Abstract
Health behavior theorists and prevention researchers use a variety of measures of adolescent and young adult (AYA) risk and benefit perceptions to predict tobacco-use and marijuana-use behaviors. However, studies have not examined whether and how perception measures that ask about likelihood of more general outcomes such as “harm” versus ask about specific risk or benefit outcomes compare or whether they differentially predict AYA willingness to use if one of your best friends were to offer it and intentions to use in the next year; and if these measures have differential ability to predict actual use of tobacco and marijuana. We used data from a prospective cohort of California AYAs to create and test new scales to measure perceptions of specific health and social outcomes related to risks (e.g., smell bad) and benefits (e.g., look cool) related to tobacco and marijuana, and then addressed three questions: (1) Whether and how measures of perceptions of specific social and health risks and benefits (for our purposes “specific measures”) and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? (2) Are specific versus general measures differentially associated with and predictive of tobacco and cannabis use behavior? (3) Are specific perceptions measures differentially predictive of behavior compared to measures of willingness, social norms, and behavioral intentions? Our results demonstrate that to better predict AYA tobacco and marijuana use, measures that address general outcomes, such as harmfulness, as well as willingness and behavioral intention should be used. We also found that measures of specific perceived risks (short-term, long-term, social) and benefits were unrelated and correlated differently with different products. For example, adolescents perceived both risks and benefits from using products like e-cigarettes, and perceived greater risk from smokeless tobacco compared to combustible cigarettes. These findings indicate that measures of specific perceived social and health outcomes can be useful to discern nuanced differences in motivation for using different substances. Study implications are important for survey dimension-reduction and assessing relationships among perceptions, motivations, and use of tobacco and marijuana products.
Highlights
Explanations for adolescent and young adult (AYA) tobacco and marijuana use reside in theories of health behavior, which argue that behavior is influenced by risk and benefit perceptions, social norms, and willingness and intentions to engage in such behavior (Ajzen, 1985, 1991; Liu et al, 2017; Prochaska et al, 1992; Rosenstock, 1974; Smith et al, 2007)
Studies have not examined whether and how perceptions measures that ask about a more general outcome such as “harm” versus specific outcomes related to risks or benefits compare with AYA’s willingness to use if one of your best friends were to offer it (Centers for Disease Control and Prevention, 2019; Orlan et al, 2019) and intentions to use in the year (Centers for Disease Control and Prevention, 2019); and if they have differential ability to predict actual use of tobacco and marijuana
We set out to answer the following three questions regarding AYA use of tobacco, blunts, smoked marijuana, and vaped marijuana: (1) Whether and how measures of perceptions of specific social and health risks and benefits and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? (2) Are specific versus general measures differentially associated with and predictive of behavior? (3) Are specific perceptions measures differentially predictive of behavior compared to measures of willingness, social norms, and behavioral intentions?
Summary
Explanations for adolescent and young adult (AYA) tobacco and marijuana use reside in theories of health behavior, which argue that behavior is influenced by risk and benefit perceptions, social norms (e.g., perceived prevalence), and willingness and intentions to engage in such behavior (Ajzen, 1985, 1991; Liu et al, 2017; Prochaska et al, 1992; Rosenstock, 1974; Smith et al, 2007). We set out to answer the following three questions regarding AYA use of tobacco (cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookah), blunts (hollowed out cigars filled with marijuana), smoked marijuana (not including blunts), and vaped marijuana: (1) Whether and how measures of perceptions of specific social and health risks and benefits (for our purposes “specific measures”) and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? We set out to answer the following three questions regarding AYA use of tobacco (cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookah), blunts (hollowed out cigars filled with marijuana), smoked marijuana (not including blunts), and vaped marijuana: (1) Whether and how measures of perceptions of specific social and health risks and benefits (for our purposes “specific measures”) and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? (2) Are specific versus general measures differentially associated with and predictive of behavior? (3) Are specific perceptions measures differentially predictive of behavior compared to measures of willingness, social norms, and behavioral intentions?
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