The Prototypes of Tobacco Users Scale (POTUS) for Cigarette Smoking and E-Cigarette Use: Development and Validation.

Eboneé N Butler,Jessica K Pepper,Hart Blanton,Marissa G Hall,May S Chen,Noel T Brewer

doi:10.3390/ijerph17176081

Abstract

Endorsing prototypes of cigarette smokers predicts cigarette smoking, but less is known about prototypes of users of other tobacco products. Our study sought to establish the reliability and validity of a measure of prototypes of smokers and e-cigarette users. Participants were from a national survey of smokers and non-smokers (n = 1414), a randomized clinical trial (RCT) of adult smokers (n = 2149), and adolescent children of adults in the trial (n = 112). The Prototypes of Tobacco Users Scale (POTUS) has four positive adjectives (cool, sexy, smart, and healthy) and four negative adjectives (disgusting, unattractive, immature, and inconsiderate) describing cigarette smokers and e-cigarette users. Confirmatory factor analyses identified a two-factor solution. The POTUS demonstrated strong internal consistency reliability in all three samples (median α = 0.85) and good test–retest reliability among adults in the RCT (median r = 0.61, 1–4 weeks follow-up). In the RCT, smokers more often agreed with negative prototypes for smokers than for e-cigarette users (mean = 2.03 vs. 1.67, p < 0.05); negative prototypes at baseline were also associated with more forgoing of cigarettes and making a quit attempt at the end of the trial (Week 4 follow-up). The POTUS may be useful to public health researchers seeking to design interventions that reduce tobacco initiation or cessation through the manipulation of tobacco user prototypes.

Highlights

Social experiences play a meaningful role in shaping health behaviors early in life, from late childhood through young adulthood [1,2]
We evaluate whether established prototypes of smokers accurately reflect positive and negative perceptions of both cigarette and e-cigarette users, and we examine relationships between tobacco user prototypes and attitudes, behaviors, and beliefs linked to smoking and e-cigarette use in adolescent and adult samples
The smoker Prototypes of Tobacco Users Scale (POTUS) was associated with smoking behavior; positive smoker prototypes correlated with being a smoker, and negative prototypes correlated with being a non-smoker

Summary

Introduction

Social experiences play a meaningful role in shaping health behaviors early in life, from late childhood through young adulthood [1,2]. During these developmental stages, new and unfamiliar situations present opportunities for youth and young adults to make consequential decisions about risky behaviors such as tobacco use. The Prototype/Willingness (P/W) model posits that two separate processes motivate people to engage in risk behaviors [3]. The social images of those engaged in a behavior—known as prototypes—increase willingness to act, which increases the likelihood of engaging in the behavior when the opportunity presents itself [3]. The more passive social process, which relies on prototypes, Int. J. Public Health 2020, 17, 6081; doi:10.3390/ijerph17176081 www.mdpi.com/journal/ijerph

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Discussion

Conclusion