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Zhao S, Li Z, Zhang L, Yu Z, Zhao X, Li Y, Zhu J. The characteristics and risk factors of e-cigarette use among adolescents in Shanghai: A case-control study. Tob Induc Dis 2023; 21:83. [PMID: 37342865 PMCID: PMC10277906 DOI: 10.18332/tid/166131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/26/2023] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION This study was conducted to explore the characteristics and risk factors of e-cigarette use in adolescents, aiming for tobacco control and reducing e-cigarette use in this population. METHODS Using 1:1 matching, 88 students from three vocational high schools in Shanghai were recruited to conduct a case (using e-cigarettes) - control (not using e-cigarettes) study. Group interviews and questionnaire surveys were used for this qualitative and quantitative mixed-methods study. The keywords were extracted from the interview data and analyzed by the Colaizzi seven-step method. RESULTS The characteristics of adolescents' use of e-cigarettes include young age at first use, consumption of a large amount, as well as smoking in discrete locations in order to hide from adults. The reasons for using e-cigarettes include curiosity and wanting to replace traditional cigarettes. The risk factors of using e-cigarettes include insufficient understanding of the harm of e-cigarettes at the individual level (The positive outcome expectancy points: Z= -3.746, p<0.001; The negative outcome expectancy points: Z= -3.882, p<0.001), peer influence at the interpersonal level (χ2=6.510, p<0.01), and the influence of social and environmental factors such as e-cigarette sales in the stores and WeChat Moments (p<0.05 for all associations). CONCLUSIONS Having friends who use e-cigarettes, curiosity and sales exposure about e-cigarettes are important factors affecting the use of e-cigarettes by adolescents. It is necessary to strengthen the publicity of the potential hazards of e-cigarettes and to reduce overall usage by improving relevant laws and regulations.
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Affiliation(s)
- Suizi Zhao
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Ziyan Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Lulu Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Florida, United States
| | - Xixuan Zhao
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Jingfen Zhu
- Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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2
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Thoonen KAHJ, Jongenelis MI. Perceptions of e-cigarettes among Australian adolescents, young adults, and adults. Addict Behav 2023; 144:107741. [PMID: 37121085 DOI: 10.1016/j.addbeh.2023.107741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
Increases in e-cigarette use are of concern to public health authorities given the harms associated with vaping. Understanding people's perceptions of the risks and benefits of e-cigarette use has the potential to assist with prevention efforts. However, research assessing the perceptions of Australian adolescents and any differences in perceptions between adolescents, young adults, and adults is limited. Additionally, research exploring perceptions of various types of e-cigarettes is lacking. To inform the development of prevention and intervention programs and policies, this study aimed to explore Australians' perceptions of the risks and benefits associated with e-cigarette use and whether perceptions differ by age and user status. A sample of 4,617 Australians aged 12 + years completed an online survey that assessed (i) smoking and e-cigarette user status, (ii) e-cigarette risk perceptions, (iii) beliefs about e-cigarettes as a smoking cessation tool, and (iv) positive e-cigarette outcome expectancies. Across all age groups, respondents perceived non-nicotine and flavoured e-cigarettes as less harmful than nicotine e-cigarettes. Significantly more adolescents and young adults than adults held positive outcome expectancies, and a substantial minority of non-users and never users in all age groups believed that using e-cigarettes confers social and mental health benefits. Given the potential benefits they perceived to be associated with e-cigarette use, a substantial proportion of adolescent and young adult never users may be vulnerable to initiation. These findings highlight the importance of (i) adequately communicating the risks associated with non-nicotine e-cigarette use and (ii) addressing misperceptions about use, especially among youth.
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Affiliation(s)
- Karlijn A H J Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia.
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3
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Alanazi AMM, Alqahtani MM, Wells JM, Lein DH, Hendricks PS. Outcome Expectancies and Resistance Self-Efficacy Mediate the Relationship Between Asthma Diagnosis and E-cigarette Use among Youth and Young Adults. J Asthma 2022; 60:1088-1096. [PMID: 36197727 DOI: 10.1080/02770903.2022.2132955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Introduction: The use of electronic cigarettes (e-cigarettes) may exacerbate pulmonary complications in youth and young adults with asthma. We sought to identify the cognitive mechanisms that might explain e-cigarette use in this population. We hypothesized that e-cigarette outcome expectancies and e-cigarette resistance self-efficacy would mediate the relationship between asthma diagnosis and e-cigarette use in youth and young adults. Methods: We enrolled youth and young adults (15-25 years old) in Alabama with a clinical diagnosis of asthma (n = 130) or without a diagnosis of any chronic pulmonary disease (n = 115; reference group). Author-constructed and validated questionnaires (young adult e-cigarette use outcome expectancies and modified Self-efficacy Scale for Adolescent Smoking) were administered to collect demographic data and assess susceptibility to e-cigarette use as well as current use of e-cigarettes, e-cigarette outcome expectancies, and e-cigarette resistance self-efficacy. We then conducted structural equation modeling to test whether e-cigarette expectancies and e-cigarette resistance self-efficacy mediate the relationship between asthma and susceptibility to e-cigarette use as well as current e-cigarette use. Results: The frequency of the susceptibility to e-cigarette use and current e-cigarette use was lower among those with clinically diagnosed asthma than among those without asthma (35.8% vs 59.8% for susceptibility and 6.0% vs 18.2% for current use). Individuals with asthma reported weaker expectancies that e-cigarettes would make them feel relaxed which, in turn, was a significant predictor of lower susceptibility to e-cigarette use and current e-cigarette use, suggesting mediation. Finally, individuals with asthma demonstrated greater e-cigarette resistance self-efficacy in the context of social opportunities and friends' influence to use e-cigarettes. This self-efficacy was associated with lower susceptibility to e-cigarette use as well as current e-cigarette use. Conclusion: Although longitudinal studies are needed to determine relationships prospectively, targeted interventions that reduce outcome expectancies and increase resistance self-efficacy to e-cigarette use may further reduce e-cigarette use among youth and young adults with asthma.
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Affiliation(s)
- Abdullah M M Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed M Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.,Rehabilitation Science, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL
| | - J Michael Wells
- Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Donald H Lein
- Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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4
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Noar SM, Gottfredson NC, Kieu T, Rohde JA, Hall MG, Ma H, Fendinger NJ, Brewer NT. Impact of Vaping Prevention Advertisements on US Adolescents: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2236370. [PMID: 36227597 PMCID: PMC9561946 DOI: 10.1001/jamanetworkopen.2022.36370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022] Open
Abstract
Importance Understanding whether prevention advertisements reduce susceptibility to vaping is important owing to concerning levels of adolescent vaping. Objective To examine whether vaping prevention advertisements from the US Food and Drug Administration (FDA) national Real Cost campaign lead to lower susceptibility to vaping among adolescents. Design, Setting, and Participants For this 3-group randomized clinical trial with parallel assignment, participants were US adolescents aged 13 to 17 years who were susceptible to vaping or current e-cigarette users, recruited from online panels. Adolescents were randomized to 1 of 2 Real Cost vaping prevention trial groups (health harms- or addiction-themed advertisements) or to a control group (investigator-created neutral videos about vaping). Adolescents completed 4 weekly online surveys at visits 1 to 4 over a 3-week period. Data were analyzed from December 1, 2021, to August 25, 2022. Interventions Adolescents saw 3 randomly ordered 30-second video advertisements online at each of 3 weekly study visits (visits 1, 2, and 3). Main Outcomes and Measures The primary trial outcome was susceptibility to vaping. Surveys also assessed susceptibility to smoking cigarettes to examine any spillover effects of vaping prevention advertisements on smoking outcomes. Both susceptibility measures had 3 items and ranged from 1 (indicating not susceptible) to 4 (indicating highly susceptible). The primary analyses compared Real Cost groups (combined) with the control group, while exploratory analyses compared the Real Cost groups with each other. Results Participants were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years), including 504 randomized to the Real Cost health harms group, 506 randomized to the Real Cost addiction group, and 504 randomized to the control group. Adolescents in the Real Cost groups (combined) had lower susceptibility to vaping at visit 4 than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). The Real Cost groups did not differ from one another on susceptibility to vaping (visit 4: b = -0.05; 95% CI, -0.17 to 0.07). Adolescents in the Real Cost groups (combined) also had lower susceptibility to smoking cigarettes than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). For both vaping and smoking, Real Cost groups had less positive attitudes (vaping: b = -0.27; 95% CI, -0.40 to -0.14; smoking: b = -0.23; 95% CI, -0.39 to -0.08) compared with the control group. Conclusions and Relevance These findings suggest that vaping prevention advertisements from the FDA Real Cost campaign led to lower adolescent susceptibility to vaping and had beneficial spillover effects on cigarette smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco use. Trial Registration ClinicalTrials.gov Identifier: NCT04836455.
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Affiliation(s)
- Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | - Nisha C. Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Talia Kieu
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Jacob A. Rohde
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill
| | - Marissa G. Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
- Carolina Population Center, University of North Carolina, Chapel Hill
| | - Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
| | | | - Noel T. Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
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5
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Gaddy MY, Vasquez D, Brown LD. Predictors of e-cigarette initiation and use among middle school youth in a low-income predominantly Hispanic community. Front Public Health 2022; 10:883362. [PMID: 36238238 PMCID: PMC9551350 DOI: 10.3389/fpubh.2022.883362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction E-cigarette use among middle and high school youth increased from 2. 5 million in 2014 to 9.2 million in 2019, becoming the most common tobacco product used among youth. Hispanic youth, the largest ethnic minority in the United States, have higher rates of tobacco use, including e-cigarettes, than non-Hispanics. Identifying factors that put youth at risk for future e-cigarette use is vital to focusing prevention efforts. Informed by social cognitive theory, this study identifies predictors of e-cigarette uptake among e-cigarette naïve youth in a predominantly low-income Hispanic community. Methods 1,249 students (6-8th grades) from two middle schools in El Paso, Texas consented to participate in this longitudinal survey during the 2016-2017 school year. The study sample for analysis was restricted to e-cigarette naïve students (n = 862). Outcome measures were e-cigarette initiation and current use at follow-up. Logistic regression models tested six hypotheses about predictors of e-cigarette initiation and current use: (1) intention, (2) outcome expectations, (3) knowledge, (4) friendship network exposure, (5) normative beliefs, and (6) social acceptability. Results Among e-cigarette naïve students at baseline, 8% (n = 71) reported initiation at follow-up; of these, 3% (n = 23) reported current use. Significant predictors of initiation were intention (AOR = 2.46; 95% CI 1.69-3.59; p < 0.001), outcome expectations (AOR = 1.73; 95% CI 1.14-2.61; p = 0.009), friendship network exposure (AOR = 1.53; 95% CI 1.11-2.11; p =0.01), normative beliefs (AOR = 2.12; 95% CI 1.47-3.08; p < 0.001), and social acceptability (AOR = 1.91; 95% CI 1.28-2.85; p = 0.002). Significant predictors of current use were intention (AOR = 1.98; 95% CI 1.07-3.69; p = 0.03) and friendship network exposure (AOR = 1.69; 95% CI 1.06-2.70; p = 0.03). Conclusions With the increasing popularity of e-cigarettes, age appropriate and culturally sensitive prevention strategies tailored at altering these predictive factors are essential in preventing future e-cigarette use.
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Affiliation(s)
- M. Yvonne Gaddy
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, El Paso, TX, United States
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6
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Pokhrel P, Phillips KT, Tam H, Kawamoto CT, Nakama M, Kaholokula JK. Ethnicity and the mechanisms of point-of-sale e-cigarette marketing's influence on behavior: A longitudinal study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:452-465. [PMID: 34570528 PMCID: PMC9232211 DOI: 10.1037/adb0000784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: To test the mechanisms by which exposure to point-of-sale (POS) e-cigarette marketing mediate the relationship between an ethnic minority group highly vulnerable for tobacco product use, namely Native Hawaiian/Other Pacific Islander (NHPI), and increased future e-cigarette use through explicit (positive outcome expectancies) and implicit (spontaneous positive reactions) pathways. Method: Four waves of data were collected in 6-month intervals from 2,327 multiethnic young adults (Mage = 21.2, SD = 2.2; 54% women) enrolled across two 4-year and four 2-year colleges belonging to a University system in Hawaii. POS e-cigarette marketing exposure was assessed with an objective measure involving store visit patterns and store audits, as well as a measure of self-reported exposure. Spontaneous reactions were assessed with an implicit measure, namely Affect Misattribution Procedure (AMP). Path analyses were used to test the hypotheses. Results: In a model employing the objective measure of POS exposure, a statistically significant pathway was found from NHPI ethnicity to increased current e-cigarette use at Wave 4 mediated through increased POS exposure at Wave 2, and increased affect regulation expectancies at Wave 3. Similar indirect effects on prospective e-cigarette use were found for Asian ethnicity. The dual process model of the effects of POS exposure on e-cigarette use was not fully supported, although the implicit measure was found to independently predict e-cigarette use. Conclusions: Differential exposure to POS marketing may explain some of the ethnic disparities in tobacco product use behavior such as e-cigarette use. POS marketing may affect e-cigarette use behavior mainly through the explicit pathway, notably affect regulation expectancies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | - Hollis Tam
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Crissy T. Kawamoto
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Mark Nakama
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
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McLeish AC, Hart JL, Wood LA, Walker KL. Differences in young adults' perceptions of e-cigarettes by history of use. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-5. [PMID: 35882085 PMCID: PMC9877241 DOI: 10.1080/07448481.2022.2103375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 05/04/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Objective: The current study examined group differences in college students' views on e-cigarettes in terms of safety, popularity, health risks, social acceptability, efficacy as a cessation aid, and promoting combustible cigarette use. Participants: 337 undergraduates (Mage = 20.84, SD = 3.79; 72.1% female; 68.5% White) divided into three groups: Never Users (n = 178), Ever Users (n = 108), and Current Users (n = 51). Methods: Participants completed questionnaires for course credit. Results: Compared to Ever and Never Users, Current Users believed e-cigarettes were safer, healthier, a useful tool to quit smoking, did not lead to combustible cigarette smoking, and that nicotine was less dangerous. Current Users also were less likely to endorse boosting social image as a motive for use. Conclusions: Public health campaigns could benefit from targeting current users' positive beliefs about e-cigarettes to reduce the prevalence of e-cigarette use among college students.
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Affiliation(s)
- Alison C. McLeish
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX
| | - Joy L. Hart
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX
- Department of Communication, University of Louisville
| | - Lindsey A. Wood
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- Department of Epidemiology, University of Louisville
| | - Kandi L. Walker
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX
- Department of Communication, University of Louisville
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8
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Holt LJ, Ginley MK, Pingeon C, Feinn R. Primed for positive perceptions? Applying the acquired preparedness model to explain college students' e-cigarette use and dependence. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-11. [PMID: 35816741 DOI: 10.1080/07448481.2022.2089846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 05/06/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE College students use electronic nicotine delivery systems (ENDS) more often than any other US demographic group. In a novel application of the acquired preparedness model, we examined how proximal (e.g., cognitions) and distal (e.g., dispositional) influences accounted for ENDS use and dependence. PARTICIPANTS Undergraduates (N = 1075; 72% female, 74% White) from seven US campuses completed an online survey between October 2019-March 2020. METHODS We modeled ENDS use and dependence, respectively, as zero-inflated Poisson distributions with impulsivity as an independent variable and perceived risks and benefits of e-cigarettes as mediators. RESULTS Students higher in impulsivity perceived more benefits and, in turn, reported greater ENDS use and dependence. Curiosity and friends' use motivated ENDS initiation; stress management and nicotine motivated continued use. CONCLUSIONS ENDS interventions should be tailored to students higher in impulsivity, as they hold more favorable perceptions of ENDS, and should enhance skills to manage stress and nicotine cravings.
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Affiliation(s)
| | | | | | - Richard Feinn
- Frank H. Netter School of Medicine, Quinnipiac University, Hamden, Connecticut, USA
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Park E, Kwon M, Chacko T, Zhou Y, Chen C, Goniewicz ML, Li CS, Chang YP. Instruments to measure e-cigarette related constructs: a systematic review. BMC Public Health 2022; 22:1135. [PMID: 35668485 PMCID: PMC9172158 DOI: 10.1186/s12889-022-13510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) are relatively new tobacco products that are attracting public attention due to their unique features, especially their many flavor options and their potential as an alternative to cigarettes. However, uncertainties remain regarding the determinants and consequences of e-cigarette use because current research on e-cigarettes is made more difficult due to the lack of psychometrically sound instruments that measure e-cigarette related constructs. This systematic review therefore seeks to identify the instruments in the field that are designed to assess various aspects of e-cigarette use or its related constructs and analyze the evidence presented regarding the psychometric properties of the identified instruments. METHODS This systematic review utilized six search engines: PubMed, Medline, CINAHL, PsycINFO, Web of Science, and EMBASE, to identify articles published in the peer-reviewed journals from inception to February 2022 that contained development or validation processes for these instruments. RESULTS Eighteen articles describing the development or validation of 22 unique instruments were identified. Beliefs, perceptions, motives, e-cigarette use, and dependence, were the most commonly assessed e-cigarette related constructs. The included studies reported either construct or criterion validity, with 14 studies reporting both. Most studies did not report the content validity; for reliability, most reported internal consistencies using Cronbach's alpha, with 15 instruments reporting Cronbach's alpha > 0.70 for the scale or its subscales. CONCLUSIONS Twenty-two instruments with a reported development or validation process to measure e-cigarette related constructs are currently available for practitioners and researchers. This review provides a guide for practitioners and researchers seeking to identify the most appropriate existing instruments on e-cigarette use based on the constructs examined, target population, psychometric properties, and instrument length. The gaps identified in the existing e-cigarette related instruments indicate that future studies should seek to extend the validity of the instruments for diverse populations, including adolescents. Instruments that explore additional aspects of e-cigarette use and e-cigarette related constructs to help build a strong theoretical background and expand our current understanding of e-cigarette use and its related constructs, should also be developed.
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Affiliation(s)
- Eunhee Park
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA.
| | - Misol Kwon
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Thomas Chacko
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Yanjun Zhou
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Chiahui Chen
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Maciej L Goniewicz
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Chin-Shang Li
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Yu-Ping Chang
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
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Masaki K, Taketa RM, Nakama MK, Kawamoto CT, Pokhrel P. Relationships Between Depressive Symptoms, Anxiety, Impulsivity and Cigarette and E-cigarette Use Among Young Adults. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:51-57. [PMID: 35261985 PMCID: PMC8899082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Depression and anxiety have been associated with cigarette use among young people. Higher impulsivity has also been associated with increased smoking behavior. However, relatively less is known about the associations between depression, anxiety, impulsivity and e-cigarette use and how these associations compare with the associations between depression, anxiety, impulsivity and cigarette smoking. In addition, little is known about how impulsivity influences the relationships between depression, anxiety, cigarette, and e-cigarette use. This study tested the hypothesis that higher depression and anxiety symptoms are associated with higher e-cigarette use and cigarette smoking in a similar way, and that these associations would be stronger among those with higher impulsivity. A sample of 2,622 young adults (18-25 year olds; 54% women) enrolled in 4-year and 2-year colleges in Hawai'i participated in a cross-sectional survey. Approximately 68% of the sample reported no use of either e-cigarettes or cigarettes, 13% reported only e-cigarette use, 9% reported only cigarette smoking, and 11% reported use of both. The study found that higher depressive and anxiety symptoms and higher impulsivity were significantly associated with current cigarette and e-cigarette use. For example, one unit increases in depression, anxiety, and impulsivity were associated with 34%, 17%, and 38% increased odds of e-cigarette use versus non-use, respectively. Impulsivity was found to significantly moderate the association between higher anxiety and higher cigarette smoking, such that the association was stronger among those with higher impulsivity. Impulsivity was not found to moderate any other association. Results suggest that tobacco product use prevention education should target children and young adults with higher internalizing symptoms, with particular attention to those who show higher impulsivity.
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Affiliation(s)
- Kelly Masaki
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, University of Hawai‘i at Manoa, Honolulu, HI
| | - Rachel M. Taketa
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, University of Hawai‘i at Manoa, Honolulu, HI
| | - Mark K. Nakama
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, University of Hawai‘i at Manoa, Honolulu, HI
| | - Crissy T. Kawamoto
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, University of Hawai‘i at Manoa, Honolulu, HI
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, University of Hawai‘i at Manoa, Honolulu, HI
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11
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Enlow PT, Williford DN, Romm KF, Dino GA, Blank MD, Murray PJ, Banvard CA, Duncan CL. Predicting Adolescent Electronic Cigarette Use: Differences by Never, Ever, and Current Users. J Pediatr Psychol 2022; 47:1-11. [PMID: 34524431 PMCID: PMC9125499 DOI: 10.1093/jpepsy/jsab082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Rising rates of adolescent electronic cigarette (ECIG) use is concerning because it can lead to adverse health outcomes and increased risk behavior. There are known predictors of ever versus never ECIG use, but less are known about risk factors for ever versus current use of ECIGs. Problem behavior theory (PBT) was used to evaluate possible risk factors for different ECIG use status. METHODS Participants were 573 high school students who completed questionnaires measuring ECIG use, as well as constructs within the Social Environment, Perceived Environment, Personality, and Behavior domains of PBT. Multinomial logistic regression was used to evaluate how predictor variables differentiated between participants who reported (a) never use, (b) ever ECIG use, or (c) current ECIG use. RESULTS Adolescents were more likely to endorse ever ECIG use than never use if they reported peer ECIG use, perceived more benefits and fewer costs (e.g., health) of ECIG use, higher extraversion, alcohol and cigarette use (never vs. ever vs. past 30 days), or attended a school with a higher percentage of socioeconomically disadvantaged students. Adolescents were more likely to report current ECIG use than ever ECIG use if they perceived fewer costs of ECIG use or used cannabis in their lifetime (yes/no). CONCLUSIONS PBT variables differentiated between ever ECIG use and never ECIG use. However, these variables did not differentiate between ever and current ECIG use. Identifying unique risk factors for current versus ever ECIG use is important to understanding persistent ECIG use and subsequent targeted prevention and intervention programs.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, PA, USA
| | | | - Katelyn F Romm
- Milken Institute of Public Health, George Washington University, Washington, DC, USA
| | - Geri A Dino
- WV Prevention and Research Center, Department of Social and Behavioral Sciences, WVU School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- WV Prevention and Research Center, Department of Social and Behavioral Sciences, WVU School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Pamela J Murray
- Department of Pediatrics, Section of Adolescent Medicine, West Virginia University, Morgantown, WV, USA
| | - Christine A Banvard
- Department of Pediatrics, Section of Adolescent Medicine, West Virginia University, Morgantown, WV, USA
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Prokhorov AV, Calabro KS, Arya A, Russell S, Czerniak KW, Botello GC, Chen M, Yuan Y, Perez A, Vidrine DJ, Perry CL, Khalil GE. Mobile Text Messaging for Tobacco Risk Communication Among Young Adult Community College Students: Randomized Trial of Project Debunk. JMIR Mhealth Uhealth 2021; 9:e25618. [PMID: 34822339 PMCID: PMC8663493 DOI: 10.2196/25618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/19/2021] [Accepted: 10/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The use of new and emerging tobacco products (NETPs) and conventional tobacco products (CTPs) has been linked to several alarming medical conditions among young adults (YAs). Considering that 96% of YAs own mobile phones, SMS text messaging may be an effective strategy for tobacco risk communication. OBJECTIVE Project Debunk is a community-based randomized trial aiming to identify specific types of messages that effectively improve perceived NETP and CTP risk among YAs in community colleges. METHODS With YAs recruited offline from 3 campuses at the Houston Community College (September 2016 to July 2017), we conducted a 6-month randomized trial with 8 arms based on the combination of 3 message categories: framing (gain-framed vs loss-framed), depth (simple vs complex), and appeal (emotional vs rational). Participants received fully automated web-based SMS text messages in two 30-day campaigns (2 messages per day). We conducted repeated-measures mixed-effect models stratified by message type received, predicting perceived CTP and NETP risks. Owing to multiple testing with 7 models, an association was deemed significant for P<.007 (.05 divided by 7). RESULTS A total of 636 participants completed the baseline survey, were randomized to 1 of 8 conditions (between 73 and 86 participants per condition), and received messages from both campaigns. By the 2-month post campaign 2 assessment point, 70.1% (446/636) completed all outcome measures. By the end of both campaigns, participants had a significant increase in perceived NETP risk over time (P<.001); however, participants had a marginal increase in perceived CTP risk (P=.008). Separately for each group, there was a significant increase in perceived NETP risk among participants who received rational messages (P=.005), those who received emotional messages (P=.006), those who received simple messages (P=.003), and those who received gain-framed messages (P=.003). CONCLUSIONS In this trial, YAs had an increase in perceived NETP risk. However, with stratification, we observed a significant increase in perceived NETP risk upon exposure to rational, emotional, simple, and gain-framed messages. In addition, YAs generally had an increase in perceived CTP risk and presented nonsignificant but observable improvement upon exposure to emotional, complex, and loss-framed messages. With the results of this study, researchers and practitioners implementing mobile health programs may take advantage of our tailored messages through larger technology-based programs such as smartphone apps and social media campaigns. TRIAL REGISTRATION ClinicalTrials.gov NCT03457480; https://clinicaltrials.gov/ct2/show/NCT03457480. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/10977.
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Affiliation(s)
- Alexander V Prokhorov
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Karen Sue Calabro
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Ashish Arya
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sophia Russell
- Department of Health Disparities, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Katarzyna W Czerniak
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Gabrielle C Botello
- Department of Health Services Research, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Minxing Chen
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Ying Yuan
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Adriana Perez
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Austin, TX, United States
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Cheryl L Perry
- School of Public Health, Health Science Center, University of Texas, Austin, TX, United States
| | - Georges Elias Khalil
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
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13
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Fairman RT, Weaver SR, Akani BC, Dixon K, Popova L. "You have to vape to make it through": E-cigarette Outcome Expectancies among Youth and Parents. Am J Health Behav 2021; 45:933-946. [PMID: 34702440 DOI: 10.5993/ajhb.45.5.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objectives: Outcome expectancies are central to explaining health behavior and have been shown to predict tobacco use. Research on outcome expectancies for e-cigarette use among youth is scarce but increasingly important given the growing rates of use, particularly of high-nicotine pod devices and the recent outbreak of e-cigarette related lung disease. Methods: In 2019, we conducted 3 focus groups with middle school youth (N=25), 5 with high school youth (N=38), and 4 with parents (N=27). Youth and parents were not related and groups included both users and non-users. Participants discussed reasons for e-cigarette use and bad and good things that might happen to a person who vapes. Results: Participants described positive and negative psychoactive/sensory, social, and health-related outcome expectancies. Both youth and parents mentioned stress relief and appearing older as positive outcome expectancies, and e-cigarette flavors, acting rebellious, and structural opportunities as other reasons for initiating e-cigarette use. Social consequences and health outcomes were negative outcome expectancies deterring use. Conclusions: Regulations and public communication campaigns can counteract the positive outcome expectancies (flavor regulation, providing stress reduction tips) and capitalize on negative ones (communicating negative health outcomes) to decrease youth e-cigarette use.
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Affiliation(s)
- Robert T. Fairman
- Robert T. Fairman, Second Century Initiative Fellow, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Scott R. Weaver
- Scott R. Weaver, Associate Professor, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Bangaman C. Akani
- Bangaman C. Akani, Graduate Research Assistant, School of Public Health, Georgia State University, Atlanta, GA, United States. Also Assistant Lecturer, Department of Public Health, Felix Houphouet Boigny University, Abidjan,
Cote d'Ivoire
| | - Kristin Dixon
- Kristin Dixon, Health Promotion Director, Fulton County Board of Health, Atlanta, GA, United States
| | - Lucy Popova
- Lucy Popova, Associate Professor, School of Public Health, Georgia State University, Atlanta, GA, United States;,
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14
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Pokhrel P, Bennett BL, Boushey CJ. Body esteem, weight-control outcome expectancies, and e-cigarette use among young adults. Nicotine Tob Res 2021; 23:454-461. [PMID: 31927589 DOI: 10.1093/ntr/ntaa009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/09/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Evidence is still scarce regarding the use of e-cigarettes by young people for weight-control reasons. This study aimed to test a model in which the prospective association between negative body esteem and e-cigarette use is mediated by weight-control outcome expectancies for e-cigarette use. The model was tested across genders. METHODS Data were collected at three time points, 6 months apart, from 2327 young adults (mean age = 21.2; SD = 2.2; 54% women). Self-reported data were collected on demographics, body mass index, body esteem, weight-control outcome expectancies for e-cigarette use, and current e-cigarette use and cigarette smoking. RESULTS Among women, we found a significant indirect effect of lower body esteem on higher likelihood of current e-cigarette use 1 year later, mediated by higher weight-control outcome expectancies at 6-month follow-up, adjusting for demographics, body mass index, and baseline e-cigarette use and cigarette smoking. Among men, body esteem was not found to have significant effect on either weight-control expectancies or e-cigarette use. CONCLUSIONS Based on the current findings, young adult women who have higher negative body esteem are at increased risk for using e-cigarettes for weight-control motives. IMPLICATIONS The current findings are some of the first to show prospective associations among weight-control motives and e-cigarette use among young adults. These findings suggest that a group of vulnerable young women may be using e-cigarettes to lose or control weight. More research is needed to understand their choice of flavors, nicotine concentration, and device type. In addition, research is needed to understand whether e-cigarettes are being marketed, directly or indirectly, as being useful for weight loss or control. There may be a need for health promotion strategies that provide healthier alternatives to young women struggling with low body esteem who use e-cigarettes for weight loss or control.
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Affiliation(s)
- Pallav Pokhrel
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Brooke L Bennett
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Carol J Boushey
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
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15
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Burnley A, Bold KW, Kong G, Wu R, Krishnan-Sarin S. E-cigarette use perceptions that differentiate e-cigarette susceptibility and use among high school students. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:238-246. [PMID: 33058696 DOI: 10.1080/00952990.2020.1826501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND E-cigarette use among adolescents is increasingly popular and a growing public health concern. OBJECTIVES To examine how individual e-cigarette use perceptions differ between adolescents based on e-cigarette use status and susceptibility to future use of e-cigarettes. METHODS Data were collected using surveys administered across eight Connecticut high schools (grades 9-12), Spring 2015. N = 2592 students (Mage = 16.01, SD = 1.28, Female = 51.7%) reported e-cigarette use and susceptibility and were categorized into non-susceptible never-users (57.8%), susceptible never-users (16.9%) and ever-users (25.4%). Youth also responded to 12 e-cigarette use perceptions describing perceived benefits and risks of e-cigarette use. RESULTS A multinomial logistic regression model was used. Eight use perceptions were related to susceptibility or use of e-cigarettes. The benefit-related use perception "feel relaxed" was the only item associated with greater odds of being both susceptible (vs. non-susceptible, p <.001) and an ever-user (vs. susceptible; p <.05). Two other benefit-related use perceptions were related to higher odds of being susceptible to e-cigarette use ("control your weight"; AOR = 1.82, p <.05; "look cool"; AOR = 3.13, p <.05). Results also identified key risk-related use perceptions that related to lower odds of either being susceptible to e-cigarette use ("have a heart attack"; AOR =.43, p <.001) or of ever-use ("have bad breath"; AOR =.28, p <.001; "get lung cancer"; AOR =.58, p <.05). CONCLUSION E-cigarette use perceptions among youth differ by e-cigarette use and susceptibility status. Findings could help identify youth who are vulnerable to e-cigarette use and inform prevention, for example by developing counter-messaging for benefit perceptions associated with susceptibility and ever-use.
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Affiliation(s)
- Annabel Burnley
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Krysten W Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ran Wu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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16
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Zvolensky MJ, Manning K, Garey L, Alfano CA, Mayorga NA, Peraza N. Emotion dysregulation, fatigue, and electronic cigarette expectancies. Cogn Behav Ther 2021; 50:138-153. [PMID: 33006499 PMCID: PMC7916989 DOI: 10.1080/16506073.2020.1819868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Emotion dysregulation and the experience of fatigue have both been linked to the maintenance of substance use. However, limited empirical data has evaluated individual differences in these constructs in terms of e-cigarette use expectancies. The present study examined a theoretically relevant model focused on whether the experience of more severe fatigue explains, in part, the relation between individual differences in emotion dysregulation and positive and negative e-cigarette expectancies among 525 adult e-cigarette users (50.9% female, Mage = 35.25 years, SD = 10.10). It was hypothesized that emotion dysregulation, via fatigue severity, would significantly predict greater positive and negative e-cigarette expectancies, which was examined in two separate mediation models. Fatigue severity significantly explained, in part, the relation between emotion dysregulation and positive (b = 0.02, CI [0.01, 0.02]) and negative expectancies of e-cigarette use (b = 0.02, 95% CI [0.02, 0.03]). The current findings suggest that the experience of fatigue helps explain the relation between emotion dysregulation and positive and negative e-cigarette expectancies among adult e-cigarette users. Future work is needed to explicate how reducing fatigue severity in the context of emotion dysregulation may change expectancies about e-cigarette expectancies.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Psychology, HEALTH Institute, University of Houston, Houston, TX, USA
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Natalia Peraza
- Department of Psychology, University of Houston, Houston, TX, USA
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17
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Pokhrel P, Ing C, Kawamoto CT, Laestadius L, Buente W, Herzog TA. Social media's influence on e-cigarette use onset and escalation among young adults: What beliefs mediate the effects? Addict Behav 2021; 112:106617. [PMID: 32911352 PMCID: PMC7885807 DOI: 10.1016/j.addbeh.2020.106617] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
As an extension of a previous cross-sectional study, this study employed prospective data to test positive outcome expectancy beliefs as mediators of social media's influence on e-cigarette use progression among young adults. Self-report data were collected from 2327 young adult college students (Mean age = 21.2; SD = 2.1; 54% women) between 2017 and 2019, every 6-month, at 3 time-points. Structural equation modeling was used to test the mediational models. Among baseline never e-cigarette users, higher affect regulation expectancies-e.g., beliefs that e-cigarette use results in feeling good, reduced boredom and stress-mediated the effects of higher baseline social media e-cigarette exposure on e-cigarette use onset one year later. Among baseline lifetime e-cigarette users, higher positive sensory, positive "smoking" experience, and affect regulation expectancy beliefs mediated the effects of higher social media e-cigarette exposure at baseline on increased current e-cigarette use one year later. E-cigarette content on social media may persuade young adults to try e-cigarettes by imparting the sense that e-cigarettes make one feel good and help reduce stress. E-cigarette content on social media that promote e-cigarette flavors and e-cigarettes as cleaner and a socially more acceptable alternative to cigarettes may work to escalate e-cigarette use among experimenters. Efforts to prevent e-cigarette use onset and escalation may need to target the outcome expectancy beliefs influenced by social media.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States.
| | - Claire Ing
- Department of Native Hawaiian Health, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Crissy T Kawamoto
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Linnea Laestadius
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee WI53205, United States
| | - Wayne Buente
- School of Communications, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Thaddeus A Herzog
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
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Trucco EM, Fallah-Sohy N, Hartmann SA, Cristello JV. Electronic Cigarette Use Among Youth: Understanding Unique Risks in a Vulnerable Population. CURRENT ADDICTION REPORTS 2020; 7:497-508. [PMID: 33409119 PMCID: PMC7781233 DOI: 10.1007/s40429-020-00340-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE OF REVIEW This review discusses prevalence rates of electronic (e-)cigarette use among youth and factors that likely contribute to their growing popularity among this population. Trends shaping the e-cigarette landscape, the appeal of e-cigarettes among youth, perceptions contributing to the initiation of e-cigarettes, available assessments capturing the usage of and attitudes towards e-cigarettes, and e-cigarette policies and regulations are reviewed. RECENT FINDINGS E-cigarette use among this vulnerable group may relate to factors associated with the promotion of social status, individuality, and enjoyment, along with low perceptions of risk and harm. Measures assessing factors unique to e-cigarette use among youth (e.g., individuality) still need to be developed and validated. Effects of existing regulations to limit youth access to e-cigarettes may be limited, and shortcomings of current policy measures are discussed with recommendations. SUMMARY The rise of e-cigarette use among youth culminated through a perfect storm of clever marketing targeting youth appeal, innovations in more effective nicotine delivery systems, capitalizing on increased susceptibility of the adolescent brain, and regulatory gaps. Understanding risk and protective factors specific to this vulnerable group, which can be gleaned in part by psychometrically valid assessments, could inform regulatory strategies and prevention programming efforts. Yet, few validated measures exist that assess attitudes, behaviors, and patterns of e-cigarette use that are specific to youth. Ultimately, it is incumbent upon policymakers to create comprehensive regulations that prioritize harm reduction and can evolve in lockstep with the constantly changing e-cigarette product landscape.
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Affiliation(s)
- Elisa M. Trucco
- Florida International University, Psychology Department, Center for Children and Families 11200 SW 8 Street, AHC-1, Miami, FL 33199
- University of Michigan, Psychiatry Department, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Nilofar Fallah-Sohy
- Florida International University, Psychology Department, Center for Children and Families 11200 SW 8 Street, AHC-1, Miami, FL 33199
| | - Sarah A. Hartmann
- Florida International University, Psychology Department, Center for Children and Families 11200 SW 8 Street, AHC-1, Miami, FL 33199
| | - Julie V. Cristello
- Florida International University, Psychology Department, Center for Children and Families 11200 SW 8 Street, AHC-1, Miami, FL 33199
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Knowledge, Attitudes, and Perceptions of Young Adults About Electronic Nicotine Delivery Systems in the United States: An Integrative Review. J Cardiovasc Nurs 2020; 37:86-97. [PMID: 32740220 DOI: 10.1097/jcn.0000000000000731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The causal link between cigarettes and cardiovascular disease is well known. The long-term effects of e-cigarettes are yet unknown, although early studies show biomarkers indicating inflammation and damage to endothelial cells associated with later development of cardiovascular disease. With the rapid rise in e-cigarette use, especially in young adults, it is imperative that health professionals understand the knowledge, perceptions, and motivations for use among young adults. OBJECTIVES The purpose of this integrative review is to explore existing literature on young adults' knowledge, attitudes, values, and perceptions about e-cigarettes, as well as the social norms they experience. METHODS The Whittemore and Knafl model for integrative review guided the methodology. Three databases were searched from January 2010 through December 2018. The study selection process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion and exclusion criteria were applied. Studies were evaluated for quality and strength. Key themes were extracted, coded, and synthesized. RESULTS Seventy-one full-text studies were assessed for inclusion criteria; 15 articles were included, coded, and analyzed for quality and thematic content. Current e-cigarette users represented just 3% to 35% of study participants. Three themes arose from a synthesis of the literature: "Is it bad for me?," "I just like it," and "Is it cool or not?" CONCLUSIONS Young adults are not armed with the accurate knowledge to make informed choices about using e-cigarettes. E-cigarette users are understudied and tend to value appearance and physical sensation over health. Social norms related to e-cigarette use are linked to perception of identity and the current technology-focused culture.
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20
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Psychometric Properties of Turkish Version of the E-Cigarette Use Outcome Expectancies Scale. J Addict Nurs 2020; 31:124-133. [PMID: 32487939 DOI: 10.1097/jan.0000000000000338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study was carried out to evaluate the validity and reliability of the E-Cigarette Use Outcome Expectancies Scale (EUOES) in the Turkish context. METHOD The sample for the study was composed of 1,725 first-, second-, third-, and fourth-year university students aged 18-25 years. The data from the study were collected using a sociodemographic data collection form and the EUOES. Numbers and percentages were used for the evaluation of the data. In addition, content validity index, Pearson's correlation analysis, a paired samples t test, Cronbach's alpha coefficient, and exploratory and confirmatory factor analyses were employed for the analysis of language validity and expert opinions. FINDINGS As a result of the confirmatory factor analysis, the factor loadings of the scale were found to range from 0.450 to 0.939. The confirmatory factor analysis revealed that the fit indices of the scale were 0.90 and higher. Cronbach's alpha coefficient of the scale was determined as .86. CONCLUSION As a result of the analysis, the EUOES was found to be a valid and reliable measurement tool for the Turkish sample.
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Subica AM, Guerrero E, Wu LT, Aitaoto N, Iwamoto D, Moss HB. Electronic Cigarette Use and Associated Risk Factors in U.S.-Dwelling Pacific Islander Young Adults. Subst Use Misuse 2020; 55:1702-1708. [PMID: 32397921 PMCID: PMC7521610 DOI: 10.1080/10826084.2020.1756855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: E-cigarette use is rapidly increasing among US young adults, heightening their risk for vaping-related illnesses. Yet, little is known about e-cigarette use among young adult Native Hawaiians and Pacific Islanders (NHPI): an indigenous-colonized US racial group rarely described in research literature. This exploratory study provides the first known data on e-cigarette use and potential risk factors in NHPI young adults. Method: Self-report data were collected from 143 NHPI young adults (age 18-30 years) living in two large NHPI communities: Samoans in urban Los Angeles County and Marshallese in rural Arkansas. We assessed rates of e-cigarette, cigarette, alcohol, and marijuana use, and positive and negative outcome expectancies from e-cigarettes, that is expected outcomes from e-cigarette use. To identify potential risk factors for NHPI e-cigarette use, regressions explored associations between participants' current e-cigarette use with current cigarette, alcohol, and marijuana use, and e-cigarette outcome expectancies. Results: Among NHPI young adults, lifetime e-cigarette use rate was 53% and current use rate was 39%. Current rate of dual e-cigarette/cigarette, e-cigarette/alcohol, and e-cigarette/marijuana use was 38%, 35%, and 25%, respectively. In our regression models, current marijuana use and positive e-cigarette outcome expectancies were significantly associated with current e-cigarette use. Conclusions: E-cigarette use is common among NHPI young adults, exceeding rates for other at-risk racial groups. Marijuana use and positive expectations about e-cigarette use may represent potential e-cigarette use risk factors. Collectively, findings underscore the need for additional research to further explore the scope of, and risk and protective factors for, e-cigarette use in this understudied high-risk population.
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Affiliation(s)
| | - Erick Guerrero
- I-Lead Institute, Research to End Healthcare Disparities Corp
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22
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Correa JB, Tully LK, Doran N. Expectancies and reasons for use of e-cigarettes among young adults: A longitudinal analysis. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:730-736. [PMID: 31535871 PMCID: PMC6889054 DOI: 10.1037/adb0000514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Use of electronic cigarettes, or e-cigarettes, has increased exponentially in recent years. Mechanisms that might underlie this increase include expectancies and reasons for e-cigarette use. This study was designed to identify and evaluate changes in expectancies and reasons for e-cigarette use among young adults over time and to determine whether such changes were associated with changes in e-cigarette use. Data for these analyses were collected from a sample of 137 young adult e-cigarette users who completed electronic surveys 5 times over a 12-month period. Results yielded five e-cigarette use expectancy and reason factors: Affect-Related Reasons, Social Reasons, Positive Social Expectancies, Positive Internal Expectancies, and Negative Expectancies. Linear mixed models showed that Negative Expectancies significantly increased over time (p = .004), whereas Affect-Related Reasons significantly decreased over time (p = .001). Additional linear mixed models indicated that, whereas both frequency and quantity of e-cigarette use decreased over time, changes in Positive Internal Expectancies were positively associated with changes in frequency of e-cigarette use (p = .032) and changes in Positive Social Expectancies were positively associated with changes in both frequency (p = .007) and quantity (p = .026) of e-cigarette use. These findings suggest that young adults' expectancies and reasons for using e-cigarettes fluctuate over time, and changes in expectancies seem to be longitudinally associated with changes in e-cigarette use. Positive expectancies for e-cigarette use represent targets for clinical, prevention, and intervention efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Jongenelis MI, Brennan E, Slevin T, Kameron C, Jardine E, Rudaizky D, Pettigrew S. Factors associated with intentions to use e-cigarettes among Australian young adult non-smokers. Drug Alcohol Rev 2019; 38:579-587. [PMID: 31317596 DOI: 10.1111/dar.12963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/21/2019] [Accepted: 06/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS A growing body of evidence suggests e-cigarette use increases the risk of conventional cigarette use. Assessing the factors associated with intentions to use e-cigarettes can inform programs designed to minimise uptake, potentially assisting in preventing a new population of smokers. This study developed and tested a model assessing the importance of various factors that may be associated with intentions to use e-cigarettes among young adults who have never used e-cigarettes or tobacco cigarettes. DESIGN AND METHODS A web-panel provider recruited 429 Australian 18- to 25-year-olds who had never used e-cigarettes or smoked tobacco cigarettes (56% female, mean age = 21.17 years). Various individual and social factors were assessed as potential direct and indirect predictors of e-cigarette use intentions. RESULTS The developed model provided an excellent fit to the data and accounted for 49% of the variance in use intentions. Males had greater intentions to use e-cigarettes compared to females (β = -0.13). Having a greater number of friends who smoke tobacco cigarettes (β = 0.11) and curiosity about e-cigarette use (β = 0.58) were also directly associated with greater use intentions. Positive expectancies about e-cigarettes (β = 0.14), having family members who use e-cigarettes (β = 0.11), and having friends who smoke tobacco cigarettes (β = 0.07) were indirectly associated with intentions via curiosity. DISCUSSION AND CONCLUSIONS Curiosity about e-cigarette use was strongly associated with use intentions. Aspects of the social environment were also important. Further research is needed to identify effective means of challenging positive e-cigarette expectancies given these were found to be strongly associated with intentions via curiosity.
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Affiliation(s)
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
| | - Terry Slevin
- School of Psychology, Curtin University, Perth, Australia.,Public Health Association of Australia, Canberra, Australia
| | - Caitlin Kameron
- School of Psychology, Curtin University, Perth, Australia.,Cancer Council WA, Perth, Australia
| | | | - Daniel Rudaizky
- School of Psychological Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Barker JO, Kelley DE, Noar SM, Reboussin BA, Cornacchione Ross J, Sutfin EL. E-Cigarette Outcome Expectancies among Nationally Representative Samples of Adolescents and Young Adults. Subst Use Misuse 2019; 54:1970-1979. [PMID: 31188055 PMCID: PMC6764885 DOI: 10.1080/10826084.2019.1624773] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: We conducted nationally representative surveys of adolescents and young adults to examine associations between e-cigarette outcome expectancies and e-cigarette use. Background: E-cigarette use among adolescents and young adults has grown rapidly in recent years, yet little research has examined the beliefs that may underlie this behavior among nationally representative samples. Methods:N = 1,298 adolescents (13-17) and 2,219 young adults (18-25) were surveyed using a probability-based web panel. Participants completed a survey that included a new outcome expectancy measure examining 3 positive (enjoyment, social influences, advantage over cigarettes) and 2 negative (health concerns, smoker association) expectancy domains and ever having used e-cigarettes [ever use]. Results: Confirmatory factor analyses demonstrated a good fit of the outcome expectancies' factor structure to the data. All outcome expectancies were associated with e-cigarette use in both populations in univariate analyses. In multiple logistic regression models controlling for several covariates, higher expected enjoyment was positively associated with a greater likelihood of e-cigarette use (aOR = 2.10, p < .05) among adolescents. Among young adults, enjoyment (aOR = 3.08, p < .001) was positively associated with a greater likelihood of use while both health concerns (aOR = 0.70, p < .01) and smoker association (aOR = 0.73, p < .05) were negatively associated with e-cigarette use. Conclusions: This study suggests that expected enjoyment is robustly associated with e-cigarette use among both adolescents and young adults. Health concerns may also play a role in e-cigarette use. Implications for e-cigarette prevention efforts and future research directions are discussed.
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Affiliation(s)
- Joshua O Barker
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Dannielle E Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine , Winston-Salem , North Carolina , USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine , Winston-Salem , North Carolina , USA
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Prokhorov AV, Khalil GE, Calabro KS, Machado TC, Russell S, Czerniak KW, Botello GC, Chen M, Perez A, Vidrine DJ, Perry CL. Mobile Phone Text Messaging for Tobacco Risk Communication Among Young Adult Community College Students: Protocol and Baseline Overview for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e10977. [PMID: 30322833 PMCID: PMC6231779 DOI: 10.2196/10977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/18/2022] Open
Abstract
Background Community-college students are at high risk for tobacco use. Because the use of mobile phone text messaging is nearly ubiquitous today, short message service (SMS) may be an effective strategy for tobacco risk communication in this population. Little is known, however, concerning the message structure significantly influencing perceived tobacco risk. Objective We aim to outline the rationale and design of Project Debunk, a randomized trial comparing the effects of different SMS text message structures. Methods We conducted a 6-month randomized trial comparing 8 arms, based on the combination of the 3 message structures delivered to young adults in a 2×2×2 study design: framing (gain-framed or loss-framed), depth (simple or complex), and appeal (emotional or rational). Participants were invited to participate from 3 community colleges in Houston from September 2016 to July 2017. Participants were randomized to 1 arm and received text messages in 2 separate campaigns. Each campaign consisted of 2 text messages per day for 30 days. Perceived tobacco risk was assessed at baseline, 2 months after the first campaign, and 2 months after the second campaign. We assessed the perceived risk of using conventional products (eg, combustible cigarettes) and new and emerging products (eg, electronic cigarettes). The validity of message structures was assessed weekly for each campaign. A 1-week follow-up assessment was also conducted to understand immediate reactions from participants. Results We completed data collection for the baseline survey on a rolling basis during this time and assessed the validity of the message structure after 1 week of SMS text messages. For the entire sample (N=636), the average age was 20.92 years (SD 2.52), about two-thirds were male (430/636, 67.6%), and most were black or African American (259/636, 40.7%) or white (236/636, 37.1%). After 1 week of receiving text messages, the following was noted: (a) loss-framed messages were more likely to be perceived as presenting a loss than gain-framed messages (F7,522=13.13, P<.001), (b) complex messages were perceived to be more complex than simple messages (F7,520=2.04, P=.05), and (c) emotional messages were perceived to be more emotionally involving than rational messages (F7,520=6.46, P<.001). Conclusions This study confirms that the recruitment, randomization, and message composition have been successfully implemented. Further analyses will identify specific types of messages that are more effective than others in increasing the perceived risk of tobacco use. If our results suggest that any of the 8 specific message structures are more effective for helping young adults understand tobacco risk, this would provide evidence to include such messages as part of a larger technology-based campaign such as mobile phone apps, entertainment-based campaigns, and social media. Trial Registration ClinicalTrials.gov NCT03457480; https://clinicaltrials.gov/ct2/show/NCT03457480 (Archived by WebCite at http://www.webcitation.org/6ykd4IIap) Registered Report Identifier RR1-10.2196/10977
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Affiliation(s)
- Alexander V Prokhorov
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Georges Elias Khalil
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Karen Sue Calabro
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Tamara Costello Machado
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sophia Russell
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Katarzyna W Czerniak
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Gabrielle C Botello
- Department of Behavioral Science, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Minxing Chen
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Adriana Perez
- Department of Biostatistics and Data Science, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, United States
| | - Damon J Vidrine
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, The University of Oklahoma, Oklahoma City, OK, United States
| | - Cheryl L Perry
- School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, United States
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