This clinical trial studies the health perceptions and social behaviors of Ohio State University (OSU) graduate students to develop an interactive, social norms-based approach that is effective in communicating the addictive risks of oral nicotine pouches (ONPs). The use of ONPs is rising rapidly among young adults (YA). Various factors contribute to the growing popularity of ONPs, including their affordability, accessibility both online and in physical stores, discreet use, and heavy internet advertising. However, for those who are experimenting, have tried ONPs in the past, or have never used them but are surrounded by others who do, factors like affordability and availability may not be the only reasons for initiating or continuing use. Social norms are also a significant factor influencing YA tobacco use. Peer influence on college campuses and in other social environments may encourage YA to conform to behaviors they perceive as popular or acceptable. Being surrounded by peers who use ONPs may create pressure to try them, especially as YA seek to fit in within their social circles. Studying the health perceptions and social behaviors of OSU graduate students may help researchers develop an interactive, social norms-based approach that is effective in communicating the addictive risks of ONPs.
AIM 1: OSU graduate students aged 21 years or older
AIM 2 AND 3: Students identified in Aim 1 as susceptible to ONPs, having experimented with ONPs, or currently using ONPs-those considered at high risk for nicotine dependence-will be invited to participate in Aim 2 or Aim 3
AIM 3: Participants in Aim 2 will not be invited to participate in Aim 3, as they will have already been exposed to the experimental stimuli
None
Parallel
Preventive Intervention
Other interventionView social norm-based ONP messages
Preventive Intervention
Other interventionView static visual ONP risk messages
Preventive Intervention
Other interventionView dynamic visual ONP risk messages
Survey Administration
Other interventionAncillary studies
Susceptibility to Oral Nicotine Pouch Use (Three Item Susceptibility Scale) (Aim 1)
Susceptibility will be measured using the Three Item Susceptibility to Oral Nicotine Pouch Use Scale, a validated three-item measure assessing the likelihood of trying oral nicotine pouches in the future (e.g., "Would you try an ONP if offered by a friend?"). Each item will be rated on a 4 point Likert type scale with response options: Definitely yes, Probably yes, Probably not, and Definitely not. Responses will be coded from 1 (Definitely not) to 4 (Definitely yes) and averaged to create a composite susceptibility score, with possible values ranging from 1 to 4. Higher scores indicate greater susceptibility to ONP use.
Perceived Harm of Oral Nicotine Pouches (Three Item Comparative Harm Perceptions of Oral Nicotine Pouches Scale) (Aim 1)
Perceived harm of oral nicotine pouches will be measured using the Comparative Harm Perceptions of Oral Nicotine Pouches Scale, a three item measure assessing whether nicotine pouches are more or less harmful compared to cigarettes, e cigarettes, and coffee. Each item uses a 5 point response scale from 1 (A lot less harmful) to 5 (A lot more harmful). Responses will be averaged to create a composite comparative harm score with possible values ranging from 1 to 5. Higher scores indicate greater perceived harm of ONPs relative to the comparison product (worse outcome).
Descriptive Norm Perceptions of Oral Nicotine Pouch Use (Six Category Perceived Prevalence Scale) (Aim 1)
Descriptive norms will be assessed using the Six Category Descriptive Norm Perceptions of Oral Nicotine Pouch Use Scale, which measures the perceived prevalence of ONP use across four referent groups: young adults of the participant's age in the U.S., graduate students at the institution, graduate students within the participant's program, and the participant's friends. Each item employs a six-category response scale: None (0%), Few (1% to 20%), Less than half (21% to 40%), Around half (41% to 60%), More than half but not all (61% to 80%), and Most or nearly all (81% to 100%). Responses will be coded from 1 (None, 0%) to 6 (Most or nearly all, 81% to 100%) and averaged to generate a composite descriptive norm score with potential values from 1 to 6. Higher scores reflect a higher perceived prevalence of ONP use.
Injunctive Norm Perceptions of Oral Nicotine Pouch Use (Seven Point Approval Scale) (Aim 1)
Injunctive norms will be measured using the Seven Point Injunctive Norm Perceptions of Oral Nicotine Pouch Use Scale, which assesses perceived approval of ONP use across four referent groups: young adults the participant's age in the U.S., graduate students at the institution, graduate students within the participant's program, and the participant's friends. For each referent group, participants will answer: "Do they think it is a good idea to use nicotine pouches?" using a seven-point response scale: Not at all, Slightly, Somewhat, Neutral, Moderately, Quite a bit, and Very much so. Responses will be coded from 1 (Not at all) to 7 (Very much so) and averaged to create a composite injunctive norm score with possible values ranging from 1 to 7. Higher scores indicate greater perceived approval of ONP use.
Tobacco Use History (Self Report Questionnaire) (Aim 1)
Participants will report past and current use of tobacco products, including oral nicotine pouches (ONPs) and other tobacco/nicotine products. Data will include categorical indicators of ever use, past 30 day use, frequency, and product types.
Sociodemographic Characteristics (Aim 1, Aim 2, Aim 3)
Participants will provide demographic data, including age, gender, race/ethnicity, educational program, and other demographic characteristics.
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Ohio State University Comprehensive Cancer Center
Lead sponsor
National Cancer Institute (NCI)
Collaborator
