School of Public Health

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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Subject: search.filters.subject.Tobacco use

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Now showing 1 - 3 of 3
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    Measuring the Single Cigarette Use Phenomenon: Scale Development and Validation
    (2019) Phan, Lilianna; Butler, James; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The practice of single cigarette use perpetuates normative smoking beliefs and increases smoking propensity among urban, African American smokers. Despite the 2009 Family Smoking Prevention and Tobacco Control Act’s ban of single cigarettes, there is a paucity of research to inform the public about the harms of single cigarettes and regulatory enforcement of their sales by the Food and Drug Administration. This dissertation utilized a mixed-method, three-phase design with primary data collection to: 1) examine the social context, beliefs, and attitudes of loosie use; and, 2) develop and validate two theoretically-based scales (i.e., social context and Health Belief Model) on the purchasing and use of loosies by urban, African American smokers. In Phase I, 25 semi-structured, in-depth interviews were conducted to understand the social context and underlying intrapersonal factors related to loosie use. Qualitative data, analyzed using the Framework Method, informed the development of potential scale items. During Phase II, three expert reviewers and 24 urban, African American loosie users provided feedback and pilot tested the items via the “Think Aloud” method. In Phase III, psychometric data were collected from 122 urban, African American loosie users from the District of Columbia Housing Authority public housing sites. Rigorous exploratory factor analysis and reliability and validity testing were conducted to determine the most parsimonious models for two scales: The Social Context of Loosies Scale (SCL-11) and the Health Belief Model for Loosies Scale (HBML-20). Both scales and their respective subscales demonstrated internal consistency and divergent and convergent validity. To our knowledge, this dissertation research is the first study to utilize semi- structured interviews (Phase I) to examine individualized patterns of loosie use by urban, African Americans and to develop valid scales designed by, and for, urban, African American loosie users (Phase II and Phase III). Given the strong psychometric properties of the scales, they may be used to identify meaningful targets for individual, social, and environmental intervention to prevent and reduce loosie use among this priority population.
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    Tobacco cues in India: An ecological momentary assessment
    (BioMed Central, 2016) Borzekowski, Dina L. G.; Chen, Julia Cen
    Background: Tobacco use in India is a major health concern; however, little is known about the influence of tobacco-related social and environmental cues on tobacco use. This study uses ecological momentary assessment (EMA) to examine real-time tobacco use and exposure to social and environmental cues. Methods: In Hyderabad and Kolkata, participants were recruited, and an EMA application was installed on their mobile phones. Momentary prompts (MP) were randomly used to collect real-time information and end-of-day (EOD) prompts gathered retrospective information on daily basis. Besides personal tobacco use, the surveys asked about exposure to social (e.g., presence of others using tobacco) and environmental cues (e.g., visual and olfactory stimuli). Using the data aggregation approach, bivariate and multivariate analyses were performed to examine the association of tobacco use and cue exposure. Moderating roles of participants’ socio-demographic characteristics were also tested to gain an in-depth understanding of the relationship. Results: Among the 205 participants, around a third (MP, 33.7 %; EOD, 37.6 %) used tobacco at least once during the study period. Tobacco-related social and environmental cues related were commonly reported. In the bivariate models, tobacco use was associated with gender, age, and all the examined social and environmental cues except for seeing restrictions on tobacco use. In the multivariate models, tobacco use was associated with age, gender, seeing others using tobacco, and seeing restrictions on tobacco use. Seeing others in one’s immediate group using tobacco was the strongest predictor of tobacco use in both MP and EOD assessments. Gender and age did not moderate the relationship between cue exposure and tobacco use, although males reported higher tobacco use and cue exposure in general. Conclusions: This research provides data on the ubiquity of social and environmental tobacco cues in India. The EMA approach was feasible and informative. Future cessation interventions and advocacy efforts should address the high prevalence of tobacco use and exposure to pro-tobacco use cues especially among Indian males. Health education campaigns for promoting tobacco use restrictions in private places as well as changing the norms of tobacco use in social settings are recommended.
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    The Association Between Electronic Cigarette Use and Cigarette Smoking Behavior Among Young Adults in the United States
    (2015) Coleman, Blair N.; Green, Kerry M; Glover, Elbert D; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The prevalence of electronic cigarette (e-cigarette) use is rapidly increasing in adults and youth; however, little is known about the public health impact of their use. A debate over e-cigarettes has emerged in the literature; one side recognizes the potential benefit of e-cigarettes as a harm reduction tool, while others argue e-cigarette use may delay or deter smoking cessation due to dual use or increase the risk of initiation of conventional cigarettes among previous nonsmokers. Drawing on the Theory of Planned Behavior, this dissertation focused on attitudes, beliefs, and perceived social norms of e-cigarettes, as well as openness to conventional cigarette smoking among young adult users of the product. Using a mixed methods approach, this dissertation analyzed secondary data from the 2012-2013 National Adult Tobacco Survey (NATS) as well as focus group data collected in five cities across the U.S. to better understand the relationship between e-cigarette use and cigarette smoking among young adults. In Study 1, quantitative analyses found non-cigarette smoking young adults who have tried e-cigarettes were more likely to report openness to cigarette smoking in the future compared to those who have not tried e-cigarettes (AOR= 2.4; 95% CI= 1.7-3.3). In Study 2, qualitative findings suggest that young adult exclusive e-cigarette users were less interested in conventional cigarette smoking, and overwhelmingly described negative aspects to cigarette smoking that appeared to become more salient as a result of their e-cigarette use. In Study 3, focus group participants expressed many positive attitudes towards e-cigarettes, and simultaneously reported a lack of information and knowledge about the products. The relationship between e-cigarette use and cigarette smoking is complex and multifaceted, and influenced by a myriad of individual and social factors. Although quantitative findings suggest young adults who have used e-cigarettes compared to those who have not used e-cigarettes were more likely to report openness to future cigarette smoking, qualitative findings did not support the notion that young adult e-cigarette users (who may have prior experience with cigarette smoking) are open to future cigarette smoking. These findings provide a basis for further exploration of the association between e-cigarette use and cigarette smoking.