Tobacco industry inoculation and young adult smoking: A national study

Significance: Young adults have the highest smoking prevalence of any age group in the USA. Data from California suggests that tobacco industry denormalization is negatively associated with smoking among young adults. Objective: Examine the relationship between attitudes reflecting inoculation against the tobacco industry and smoking and quitting behaviors among young adults. Methods: Cross sectional national survey of 1528 young adults (age 18-25) from a web-enabled panel maintained by the research group Knowledge Networks. The panel is derived from a random digit dialing sample for better generalizability than convenience internet samples. Results: 28.9% of young adults surveyed were current smokers by the adult definition (smoked 100 cigarettes in lifetime and now smoke every day or some days) and 30.8% were current smokers by the teen definition (smoked in the past 30 days). Among demographic variables, older age was associated with current smoking, while higher education, and African American/Hispanic race/ethnicity were negatively associated with current smoking. Inoculation against the tobacco industry was strongly negatively associated with current smoking (adjusted OR=0.38, 95% CI [0.24, 0.60] for current smoking by adult definition, OR=0.34 [0.22, 0.52] for teen definition). Inoculation against the tobacco industry was also strongly associated with intentions to quit smoking (adjusted OR= 5.54 95% CI [2.79, 11.01]). Conclusions: This study provides national confirmation that tobacco industry inoculation is strongly negatively associated young adult smoking. Media campaigns that denormalize the tobacco industry and appeal to young adults may be a useful intervention to decrease young adult smoking.