Tobacco Use Risk Research Articles

Awareness of Tobacco-Related Diseases among Adults in Poland: A 2022 Nationwide Cross-Sectional Survey.

Warning about the dangers of tobacco use is a key element of tobacco control policy. The COVID-19 pandemic may impact public perception of the health risks of tobacco use. The aim of this study was to assess the level of knowledge of tobacco-related diseases among adults in Poland, as well as to identify sociodemographic factors associated with awareness of tobacco-related diseases. This cross-sectional survey was carried out in March 2022 on a representative nationwide sample of 1090 adults in Poland using the computer-assisted web interview (CAWI) technique. Lung cancer was the most recognized tobacco-related disease (92.7%), followed by COPD (89.7%) and myocardial infarction (84%). Three-quarters of the respondents (76.8%) were aware that smoking causes stroke and 51% were aware that smoking increases the risk for type 2 diabetes. Out of 9 factors analyzed in this study, female gender, an age of 50 years and over, and being a non-smoker were significantly associated with a higher awareness of tobacco-related diseases. This study showed an increase in public awareness of smoking-related diseases during the COVID-19 pandemic. While awareness of lung cancer and COPD was very high, there are still significant gaps in the awareness of the non-respiratory effects of tobacco use.

Longitudinal latent class analysis of tobacco use and correlates among young adults over a 10-year period

IntroductionWe assessed patterns and correlates, including demographic characteristics, psychological factors, and social role transitions, of young adults’ tobacco use over time. MethodsIn the fall of 2010, we recruited a cohort of 3146 students from 11 colleges in North Carolina and Virginia. Participants completed baseline and at least two survey waves between 2010 and 2019. ResultsThe sample was 49.8% female, 15.7% non-white, and 6.6% Hispanic. Longitudinal latent class analysis revealed a five-class model with distinct patterns and correlates of tobacco use. Limited Use (52.6% of sample) had minimal use. College-Limited Combustible Tobacco Users (18.6%) had moderate probability of cigarette, cigar, and waterpipe smoking, which decreased to no use post-college. Intermittent Sustained Polytobacco Users (10.9%) had low probability of use that continued post-college. College Polytobacco with Continued Cigarette and E-Cigarette Users (14.5%) had high probability of use of cigarette smoking and increasing probability of e-cigarette, both of which continued post-college. Sustained Polytobacco Users (5.7%) had moderate probability of use of tobacco products across all waves. ConclusionsPatterns of tobacco use varied considerably. In most classes, tobacco use was highest during freshman year and in three classes, use continued post-college. Prevention activities should focus on first-year students and target those at risk for post-college tobacco use.

The toxic gift: reciprocity and social capital in cigarette exchange in China

ABSTRACT The widespread exchange of tobacco cigarettes as a gift in some societies normalises the symbolic desirability of tobacco products and promotes smoking. Little is known about how and why people exchange toxic substances as gifts. This study argues two key factors involved in social exchange processes – reciprocity and social capital – can explain gift cigarette circulation. We conducted a multistage survey among household heads from China and measured the quantity and monetary values of outgoing and incoming gift cigarettes circulated by each household and measured social capital in three dimensions: collective participation, social ties, and trust. Ordinary Least Square regressions showed that reciprocity is strongly and significantly associated with both the value and quantity of gift cigarettes. All three dimensions of social capital are varyingly associated with gifting cigarettes. Income and higher classes are also associated with greater quantity and value of received cigarettes. This study broadens the phenomenon of gifting cigarettes to the more universal patterns of reciprocity and social capital, wherein better social capital and socioeconomic position ironically lead to a higher risk of tobacco use and endanger health. We suggest policymakers target the endemic social need for gift exchange in China’s informal economy.

E-cigarette device type and combustible tobacco use: Results from a pooled analysis of 10,482 youth

IntroductionTo understand whether using a certain e-cigarette device is more strongly associated with risk of combustible tobacco use among youth. MethodsWe conducted multivariable logistic regression analyses using cross-sectional data from 4 samples of youth in Connecticut and California (N = 10,482; ages 13–24), separately for each study using the total sample and the sample of past-month e-cigarette users, to understand the association between e-cigarette device type and past-month combustible tobacco use, while controlling for age, sex, race/ethnicity, socioeconomic status, school, and past-month marijuana use. Then, we conducted meta-analyses to calculate pooled associations for adolescents, young adults, and all individuals combined. ResultsAmong the total sample, combustible tobacco use was associated with any e-cigarette device use (vs. no e-cigarette use) in the pooled analysis across all studies. Among past-month e-cigarette users, combustible tobacco use across all studies was 15.8%− 61.5%. Pooled associations among past-month e-cigarette users showed that using disposable devices (vs. pods; AOR=2.83, 95% CI: 1.73–4.61) and multiple devices most frequently (vs. pods; AOR=2.13, 95% CI: 1.16–3.90) was associated with greater odds of combustible tobacco use. Pooled associations also found that using multiple devices (vs. a single device) in the past month was associated with greater odds of combustible tobacco use (AOR 2.33, 95% CI: 1.74, 3.14). DiscussionUsing disposable e-cigarettes and multiple devices is associated with greater likelihood of combustible tobacco use among e-cigarette using youth. Future research should elucidate the trajectory of e-cigarette device used and combustible tobacco use among youth to inform prevention and product regulation.

Predicting Young Adult Tobacco, Drug and Alcohol Use Among Participants in the CAMP Trial.

The development of substance abuse in youth with asthma have seldom been examined with longitudinal research. The prospective and well-characterized CAMP cohort provides outcome data on youth with asthma over 13years. This manuscript seeks todetermine thecontributions of asthma features and child behavioral/emotional functioning to subsequent tobacco, alcohol, and drug use in early adulthood. Childhood smoking exposures as well as parent report and youth report of substance use were prospectively assessed concurrently with assessments of asthma symptoms, study medication, and lung development. Logistic regression models evaluated predictors of adolescent and young adult tobacco, alcohol, and drug use. Use of tobacco products was reported by 33% of youth with mild/moderate asthma. Tobacco use was significantly associated with self-reported externalizing behaviors. Early life passive smoke exposure, especially in utero exposure, makes a significant contribution to tobacco use (OR1.58). Greater risk for tobacco use is conveyed by self-reported externalizing behaviors, which are consistently robust predictors of any future use of tobacco products, alcohol and drugs. These findings provide evidence for health care providers to use routine behavioral screening in youth with asthma.

Exposure to tobacco and betel nut content on social media, risk perceptions, and susceptibility to peer influence among early adolescents in Guam

IntroductionThis study aimed to examine the associations between exposure to tobacco and betel nut-related content on social media, perceived risks of tobacco and betel nut use, and susceptibility to peer influence for tobacco and betel nut use among adolescents living in Guam, a United States-Affiliated Pacific Island in the Western Pacific. MethodsA representative survey of adolescents (N = 670) attending public middle schools on Guam was conducted. The survey measured exposure to tobacco and betel nut content on the following social media platforms: (a) Facebook, (b) Twitter, (c) Instagram, (d) Snapchat, and (e) WhatsApp. The survey also measured perceived risks of tobacco and betel nut use and susceptibility to peer influence for tobacco and betel nut use. ResultsGuam adolescents’ exposure to tobacco-related content on social media was found to be associated with lower perceived risks toward the use of tobacco (β = −0.18, p < 0.001) and betel nut (β = −0.16, p < 0.001). Also, exposure to tobacco-related content on social media was found to be associated with higher levels of susceptibility to peer influence for uses of both tobacco (β = 0.10, p < 0.05) and betel nut (β = 0.15, p < 0.001). Similarly, exposure to betel nut-related content on social media was associated with lower perceived risks of using betel nut (β = −0.20, p < 0.001) and tobacco (β = −0.24, p < 0.001). Also, exposure to betel nut-related content on social media was associated with increased susceptibility to peer influence for use of both betel nut (β = 0.35, p < 0.001) and tobacco (β = 0.29, p < 0.001). ConclusionsAdolescents’ exposure to tobacco- and betel nut-related content on social media may influence attitudinal risk factors associated with tobacco and betel nut use.

Tobacco smoking and blood pressure: How are they related among the Indians? - A secondary analysis of National Family Health Survey (NFHS)-4 data.

India, the second leading producer of tobacco, puts the population at a higher chance of tobacco consumption contributing to a significant disease burden. Though tobacco smoking is a modifiable risk factor for hypertension and has been on the rise among the population, studies on the relationship of tobacco with hypertension are limited in India. This study aimed to assess the population-level risk of tobacco (smoke) use and elevated blood pressure (BP) among Indians and also assess the association of risk of tobacco smoking with hypertension based on the place of residence. Data from the National Family Health Survey (NFHS)-4 conducted between January 2015 and December 2016 was utilized. The prevalence of hypertension and its magnitude of association with smoking factors was found using univariable logistic regression. Multivariable logistic regression was performed to predict the association of smoking products with elevated BP by adjusting the model for sociodemographic factors, illness, physical characteristics, and state-wise data. The weighted prevalence of hypertension was 16.56% (confidence interval [CI]: 16.34-16.78) in males and 11.20% (CI: 11.12-11.27) in females. Among those who smoked tobacco, 15.3% women and 22.4% men were hypertensive. This study highlights the significant association of smoking of various tobacco products with hypertension in both men and women on univariate analysis. But the adjusted mean elevated BP among the tobacco-using males and females was not significantly associated with smoking cigarettes, pipe, cigars, and hookah. Cigarette smoking is a modifiable factor for the development and progression of hypertension. Adequate preventive and promotive health measures targeting the young, rural inhabitants and the poorer sections of society may help in reducing tobacco consumption.

Machine learning models of tobacco susceptibility and current use among adolescents from 97 countries in the Global Youth Tobacco Survey, 2013-2017.

Adolescents are particularly vulnerable to tobacco initiation and escalation. Identifying factors associated with adolescent tobacco susceptibility and use can guide tobacco prevention efforts. Novel machine learning (ML) approaches efficiently identify interactive relations among factors of tobacco risks and identify high-risk subpopulations that may benefit from targeted prevention interventions. Nationally representative cross-sectional 2013-2017 Global Youth Tobacco Survey (GYTS) data from 97 countries (28 high-income and 69 low-and middle-income countries) from 342,481 adolescents aged 13-15 years (weighted N = 52,817,455) were analyzed using ML regression tree models, accounting for sampling weights. Predictors included demographics (sex, age), geography (region, country-income), and self-reported exposure to tobacco marketing, secondhand smoke, and tobacco control policies. 11.9% (95% CI 11.1%-12.6%) of tobacco-naïve adolescents were susceptible to tobacco use and 11.7% (11.0%-12.5%) of adolescents reported using any tobacco product (cigarettes, other smoked tobacco, smokeless tobacco) in the past 30 days. Regression tree models found that exposure or receptivity to tobacco industry promotions and secondhand smoke exposure predicted increased risks of susceptibility and use, while support for smoke-free air policies predicted decreased risks of tobacco susceptibility and use. Anti-tobacco school education and health warning messages on product packs predicted susceptibility or use, but their protective effects were not evident across all adolescent subgroups. Sex, region, and country-income moderated the effects of tobacco promotion and control factors on susceptibility or use, showing higher rates of susceptibility and use in males and high-income countries, Africa and the Americas (susceptibility), and Europe and Southeast Asia (use). Tobacco policy-related factors robustly predicted both tobacco susceptibility and use in global adolescents, and interacted with adolescent characteristics and other environments in complex ways that stratified adolescents based on their tobacco risk. These findings emphasize the importance of efficient ML modeling of interactions in tobacco risk prediction and suggest a role for targeted prevention strategies for high-risk adolescents.

Five decades of risk perception measurements of tobacco use: a review of literature

Perceptions of risk are beliefs about the likelihood of damage orloss. People make subjective judgments regarding the intensityand features of a danger. Smoking start and continuation areinfluenced by risk perception. Risk perception of tobacco useor smoking has always been controversial. Few studies foundthat risk perception is overestimated by smokers and tobaccousers, while other studies found that smokers underestimatethe risk of smoking. It has been observed that different authorshave been using different approaches to measure the risk perceptionof tobacco use. The present literature review is an ontologicalexploration of the process of calculating this constructand determining which method gives more holistic and robustinformation. A literature survey was carried out to understanddifferent ways in which risk perception can be measured. Fifty-seven studies were identified from 1970 to 2020 in which riskperception was calculated for any form of tobacco use. Theliterature review found that the researchers used two practicalapproaches to measure risk perception. In the first approach,the researchers tried to measure only the health risks of tobaccouse, and in the second, multiple dimensions of tobaccouse were measured. Most commonly perceived addictionand then the social risk of tobacco use was accessed. Thoughrecent literature is dominated by an approach where a singledimension, i.e., perceived health risk of tobacco use, is mostcommonly access, it is inferring from the available literature thattools that access multiple sizes of the perceived risk of tobaccouse give more comprehensive and robust information aboutthat construct which can be used further to create tobacco useprevention intervention.

Anti-Smoking Campaign – An Innovative Initiative against Smoking by Tertiary Care Teaching Institute of North India

Background: Smoking as a practice has been in existence since 5000 B.C. Smoking in public places was banned in India from 2nd October 2008. According to reports by WHO Tobacco kills more than 7 million people each year. Studies show that few people understand the specific health risks of tobacco use. The present study was done to analyze the impact of the Anti-smoking Campaign in the Institutes’ Campus and also to make people aware of the harmful effects of smoking and motivate them to quit this habit.Methodology: The campaign constituted of various interventions as screening &amp; collection, monitoring through CCTV Surveillance, imposing penalty as per the Act, Destruction of collected material, Behavioral change communication through Anti-smoking March, Public Lectures, Display of Pamphlets/Signages at various places in the institute &amp; No smoking Pledge and involvement of top management.Results: Total about 2613 Kgs of Tobacco and Tobacco products has been collected and destroyed from March 2014 till April 2020. On an average 40 Kilograms of Tobacco material is collected and destroyed per month. Till April 2020, 108 offenders who were caught smoking in the institute were penalized. ‘No smoking Pledge’ was taken by all the participants. Conclusion: The success achieved by the anti-smoking campaign in the Institute suggests that there is a dire need and challenge before us to launch such type of campaigns in all the institutes worldwide to curb this menace from our society.

Smoking by pregnant mothers and risk of future tobacco use by offspring: a meta-analysis

ABSTRACT Background There are twelve studies indicating an association between prenatal maternal smoking and the increase risk of tobacco use by offspring. Objective To examine the association between maternal smoking during pregnancy and the development of smoking behavior patterns among offspring. This paper is the first to quantify that effect systematically and explore heterogeneity sources related to this issue. Methods A literature search for material published in English and Chinese l was done using databases PubMed, Google Scholar, Web of Knowledge and Microsoft Academic Search to gather peer-reviewed studies that gave the odds ratio for maternal smoking and an offspring’s tobacco habitual use. Results Based on the results from 12 cohort studies published between 1991-2019, offspring whose mothers smoked during pregnancy were at an elevated risk for smoking (RR=1.85, 95% CI: 1.67-2.06, p<0.001, a fixed effects model with Shore correction for between study variance) compared to those children whose mothers did not smoke during pregnancy. There is a dose response between maternal smoking during pregnancy and offspring smoking. The data support a relationship between maternal smoking during pregnancy and an increased risk of offspring smoking later in life. Conclusion The findings of the research suggest that prenatal tobacco exposure may cause an increase in offspring smoking.

Studying the relationship between tobacco use and depression between Egyptian patients

Abstract Background Although much attention has been drawn to trends in smoking and smoking related diseases in the general population, increasing evidence suggests that patients with mental illness are at a high risk for tobacco use and nicotine addiction. Cigarette smokers usually state the antidepressant and anxiolytic effects of smoking, but evidence reports that cigarette smoking may promote negative effect, so that the causal direction of this association still mysterious. It was reported that there is a cause effect relationship between cigarette smoking and depression as multiple studies mentioned that tobacco use increases the risk of symptoms of depression. The relationship between smoking and depression was attributed to genetic predisposition, low level of dopamine, low self-esteem, and coping styles. Aim of the Work The current study aimed to study the pattern of tobacco use among patients with depression, to study the degree of motivation to quit in patients with depression, and to assess severity of suicidal behavior among patients with depression using tobacco. Patients and Methods This is a case control study conducted in patients with the diagnosis of depression attending the outpatient clinic or inpatient of the institute of psychiatry Ain Shams University Hospitals during the academic year 2018-2019. The sample size was consisted of 100 patients and the patients were selected randomly. The relationship between tobacco use and depression between Egyptian patients was assessed using Socioeconomic status scale (SES), Hamilton Rating scale for Depression (HRSD), FagerströmTest for Nicotine Dependence (FTND), Lebanon Waterpipe Dependence Scale-11 (LWDS-11), Reason for quitting scale (RFQ), Columbia–Suicide Severity Rating Scale (C-SSRS), and ICD-10 symptom checklist for mental disorders. Results The present study showed a statistical significant association between the following scales; Fagerstrom Test for Nicotine Dependence (FTND) and Hamilton depression rating scale (HDRS), Difference score of Reason for quitting scale (RFQ) and Hamilton depression rating scale (HDRS), and Fagerstrom Test for Nicotine Dependence (FTND) and Columbia–Suicide Severity Rating Scale (CSSRS). Conclusion Compared to non-depressive persons, the results showed that depressive groups were less desired for quitting smoking.

Protecting children and adolescents against the risks of vaping.

Youth vaping presents significant risks for the health and safety of Canadian children and adolescents. This statement provides background information about vaping, vaping products, and related devices, discusses the short- and long-term harms known to be associated with their use, and offers prevention and cessation strategies for youth who vape or are at risk for starting. Youth vaping is associated with increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries. Vaping should not be used as a smoking cessation tool for youth, due to lack of effectiveness and evidence of harm. Many preventive and treatment strategies used for tobacco cessation, including behavioural and pharmacological options, can be adapted to help youth quit vaping. Recommendations for community stakeholders and policy makers are included.

How secondhand smoke exposure affects tobacco use and smoking susceptibility of adolescents: Sex and school differences.

INTRODUCTIONSecondhand smoke (SHS) exposure affects tobacco related health behaviors during adolescence and persists into adulthood. This study aimed to investigate the influence of SHS exposure on tobacco use among adolescents stratified by school and gender, and provide recommendations for controlling tobacco use in youth.METHODSThrough stratified random cluster sampling, 12278 selected students (aged 13–18 years) from schools in China were administered questionnaires. Multiple logistic regression was used to analyze whether SHS exposure would increase the smoking risk and susceptibility of adolescents.RESULTSThe prevalence of SHS exposure among the participating students was 74.8%. Adolescents exposed to SHS were at higher odds of being susceptible and currently smoking. Students with SHS exposure at both home and public places accounted for 36.6%, greatly increasing the current smoking risk and smoking susceptibility. Home SHS exposure had greater impact on the current tobacco use of boys (OR=2.13; 95% CI: 1.50–3.03) and junior school students (OR=4.67; 95% CI: 2.41–9.06). Exposure from public places increased the risk of current smoking in boys (OR=4.20; 95% CI: 2.31–7.65) and smoking susceptibility of vocational school students (OR=1.51; 95% CI: 1.07–2.15). Students with highlevel exposure to SHS had 2.25 times higher odds of e-cigarette use.CONCLUSIONSThe prevalence of SHS exposure is still high among adolescents in China and is associated with increased risk for tobacco use regardless of gender and school level. Effective smoke-free strategies should be developed and strictly implemented. Boys and junior school students constitute vulnerable populations exposed to SHS at home.

Educating health risks of tobacco use and smoking cessation technique for physical therapy students: A great start towards tobacco endgame

Educating health risks of tobacco use and smoking cessation technique for physical therapy students: A great start towards tobacco endgame

Myanmar’s first integrated social media campaign engaging millions of people in raising awareness on health risks of smokeless tobacco use

Myanmar’s first integrated social media campaign engaging millions of people in raising awareness on health risks of smokeless tobacco use

Evaluation of Perceptions of Tobacco Cessation among the Individuals Attending a Tertiary Care Dental Hospital - A Mixed Methods Design.

Introduction:In India every year, an estimated 1 million people die from tobacco-related illnesses, which could have been avoided by stopping tobacco use. This study aimed to determine the tobacco dependence and perceptions about tobacco cessation among the patients attending a tertiary care dental hospital. Methods:A mixed-methods study was conducted among the individuals visiting the dental hospital. Self-administered questionnaires were used to record quantitative data on the current and past tobacco history, tobacco dependence, and quit attempts. Face-to-face interviews were conducted to collect qualitative data on the perceptions on tobacco quitting. Results:About 52% of participants had made an attempt to quit tobacco in the past. The majority of the smokers (82.7%), smokeless tobacco (SLT) users (71.3%), and dual users (83.1%) reported being in the contemplation phase of quitting tobacco. SLT users (12.3%) reported to have taken action in the past to quit tobacco compared to 9.6% smokers, and 1.4% of dual users. Doctors advise, motivation from family and friends motivated the participants to quit tobacco. The risk perception of tobacco use was reported as death, cancer, dental diseases, systemic diseases like chest congestion, cough, tuberculosis, lung cancer, and general body weakness. However, some of the participants were unaware of the methods to quit tobacco, some had misconceptions that shifting to other forms of tobacco and alcohol could help in quitting, and considered SLT to be less harmful than smoking forms.Conclusion:Majority of the participants were willing to quit tobacco and had taken measures to quit in the past. There is a need to increase the awareness among the tobacco users about the health risk of tobacco use, and motivate them to utilize the existing cessation services available.

Use patterns of cigarettes and alternative tobacco products and socioeconomic correlates in Hong Kong secondary school students

Smoking is a major cause of health inequities. However, sociodemographic differences in adolescent tobacco use are unclear. In a territory-wide school-based anonymous survey in 2018/19, we investigated tobacco use and sociodemographic correlates in 33,991 students (mean age 14.8 ± 1.9 years) in Hong Kong. Tobacco use prevalence and current-ever use ratios by sociodemographic factors were calculated. Generalised linear mixed models were used in association analyses. Current use was highest for cigarettes (3.2%), closely followed by alternative tobacco products (3.0%). Current-ever use ratios were highest for heated tobacco products (HTPs, 0.60), followed by nicotine e-cigarettes (0.52), waterpipe (0.51), and cigarettes (0.35). Use prevalence and current-ever use ratios of all products showed curvilinear relations with perceived family affluence (P values < 0.01), being highest in the richest families. Tobacco use was also associated with more senior grades, the lowest parental education, and boys, but current-ever use ratios of HTPs and waterpipe were higher in girls (P values < 0.05). The results suggested that adolescent ever users of nicotine-containing alternative tobacco products were more likely to keep using them than cigarettes, and the richest adolescents were at the highest risks of tobacco use. Diverse tobacco control measures are needed to improve health equity, especially on alternative tobacco products.

Prevalence of Smoking among High School Students in Thimphu, Bhutan

Smoking is common among youths due to the increasing pace of modernization. It is also a major public health problem worldwide, causing preventable deaths and giving socio-economic burdens to society. Despite strict surveillance and the Tobacco Control Act of Bhutan, Bhutanese youths are increasingly found smoking. However, Bhutan has limited studies on smoking, particularly focusing on high school students. Thus, this study determined the prevalence of smoking among high school students of Thimphu, Bhutan. The self-structured questionnaires were distributed to a sample of 357 students determined using the Yamane formula. The result showed that the overall prevalence of smoking was 48.5%. More male students (63.6%) were found smoking than female students (28.3%). Students smoked different forms of tobacco products, such as cigarettes, cigars, hookah, and bidis, but commonly used tobacco product was cigarettes (63.4%). The most cited reasons for smoking were addiction, followed by peer pressure and outlook fashion. The risks of tobacco use are highest among those who start early and continue its use for a long period. Therefore, the early age of smoking initiation underscores the urgent need to intervene and protect high school students from falling prey to smoking addiction.

Diminished Effect of Smoking Intensity on African American and Latino Smokers’ Tobacco Risk Perception

Background: According to the Minorities’ Diminished Returns (MDRs), highly educated African American (AA) and Latino people remain at high risk of tobacco use. One hypothesis suggests that this high risk of tobacco use stems from AA and Latino people remaining unrealistically optimistic, resulting in the risks of tobacco use being discounted. Aims: To better understand the role of cognitive bias as a mechanism behind the high risk of smoking in highly educated minorities, we studied ethnic variation in the association between smoking intensity and perceiving oneself as a smoker among young American adult established current smokers. Methods: In this cross-sectional study, we used baseline data of 2,475 young adults (18-24 years) who were current established smokers. The data came from the Population Assessment of Tobacco and Health (PATH; 2013) study, a nationally representative survey in the US. The independent variable was smoking intensity. The dependent variable was not perceiving oneself as a smoker (probably due to optimistic cognitive bias and discounting the risk). Age, gender, and education were the covariates. Ethnicity was the moderator. Logistic regressions were used to analyze the data. Results: From the total number of 2,475 current smokers, 2106 (85.1%) perceived themselves-as a smoker, and 369 (14.9%) smokers perceived themselves as a non-smoker. A high level of smoking intensity was associated with lower odds of not perceiving oneself as a smoker. Two significant interactions were found between Latino and AA ethnicity and smoking intensity, suggesting that the effect of smoking intensity on perceiving oneself as a smoker is weaker in AAs than Whites and Latinos than non-Latinos. Conclusions:While tobacco use intensity is associated with a lower likelihood of optimistic cognitive bias and not perceiving oneself as a smoker, Latino and AA young adults who smoke many cigarettes a day are more likely than their non-Latino White counterparts with the same smoking risk not to perceive themself as a smoker. This finding suggests a psychological discounting of risk among AA and Latino smokers. Such cognitive bias may help them avoid cognitive dissonance and reduce their own perceived risk of cancer and other fatal conditions from smoking. A cognitive bias may increase the smoking burden of AA and Latino young adults through discounting smoking risk.