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The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey

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Abstract

Dual use of conventional cigarettes and electronic cigarettes presents an emerging public health issue. Previous research has demonstrated a negative relationship between health literacy and conventional cigarette (CIG) use. However, the relationship between health literacy and e-cigarette (ECIG) use remains unclear. This studies examines the possible association of health literacy and CIG, ECIG, or dual use. A multinomial regression was used to model the association between health literacy and current CIG use, current ECIG use, or dual tobacco use status using state-optional data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 40,404). One-third of the sample (N = 13,478; 33.3%) had initiated tobacco use. Approximately 36.6% of participants exclusively used cigarettes. A smaller proportion of participants were dual users of ECIG and CIGs (7.0%) and e-cigarette exclusive users (4.5%). After adjusting for covariates, higher levels of oral health literacy was associated with lower odds of current dual use. However, there was no significant association between written HL and either conventional cigarette use or electronic cigarette use or after adjusting for covariates. Oral messaging around the dangers of CIG use may be effective at lowering odds of CIG or dual use, especially for those with higher levels of HL. Further research is needed to examine how to best disseminate information regarding the health risks of ECIGs.

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Authors and Affiliations

  1. Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, 23298-0212, USA

    James S. Clifford, Juan Lu, Courtney T. Blondino & Elizabeth C. Prom-Wormley

  2. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA

    Elizabeth K. Do

  3. VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Elizabeth K. Do

  4. Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA

    Elizabeth C. Prom-Wormley

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  1. James S. Clifford
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  2. Juan Lu
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Correspondence to James S. Clifford.

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Clifford, J.S., Lu, J., Blondino, C.T. et al. The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey. J Community Health 47, 63–70 (2022). https://doi.org/10.1007/s10900-021-01019-7

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  • DOI: https://doi.org/10.1007/s10900-021-01019-7

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