206967 Role of outcome expectancies among smokeless tobacco users: A qualitative approach

Monday, November 9, 2009

Jamie K. Lok, MPH, CHES , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Eva Sharma, MPH , School of Public Health, University of Maryland, College Park, MD
Pamela I. Clark, PhD , School of Public Health, University of Maryland, College Park, MD
Jessica Miller Rath, PhD, MPH, CHES , School of Public Health, University of Maryland, College Park, MD
Objective: To understand the role of expectancies of smokeless tobacco (ST) use among adult users.

Background: Expectancies, the anticipated effects of a behavior, have been found to strongly influence behavioral decisions. Studies suggest that positive expected outcomes (e.g., stress reduction, physical enjoyment) are stronger predictors of tobacco use than negative expected outcomes (e.g., health consequences, unkempt image). While the outcome expectancies of smoking associated with cigarette use have been studied, the relationship needs to be further examined for ST use.

Methods: Semi-structured in-depth interviews were conducted with male ST users (n=11) who participated in a randomized, single-blind, cross-over pilot study of two smokeless, spitless, tobacco products. The interviews captured participants' views and experiences with ST. One trained study staff member performed each interview to avoid inter-interviewer bias. MAXQDA was used to code emergent themes and analyze data.

Results: Interviewees' expectancy beliefs about ST were influenced by convenience (ability to use in public areas), ability to conceal use, safety (lower perceived health risk than cigarettes), physical satisfaction, craving relief, social desirability, peer and familial use, participation in team sports, and negative consequences.

Conclusions: In this sample, convenience and safety were the most commonly cited outcome expectancies of using ST. Increasing public smoking bans and promotion of ST as potentially reduced-harm product highlights the need for research on ST. The results of this study will provide guidance in instrument-development to be applied to a survey of ST users.

Learning Objectives:
1. Identify one reason for the increase of ST use. 2. Describe at least two positive outcome expectancies of ST use. 3. Describe at least one negative expectancy of ST use.

Keywords: Tobacco, Spit Tobacco

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: MPH, May 2009, University of Maryland School of Public Health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.