PT - JOURNAL ARTICLE AU - Agaku, Israel AU - Odani, Satomi AU - Vardavas, Constantine AU - Neff, Linda TI - Self-Identified Tobacco Use and Harm Perceptions Among US Youth AID - 10.1542/peds.2017-3523 DP - 2018 Apr 01 TA - Pediatrics PG - e20173523 VI - 141 IP - 4 4099 - http://pediatrics.aappublications.org/content/141/4/e20173523.short 4100 - http://pediatrics.aappublications.org/content/141/4/e20173523.full SO - Pediatrics2018 Apr 01; 141 AB - BACKGROUND: We investigated tobacco-related self-identity and risk perceptions among adolescent tobacco users.METHODS: Data were analyzed for 20 675 US sixth- to 12th-graders from the 2016 National Youth Tobacco Survey. Students who reported past-30-day use of a specific tobacco product or ≥2 products but denied having used “any tobacco product” in the past 30 days were classified as not self-identifying as tobacco users. Tobacco product harm perceptions were further assessed across products. Descriptive and multivariable logistic regression analyses were performed.RESULTS: Among past-30-day users of ≥1 specific tobacco product type, those denying having used any tobacco products in the past 30 days included single-product users of roll-your-own and/or pipe tobacco (82.2%), electronic cigarettes (e-cigarettes) (59.7%), cigars (56.6%), hookah (44.0%), smokeless tobacco (38.5%), and cigarettes (26.5%) as well as poly-tobacco users (12.7%). The odds of denying using any tobacco products were higher among those without symptoms of nicotine dependence than those with symptoms (adjusted odds ratio = 2.16); and those who access their tobacco products via social sources than those who bought them (adjusted odds ratio = 3.81; all P < .05). Among those believing “all tobacco products” were harmful, single-product users of the following believed their own product was not harmful: e-cigarettes (74.6%), hookah (56.0%), smokeless tobacco (41.8%), and cigarettes (15.5%).CONCLUSIONS: Many of those who used certain tobacco products exclusively did not self-identify as tobacco users. 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.