HealthDay News — Many adolescent users of one or more specific tobacco product type do not self-identify as tobacco users, according to a study published online in Pediatrics.

Israel Agaku, DMD, MPH, PhD, from the US Centers for Disease Control and Prevention in Atlanta, and colleagues examined tobacco-related self-identity and risk perceptions among 20,675 US sixth to 12th graders. Adolescents were classified as not self-identifying as tobacco users if they reported past 30-day use of a specific tobacco product or 2 or more products, but denied having used “any tobacco product” in the past 30 days.

Those denying having used any tobacco products included single-product users of roll-your-own and/or pipe tobacco (82.2%), electronic cigarettes (59.7%), cigars (56.6%), and cigarettes (26.5%). The researchers found that the odds of denying any tobacco product use were increased among those without vs those with symptoms of nicotine dependence (adjusted odds ratio, 2.16) and for those who access their tobacco products via social sources vs those who bought them (adjusted odds ratio, 3.81). Of those who believed “all tobacco products” were harmful, single product users of e-cigarettes, hookah, smokeless tobacco, and cigarettes believed their own product was not harmful (74.6%, 56.0%, 41.8%, and 15.5%, respectively).

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“Increasing the sensitivity of questions used to assess youth tobacco use in surveys and clinical settings can mitigate nondisclosure or underreporting of true tobacco use status,” the authors write.


Agaku I, Odani S, Vardavas C, Neff L. Self-indentified tobacoo use and harm perceptions among US youth [published online March 15, 2018]. Pediatrics. doi:10.1542/peds.2017-3523