Distinctive role of opinion leaders in the social networks of school adolescents: an investigation of e-cigarette use

Association of Perceived Stress, Social Support, and Self-Esteem with E-Cigarette Use Among U.S. College-Aged Young Adults

BACKGROUND

Given that college life is a major life-changing and stressful event for many young adults, they may use e-cigarettes to manage their stress, which in the long run could be detrimental to their health. Furthermore, perceived social support and self-esteem are important factors that might influence young adults' e-cigarette use behavior. This cross-sectional study examines the associations of perceived stress, social support, and self-esteem with e-cigarette use among U.S. college-aged young adults.

METHODS

Students (aged 18-24 years, n = 220) attending Slippery Rock University of Pennsylvania between February-May 2023 were recruited to complete an online survey. The outcome variables were current (past 30 days) and ever e-cigarette users, while the explanatory variables were perceived stress, perceived social support, self-esteem, and socio-demographics. Data was analyzed using bivariate and multivariable logistic regression models.

RESULTS

About 30.1% and 55.0% of participants were current users and ever users of e-cigarettes, respectively. Participants who perceived high stress (vs. low stress) were 12.4 (Adjusted Odds ratio (aOR) = 12.39, p = 0.02) and 7.4 (aOR = 7.37, p = 0.04) times more likely to be current users and ever users of e-cigarettes, respectively. For every one-unit increase in self-esteem score, the likelihood of participants being current e-cigarette users decreased by 7% (OR = 0.93, p = 0.01).

CONCLUSION

Perceived stress and self-esteem are significantly associated with e-cigarette use among college-aged young adults. Public health efforts should focus on stress reduction, healthy coping strategies, and improving self-esteem in order to prevent e-cigarette use among this population.

Risk factors for early use of e-cigarettes and alcohol: Dimensions and profiles of temperament

Adolescent e-cigarette use has been labeled an epidemic and alcohol use during this developmental period is associated with deleterious outcomes. Though specific temperamental dimensions have been shown to predict substance use, profiles of temperament have rarely been examined as predictors. This study examines dimensions and profiles of adolescent temperament as predictors of early use of e-cigarettes and alcohol. The sample was comprised of adolescent (62.07% female, 87.59% White, 82.76% Hispanic/Latinx)/caregiver dyads (N = 146) who completed the first two timepoints (M age at second timepoint = 16.16, SD = 0.68) of a longitudinal adolescent substance use study. Models showed parent-reported effortful control predicted protection against adolescent use of e-cigarettes, whereas adolescent report of effortful control predicted protection against alcohol use. Though dissimilar in temperamental pattern, three profiles emerged from both parent- and adolescent-report-based latent profile analysis models. Adolescents characterized by parents as displaying a Resilient profile had greater odds of e-cigarette use than those characterized by a Reserved profile, whereas adolescents who self-characterized as Mixed-type had markedly greater odds of alcohol use than those who self-characterized as Resilient. Utilization of temperamental profiles may aid in identification of particularly vulnerable subgroups of adolescents who may benefit from relevant preventative programing.

Social Network Ties and Responses to COVID-19 Among E-Cigarette Users

Social networks can enhance behavioral changes or entrench existing patterns of behavior. We aimed to identify how network ties to other e-cigarette users shaped responses to the pandemic and e-cigarette considerations. A national U.S. survey of 562 e-cigarette users was conducted during April 2020. Participants self-reported network ties to other e-cigarette users and pandemic outcomes: receiving expressions of concern about vaping, risk for a bad COVID outcome, changes in e-cigarette risk perceptions, and considerations of quitting. Each additional e-cigarette user tie was associated with a 0.014 unit increase in expressions of concern (p < 0.001), a 0.034 unit increase in perceived risk of a bad outcome (p < 0.05), and 3.9% higher odds of quit considerations (OR = 1.039; p < 0.01). Family ties to e-cigarette users were particularly important. Additional e-cigarette users within a network shaped risk perceptions in response to COVID-19. Network ties to other e-cigarette users have implications for cessation or reduction of e-cigarette use.

E-cigarette use and intentions related to psychological distress among cigarette, e-cigarette, and cannabis vape users during the start of the COVID-19 pandemic

Background

This study examines associations between psychological distress, intentions to use e-cigarettes, and cigarette smoking, e-cigarette use, and cannabis consumption through e-cigarette use among a diverse sample of U.S. young adults.

Procedures

Young adults (N = 314; 72.5% female) were recruited to complete an online survey during the first few months of the COVID-19 pandemic.

Results

Associations between psychological distress and cigarette smoking, e-cigarette use, cannabis vaping, and intentions to use e-cigarettes were found. Current e-cigarette use (OR = 1.23, 95% CI 1.17, 1.28, p < .001; 7.5%) and cannabis vaping (OR = 2.03, 95% CI 1.88, 2.18, p < .001; 10%) was higher among female, possibly due to the significantly higher psychological distress reported among females. Interactions between intentions to use e-cigarettes and psychological distress variables were found for all smoking and vaping behaviors.

Conclusions

Public health efforts should increase focus on providing psychological services for young adults to improve coping strategies that are alternative to smoking and vaping behaviors.

Dynamic Robustness of Open-Source Project Knowledge Collaborative Network Based on Opinion Leader Identification

A large amount of semantic content is generated during designer collaboration in open-source projects (OSPs). Based on the characteristics of knowledge collaboration behavior in OSPs, we constructed a directed, weighted, semantic-based knowledge collaborative network. Four social network analysis indexes were created to identify the key opinion leader nodes in the network using the entropy weight and TOPSIS method. Further, three degradation modes were designed for (1) the collaborative behavior of opinion leaders, (2) main knowledge dissemination behavior, and (3) main knowledge contribution behavior. Regarding the degradation model of the collaborative behavior of opinion leaders, we considered the propagation characteristics of opinion leaders to other nodes, and we created a susceptible–infected–removed (SIR) propagation model of the influence of opinion leaders’ behaviors. Finally, based on empirical data from the Local Motors open-source vehicle design community, a dynamic robustness analysis experiment was carried out. The results showed that the robustness of our constructed network varied for different degradation modes: the degradation of the opinion leaders’ collaborative behavior had the lowest robustness; this was followed by the main knowledge dissemination behavior and the main knowledge contribution behavior; the degradation of random behavior had the highest robustness. Our method revealed the influence of the degradation of collaborative behavior of different types of nodes on the robustness of the network. This could be used to formulate the management strategy of the open-source design community, thus promoting the stable development of OSPs.

Behavioral barriers of tuberculosis notification in private health sector: policy implication and practice

Purpose

Underreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran.

Design/methodology/approach

The authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior.

Findings

Of 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16).

Practical implications

Considering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians.

Originality/value

To the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases.

The Role of the Opinion Leader Research Process in Informing Policy Making for Improved Nutrition: Experience and Lessons Learned in Southeast Asia

Opinion leader research (OLR) has been widely used in public health to identify influential persons or organizations to affect health care practice, inform policy-making processes, and help shape communication strategies. We used OLR to gather information related to barriers and possible solutions to guide strategic engagement for strengthening policy making for improved maternal, infant, and young child nutrition (MIYCN) practices in 5 Southeast Asian countries-Cambodia, Laos, Indonesia, Timor-Leste, and Thailand. In most countries, MIYCN policies and policymaker interest exist, but effective implementation and/or enforcement of current policies is weak. This article aims to share our experience in and lessons learned from using OLR as an advocacy tool: It helped identify opinion leaders with interest and influence to affect nutrition-related policies, it raised opinion leaders' interest in MIYCN, and it identified themes that would help generate political priority setting. Based on our experience, we recommend OLR as a strategic activity for informing and generating support for MIYCN policy-making processes.

Providing a Smart Healthy Diet for the Low-Income Population: Qualitative Study on the Usage and Perception of a Designed Cooking App

BACKGROUND

Health behaviors among low-income groups have become a major issue in the context of increasing social inequalities. The low-income population is less likely to be receptive to nutritional recommendations, but providing cooking advice could be more effective. In this domain, taking advantage of digital devices can be a bonus with its own challenges.

OBJECTIVE

The aim of this study was to develop and deploy NutCracker, a social network-based cooking app for low-income population, including cooking tips and nutritional advices, aiming at creating small online communities. We further determined the usefulness, perceptions, barriers, and motivators to use NutCracker.

METHODS

The smartphone app, designed jointly with beneficiaries of the social emergency services, was implemented in a disadvantaged neighborhood of Magny, (Paris region, France). Once the app became available, 28 subjects, living in the neighborhood, tested the app for a 6-month period. Logs to the app and usages were collected by the software. In total, 12 in-depth, semistructured interviews were conducted among the users and the social workers to analyze their uses and perceptions of the app relative to their interest in cooking, cooking skills, socioeconomic constraints, and social integration. These interviews were compared with 21 supplementary interviews conducted among low-income individuals in the general population.

RESULTS

NutCracker was developed as a social network-based app, and it includes cooking tips, nutritional advice, and Web-based quizzes. We identified barriers to uses (especially technical barriers, lack of knowledge in the field of new technologies and written comprehension, and search for real contacts) and motivators (in particular, good social integration, previous use of social networks, and help of children as intermediaries). Cooking skills were both a barrier and a lever.

CONCLUSIONS

Targeting the low-income groups through a cooking app to promote healthier behaviors offers many advantages but has not been fully explored. However, the barriers in low-income milieu remain high, especially among the less socially integrated strata. Lessons from this intervention allow us to identify barriers and possible levers to improve nutrition promotion and awareness in deprived areas, especially in the time of social crisis.

Different Effects of Social Support on Adolescent Smoking and the Mediation by Smartphone Dependence

BACKGROUND AND AIMS

This study examines the relationship between social support (from parents and peers) and cigarette use, through the mediating effect of smartphone dependence, among adolescents.

STUDY DESIGN

Prospective cohort study.

METHODS

A survey, conducted among 472 adolescents (average age = 16.2 years) attending classes in 3 schools in Lille, France, provides the data. The theoretical model features social support (parental and peer) and cigarette use, with smartphone dependence as a mediator, such that the authors simultaneously examine direct (support → cigarette use) and indirect (eg, peer support → smartphone dependence → cigarette use) paths.

RESULTS

The results illustrate that both parental support and peer support discourage cigarette use, but the indirect effect through smartphone dependence is positive. That is, smartphone dependence mediates the relationship between peer support and cigarette use. Parental support and peer support shape adolescents' cigarette use and smartphone dependence differently, depending on the adolescents' gender.

CONCLUSIONS

Policy makers should acknowledge the positive effects of social support, the negative effect of smartphone dependence, and the importance of gender when developing anti-smoking policies and campaigns.

E-Cigarette Use Among Adolescents Not Susceptible to Using Cigarettes

Introduction

Research suggests that adolescents who use electronic cigarettes (e-cigarettes), including adolescents not susceptible to smoking cigarettes (ie, those who have never smoked cigarettes and are not attitudinally susceptible to using cigarettes), are more likely to initiate using cigarettes or other combustible tobacco products than adolescents who do not use e-cigarettes. In this study, we examined correlates of e-cigarette use and susceptibility among adolescents not susceptible to future cigarette smoking.

Methods

We used data on high school students from the 2015 North Carolina Youth Tobacco Survey (n = 1,627). SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights.

Results

Increasing perceived harm of e-cigarettes was associated with lower odds of susceptibility to using e-cigarettes (adjusted odds ratio [AOR] = 0.79; 95% confidence interval [CI], 0.65–0.96) and current use of e-cigarettes (AOR = 0.43; 95% CI, 0.25–0.72). Similar patterns were found for perceived harm of secondhand e-cigarette vapor. Exposure to e-cigarette vapor in indoor or outdoor public places was positively associated with susceptibility to using e-cigarettes (AOR = 1.96; 95% CI, 1.33–2.91) and with current e-cigarette use (AOR = 5.69; 95% CI, 2.57–12.61).

Conclusion

To prevent initiation of e-cigarette use, particularly among adolescents not susceptible to smoking cigarettes, educational campaigns could target harm perceptions associated with e-cigarettes. In addition, regulations that limit adolescents’ exposure to e-cigarettes in public places may decrease e-cigarette use by nonsusceptible adolescents.