinking about the people who are important more
to you, how would you describe their views on using tobacco in general? show less
N/A
PX750304_Social_Norms_About_Tobacco___Youth_Household_Use
PX750304010000 Not including yourself does anyone who lives more
with you now do any of the following? Choose all that apply. show less
N/A
PX750304_Social_Norms_About_Tobacco___Youth_Number_Friends_Use
PX750304020000 How many of your five closest friends smoke more
cigarettes? show less
N/A
Tobacco Regulatory Research: Environment
Measure Name

Social Norms about Tobacco

Release Date

May 3, 2024

Definition

This measure assesses social norms about tobacco, such as attitudes about tobacco product use among family and peers for youth and adults.

Purpose

The purpose of this measure is to evaluate perceptions and attitudes about tobacco product use by those who are important to them and by the general population, in order to develop a better understanding of the rules and standards by members of a group that guide or constrain social behavior without the force of laws.

Keywords

Social norms about tobacco – youth; Social norms; social acceptability; tobacco; smoke; smokeless tobacco; Chewing Tobacco; Snuff; dip; snus; Cigars; cigarillos; filtered cigars; International Tobacco Control; ITC; Population Assessment of Tobacco and Health; PATH; family; Friends; peers; smoking; attitudes; cigarettes; descriptive norms; injunctive norms; youth; adolescents; cigarettes; opinion; second hand smoke; secondhand smoke; second-hand smoke; e-cigarettes; electronic nicotine products; IQOS; nicotine pouches; oral nicotine products; pipe tobacco; hookah 

Measure Protocols
Protocol ID Protocol Name
750303 Social Norms about Tobacco - Adult
750304 Social Norms about Tobacco - Youth
Publications

There are no publications listed for this protocol.