Perceptions about Established and Emerging Tobacco Products: Results from Eight Focus Groups with Young Adults

Background: Young adults are targets for tobacco product purchase and consumption. As product lines expand, young adults may be more susceptible to multiple influences, including peers, family and advertising. Method: Researchers conducted eight focus groups with 67 participants mostly 18-24 years old. Participants included users and non-users, residing in rural and urban areas, and in states with tobacco ordinances and without. Participants provided feedback about knowledge, beliefs and attitudes concerning tobacco products and media. Results: Participants reported knowledge and perceptions about a wide range of tobacco products. They were unclear about the relative harmful effects of smokeless tobacco, hookah, chew, and nicotine replacement products. Only minor differences in tobacco-related knowledge, beliefs and attitudes were found among urban and rural participants and those in ordinance and non-ordinance states. Differences were found between user and non-user groups. Users had a sense of invincibility and rationalized about the possibility of negative health outcomes especially related to smokeless tobacco, hookah and chew. Some users showed interest in quitting, but peer influence, product availability, freedom of choice and unclear potential harm from alternatives hindered cessation. While choosing not to use, many non-users respected the choices of their peers and family members who used tobacco products. Conclusions: Young adults are knowledgeable about traditional tobacco products, however new tobacco products or emerging tobacco trends such as snus or hookah are less understood by young adults. Tobacco prevention and cessation information directed at young adults should include information on the dangers of these products.