Protocol - Social Norms about Tobacco - Adult
- Disapproval of Substance Use
- Passive Exposures to Tobacco Products
- Peer and Family Influence on Smoking
- Use of Tobacco Products
Description
This protocol uses a combination of questions from the 2011 International Tobacco Control (ITC) 4-Country Survey and the Population Assessment of Tobacco and Health (PATH) Survey Wave 7 instruments. Collectively, the questions are used to assess social norms within the adult population by determining whether or not a respondent resides with one or more users of tobacco products; if most people’s and those most important to the respondent’s opinions of using tobacco are positive or negative; and the smoking status of five closest friends or acquaintances.
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.
Availability
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.
Hookah and Shisha
A 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.
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
7[ ]Smoke pipe tobacco
6[ ]Smoke hookah
3[ ]Use snus
4[ ]Use smokeless tobacco (such as moist snuff, dip, spit, or chew)
8[ ]Use IQOS
11[ ]Use nicotine pouches (such as Zyn, on!, or Velo)
12[ ]Use other types of oral nicotine products (such as Velo lozenges, Rogue tablets, Lucy gum, or Pixotine toothpicks)
9[ ]Use any other form of tobacco
10[ ]No one who lives with me now uses any form of tobacco
-8[ ]Don’t know
-7[ ]Refused
2. Of the five closest friends or acquaintances that you spend time with on a regular basis, how many of them are smokers?
[ ] INSERT 0 to 5
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 Category | Required |
|---|---|
| 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
Adult
Participants
Adults (18+)
Selection Rationale
The 2011 International Tobacco Control (ITC) 4-Country Survey is an international cohort study of tobacco use whose overall objective is to measure the psychosocial and behavioral impact of key national-level policies. This survey is being used in more than 20 countries.
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.
Language
English, Other languages available at source
Standards
| Standard | Name | ID | Source |
|---|
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
Population Assessment of Tobacco and Health (PATH) Study: Final Adult Interview, Wave 7
Source
International Tobacco Control Policy Evaluation Project. (2011). International Tobacco Control (ITC) 4-Country Survey. Item 365.
National Institutes of Health, U.S. Food and Drug Administration. (2023). Population Assessment of Tobacco and Health (PATH) Study: Final Adult 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%20Adult%20Questionnaire.pdf]. Items AX0066, AX0071.
General References
National Institutes of Health, U.S. Food and Drug Administration. (2023). Population Assessment of Tobacco and Health (PATH) Study: Final Adult 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%20Adult%20Questionnaire.pdf]
Hitchman S, Fong GT, Zanna MP, Thrasher JF, Chung-Hall J, Siahpush M. Socioeconomic status and smokers’ number of smoking friends: Findings from the International Tobacco Control (ITC) Four Country Survey. Drug & Alcohol Dependence. 143:158-66. 2014
Hitchman S, Fong GT, Zanna MP, Thrasher JF, Laux F. The relation between number of smoking friends and quit intentions, attempts, and success: Findings from the International Tobacco Control (ITC) Project Four Country Survey. Psychology of Addictive Behaviors. 28(4):1144-52. 2014.
Protocol ID
750303
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping |
|---|
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 – adult; 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; adult; cigarettes; descriptive norms; injunctive norms; 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.