Parent, peer, and social factors associated with youth's inconsistent information in reporting tobacco use

Self-reported tobacco use among youth often diverges from biomarker indicators raising concerns about the accuracy of surveillance estimates. However, few studies have examined factors associated with the inconsistencies. Guided by Bristol and Mangleburg's model of youth information disclosure, this study assessed parent, peer, and social correlates of inconsistency between self-reported tobacco use and biomarker-verified nicotine exposure.

Data were drawn from Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health Study. Youth aged 13-17 who self-reported no tobacco use in the past 7 days and had valid urinary cotinine data were included (unweighted N = 1659; weighted N = 22,867,704). Inconsistency was defined as cotinine levels above sex-specific thresholds (≥11.85ng/mL for males; ≥7.18ng/mL for females) despite reporting no tobacco use in the past 7 days. Confirmatory factor analysis was used to construct latent parent, peer, and social factors. Weighted logistic regression assessed associations between predicted scores of these factors and inconsistent reporting.

Approximately 19.5% of participants showed biomarker-indicated nicotine exposure inconsistent with self-reported abstinence. Higher parent factor scores, reflecting adolescents' perception of non-negative parental communication about tobacco use, were associated with lower odds of inconsistent reporting (OR=0.74, p < 0.05). Peer and social factors were not significantly associated with reporting inconsistency.

Non-negative parental communication was significantly associated with reduced inconsistency in tobacco use reporting. This finding underscores the importance of incorporating family context into youth tobacco surveillance and prevention efforts. Longitudinal research is needed to clarify the causal influence of interpersonal and environmental factors on reporting inconsistency.