Tobacco normalization and combustible smoking susceptibility among youth in Louisiana

PURPOSE: Louisiana youth experience higher tobacco utilization compared to national estimates (16.2% vs. 10.2%). Tobacco normalization could contribute to elevated smoking prevalence among Louisiana youth. This research investigates how beliefs surrounding tobacco normalization relate to youths susceptibility to smoking combustible tobacco. METHODS: Cross sectional data from the 2011 Louisiana Youth Tobacco Survey was analyzed, including 2,412 students from public middle and high schools. Susceptibility to smoking combustible tobacco was defined by 3 categories: non-smoking, non-susceptible; non-smoking, susceptible; ever smoker. Six variables were identified as beliefs describing tobacco normalization. Multinomial logistic regression was used to determine if tobacco normalization beliefs differed based on susceptibility to smoking. Gender interaction was identified, separate models were computed and a Chow test performed. RESULTS: Among the male population, non-smoking, susceptible students were more likely to be White and see tobacco use in TV/movies compared to their non-smoking, non-susceptible counterparts (p=0.037, 0.024). Among the female population, non-smoking, susceptible and ever smokers were more likely to think smokers have more friends and to see tobacco use in TV/movies compared to their non-smoking, non-susceptible counterparts (p=0.003, 0.023). Non-smoking, susceptible and ever smokers of both genders were more likely to use/wear products from a tobacco company than non-smoking, non-susceptible students (p<0.0001, <0.0001, <0.0001, <0.0001). Ever smokers of both genders were more likely to think smoking is cool than students in the other groups (p=0.005, 0.006). CONCLUSION: Beliefs surrounding tobacco normalization differ based on susceptibility to smoking, gender and race. Prevention campaigns should tailor anti-normalization messages to specific demographic groups.