Acculturation, Measurement Approaches, and Associations with Commercial Tobacco and Nicotine Use Patterns Among Hispanic Youth and Young Adults
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proxy indicators achieved perfect response rates and moderate conceptual alignment with SMAS, yet SMAS‑derived acculturation styles showed consistently stronger predictive performance across product outcomes. These findings support a dual‑measurement strategy in which low‑burden proxy measures are used for population surveillance, while multidimensional scales are reserved for studies requiring deeper cultural specificity. Essay Two extends this work by shifting from dichotomous outcomes to an ordinal measure of frequency of use. Using generalized ordered logistic regression, this study examines the association between acculturation styles and frequency of e‑cigarette, nicotine pouch, cigarette, and cigar use among current users. Findings reveal that Hispanic respondents in the integration and marginalization acculturation style groups have the highest odds of more frequent nicotine pouch and cigar use, while the separation style shows a protective pattern across several products. Household tobacco use emerged as a strong contextual risk factor independent of acculturation style, underscoring the importance of family environments in shaping escalation trajectories. Together, these studies demonstrate that acculturation influences not only whether Hispanic youth and young adults engage in commercial tobacco and nicotine use, but also how frequently they use these products. The dissertation advances acculturation measurement science, uses frequency‑based modeling in Hispanic tobacco research, and identifies cultural and contextual subgroups at heightened risk for escalating use patterns. These contributions have direct implications for public health surveillance, culturally informed prevention strategies, and equity‑focused policy development. By improving measurement precision and highlighting within‑group heterogeneity, this work lays a foundation for interventions and policies that more effectively address tobacco‑related disparities among Hispanic youth and young adults.
however, research and surveillance often treat this group as culturally homogeneous. Acculturation, a multidimensional process that affects how individuals engage with both their culture of origin and the dominant U.S. culture, has been identified as an important determinant of substance use risk, including commercial tobacco and nicotine product use. However, research on acculturation effects on tobacco and nicotine use among Hispanic youth and young adults remains limited by inconsistent measurement strategies, a focus on cigarette smoking rather than emerging products, and an emphasis on likelihood rather than frequency of use. This dissertation addresses these gaps through two empirical studies designed to evaluate acculturation measurement approaches and examine how acculturation relates to both product‑specific use and frequency of use across multiple commercial tobacco and nicotine products.Essay One compares a validated multidimensional acculturation scale, the Stephenson Multigroup Acculturation Scale (SMAS), with commonly used proxy measures, including US-Generation, nativity (US-born status), and region of origin. Using data from an online cross‑sectional sample of Hispanic youth and young adults reporting past‑30‑day tobacco use, Essay One evaluates response rates, conceptual alignment with SMAS‑derived acculturation styles, and predictive validity for four tobacco products (e‑cigarettes, nicotine pouches, cigarettes, cigars) and poly‑tobacco use. Results demonstrate a fundamental trade‑off
Hispanic youth and young adults represent the largest minority group in the United States and are a culturally diverse population
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