Evidence map›Paper›PMID 40584776›Full record

ArticleTobacco prevention & cessation2025

Do perceptions of harm and addictiveness influence adolescent's willingness to use various tobacco and nicotine products?

Melissa A Little, Indika Mallawaarachchi, Asal Pilehvari, Ponni Velmurugan, Abigail G Wester, Kara P Wiseman

Abstract read
In one paragraph

Article in Tobacco prevention & cessation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Melissa A LittleDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States.
Indika MallawaarachchiDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States.
Asal PilehvariDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States.
Ponni VelmuruganDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States.
Abigail G WesterDivision of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, United States.
Kara P WisemanDepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States.

Funding

Women's Oncology Program - WONP30CA044579 · NCI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Thomas P. Loughran · 1987 to 2026
$72.1M
NCI NIH HHS P30 CA044579
6 · The paper itself

Abstract

introductionThe Theory of Reasoned Action has been widely used to explain adolescent tobacco and nicotine product (TNP) use, focusing on intentions and subjective norms. However, the 'reactive pathway', emphasizing situational influences and willingness to use, better predicts TNP use in adolescents. While prior research has examined willingness for cigarettes and e-cigarettes, its application to the broader range of available TNPs is limited. This study investigates adolescent characteristics across varying levels of TNP use willingness. We hypothesized that perceived harm and addictiveness would be associated with willingness to use tobacco.

methodsSecondary school students aged 14-15 years (n=348) completed a survey that assessed demographics and TNP use history, willingness to use TNPs, peer use, and perceived harm and addictiveness of TNPs. Descriptive statistics were used to characterize the population overall and by willingness to use TNPs. Multivariable logistic regression models estimated associations between TNP-specific willingness to use, gender, race, ethnicity, and peer use with TNP-specific perceived harm and addictiveness.

resultsAcross the TNPs, 22.1% were current users, 23.3% were willing non-users and 54.7% were non-willing non-users. Significant differences in perceived harm by willingness were for cigarettes, e-cigarettes, and hookah, while perceptions of addictiveness varied by willingness group for all TNPs with the exception of cigarillos (all p<0.05). Willing non-users had lower odds of perceived addictiveness (smokeless tobacco, OR=0.29; 95% CI: 0.11-0.81; cigar, OR=0.33; 95% CI: 0.15-0.70) and harm (e-cigarettes, OR=0.38; 95% CI: 0.19-0.76; pipe, OR=0.41; 95% CI: 0.17-0.98; cigarillos/little cigars, OR=0.34; 95% CI: 0.12-0.92; cigars, OR=0.24; 95% CI: 0.11-0.54) compared to non-willing non-users.

conclusionsAdolescents have varying levels of susceptibility to using TNPs. In order to develop effective interventions for adolescents, the diverse range of available TNPs with specific risks and appeal need to be considered.

Indexed as

adolescentscessationpreventionsusceptibilitytobacco and nicotine productswillingness

Identifiers

PMID40584776
PMCPMC12203247

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.