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Zou W, Wang X, Yang N, Ni X, Zhao Z, Meng R, Ma H. The intention of college students to use electronic cigarettes: A study based on the theory of innovation diffusion. Tob Induc Dis 2024; 22:TID-22-53. [PMID: 38496253 PMCID: PMC10941754 DOI: 10.18332/tid/185644] [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: 12/06/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The purpose of this study is to examine the use of electronic cigarettes (e-cigarettes) among college students in Hangzhou, and to analyze the influencing factors of their intention to use e-cigarettes. METHODS Using a stratified cluster sampling method, 775 students from two universities in Hangzhou were selected for an on-site questionnaire survey from March to April 2022. Adjusted logistic regression analysis was conducted on the influencing factors of use intention, based on innovation diffusion theory. RESULTS Within our sample of college students, 16.5% of students had tried e-cigarettes; 6.32% had used e-cigarettes in the past month, and 8.0% had the intention to use e-cigarettes. There were significant differences in willingness to use e-cigarettes among different genders, economic status, smoking status of close friends around them, and their own use of tobacco and alcohol (p<0.05). The logistic regression model showed that the observability of e-cigarettes (AOR=1.28; p<0.05), personal factors (AOR=1.39; p<0.05), and social systems (AOR=1.63; p<0.05), were all influencing factors of intention to use e-cigarettes. CONCLUSIONS College students in Hangzhou have a high intention to use e-cigarettes, and the impacts of the product itself, individual characteristics and the living environment are crucial. It is necessary to strengthen the promotion of tobacco knowledge at the social and family levels to reduce the occurrence of vaping.
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Affiliation(s)
- Wenjing Zou
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaowen Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaoqing Ni
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhaoyang Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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Gaca M, Williamson J, Digard H, Adams L, Hawkridge L, Proctor C. Bridging: Accelerating Regulatory Acceptance of Reduced-Risk Tobacco and Nicotine Products. Nicotine Tob Res 2022; 24:1371-1378. [PMID: 35171296 PMCID: PMC9356683 DOI: 10.1093/ntr/ntac041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The number and variety of alternative tobacco and nicotine products that can potentially provide reduced-risk choices for cigarette smokers who switch completely to such products instead of continued smoking have grown substantially in the past decade. Innovation and choice are likely to improve the prospects of smokers making the switch, but this provides challenges to regulators and manufacturers to ensure that changes to regulations and products promote and do not hinder contributions to tobacco harm reduction. AIMS AND METHODS This paper looks at where bridging data sets for tobacco heating products, closed system vaping products, and oral nicotine products might enable innovation while protecting the interests of consumers. RESULTS We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones. CONCLUSIONS Bridging across specific product ranges can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality. IMPLICATIONS Bridging partial data sets is an established practice within other industries, that aims to improve efficiency with regulatory approvals, accepts natural product variation, and supports product innovation. We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones. This in turn can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality.
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Affiliation(s)
- Marianna Gaca
- British American Tobacco (Holdings) Ltd, Globe House, 4 Temple Place, London WC2R 2PG, UK
| | - Justine Williamson
- British American Tobacco (Holdings) Ltd, Globe House, 4 Temple Place, London WC2R 2PG, UK
| | - Helena Digard
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
| | - Louise Adams
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
| | - Lauren Hawkridge
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
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Jun J, Wen TJ, Wu L. The Effects of Self vs. Group Affirmation and Message Framing on College Students' Vape-Free Campus Policy Support. HEALTH COMMUNICATION 2021; 36:1441-1451. [PMID: 32438843 DOI: 10.1080/10410236.2020.1767446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A growing number of American colleges and universities have become vape-free campuses in response to the high e-cigarette use prevalence among young adults. However, little is known about communication or social-psychological factors associated with campus members' support for a tobacco policy prohibiting e-cigarette use on the campus (vape-free policy support). The present study explores the main and interaction effects of affirmation and message framing on the vape-free policy support among college students who vary in their vaping status. We conducted a computer-based experiment with a two (affirmation: self vs. group) by two (message framing: gain vs. loss) by two (vaping status: vapers vs. non-vapers) between-subjects design. Our analysis indicated that self-affirmation is associated with a higher level of vape-free policy support than group-affirmation. The main effects of message framing as well as two-way interactions between framing and affirmation were not statistically significant. A notable finding was the three-way interaction effect among affirmation, framing, and vaping status. For vapers, the level of policy support was the highest when they were self-affirmed and exposed to a gain-framed message. For non-vapers, the level of policy support was the highest when they were self-affirmed and exposed to a loss-framed message. Our findings suggest that colleges may use varied approaches in communicating a vape-free campus policy based on the target students' vaping status, and the group-pride or collective identity appeals may not be effective in promoting such policy.
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Affiliation(s)
- Jungmi Jun
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina
| | - Taylor J Wen
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina
| | - Linwan Wu
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina
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McKelvey K, Baiocchi M, Halpern-Felsher B. PMI's heated tobacco products marketing claims of reduced risk and reduced exposure may entice youth to try and continue using these products. Tob Control 2020; 29:e18-e24. [PMID: 32029537 PMCID: PMC7416542 DOI: 10.1136/tobaccocontrol-2019-055318] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/16/2019] [Accepted: 10/31/2019] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Philip Morris International (PMI) is seeking Food and Drug Administration's (FDA) authorisation to market IQOS as a modified risk tobacco product and to make marketing claims of reduced risk and reduced exposure. Such claims may be misunderstood by youth, thereby increasing their risk for tobacco initiation. OBJECTIVE To assess youth (mean age 19.3, SD=1.7) understanding and perceptions of PMI's proposed consumer marketing claims of reduced risk and reduced exposure, we embedded a randomised controlled experiment into a survey of 450 California youth (April to August 2018). Participants were randomised to see 'reduced exposure', 'reduced risk' or neither claim. Perceptions of IQOS-related health risks and general harm and understanding of the term 'switching completely' as used in PMI's proposed claims were compared. RESULTS Mean expectancies to experience specific health risks did not differ by claim exposure. The reduced exposure group's perceptions of general harm did not differ from those of controls nor from the reduced risk group. The reduced risk group had the largest proportion who perceived IQOS as moderately/less harmful (n=78, 52%); controls the largest proportion perceiving IQOS as quite/extremely harmful (n=91, 63%). While 71% of the sample understood the term 'switch completely' correctly as used in the reduced risk (n=194, 71%) and reduced exposure (n=206, 72%) claims, more than 1 in 4 did not. CONCLUSIONS FDA and other regulators must use caution when considering allowing claims of reduced risk or reduced exposure to appear on retail tobacco packaging. Youth misunderstand such claims, and misperceptions of harm are known to lead to tobacco-use initiation.
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Affiliation(s)
- Karma McKelvey
- Pediatrics/Adolescent Medicie, Stanford University School of Medicine, Stanford, California, USA
| | - Michael Baiocchi
- Statistics, Stanford University Stanford Prevention Research Center, Stanford, California, USA
| | - Bonnie Halpern-Felsher
- Pediatrics/Adolescent Medicie, Stanford University School of Medicine, Stanford, California, USA
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Luzius A, Dobbs PD, Jozkowski KN. College students' reasons for using different e-cigarette products: A mixed methods analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:832-838. [PMID: 31157606 DOI: 10.1080/07448481.2019.1618313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
This study examined if college students used particular e-cigarette devices for different reasons. Participants: College students from a large southern university completed an online, close- and open-ended survey. Data were delimited to those 18-25 years of age who had used e-cigarettes (n = 338). Methods: A convergent mixed-methods design was employed by quantifying qualitative responses via an inducting coding method. Next, χ2 analyses examined relationships between use of different products (i.e., cigalikes, vape pens, eGos, mods) and reasons for using e-cigarettes. Results: Emerging themes representing reasons for trying e-cigarettes included: curiosity, peer pressure, recreation, flavors, better than cigarettes, and to quit/reduce tobacco use. Significant relationships existed between use of cigalikes, (p < . 01), eGos (p < . 05), and mods (p < . 05) and use of e-cigarettes to quitting/reducing tobacco use. Conclusions: Health promotion efforts on college campuses should address curiosity about these products and provide scientifically proven therapy to those seeking to quit tobacco.
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Affiliation(s)
- Abbie Luzius
- Hope Cancer Resources, Outreach and Development Department, Springdale, USA
| | - Page D Dobbs
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Kristen N Jozkowski
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, USA
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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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Jun J, Kim SH, Wu L. Tobacco Risk Information and Comparative Risk Assessment of E-Cigarettes Vs. Cigarettes: Application of the Reinforcing Spirals Model. JOURNAL OF HEALTH COMMUNICATION 2019; 24:422-431. [PMID: 31210588 DOI: 10.1080/10810730.2019.1630526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examine how individuals seek information about e-cigarette risk and selectively expose themselves to media sources that may provide information consistent with their existing beliefs and behaviors related to e-cigarettes in application of the Reinforcing Spirals Model (Slater, 2007). Additionally, the associations among e-cigarette risk information-seeking, tobacco risk information exposure via media, and comparative risk assessment of e-cigarettes versus conventional cigarettes were identified. The results were compared among current users, former users, and those who had never used e-cigarettes ("never users"). A nationally representative data from the 2017 Health Information National Trends Surveys - FDA was employed. Our analyses suggest the presence of comparative risk perception among current users as assessing the health harm and addiction risk of e-cigarettes significantly lower than cigarettes. Current users did not avoid information about the health effects of e-cigarettes; they were more likely to look for such information than former and never users. Current users' e-cigarette risk information-seeking was negatively associated with the difference between perceived addiction risk of e-cigarettes and that of cigarettes. Current users' tobacco risk information exposure via social media was related with a lower level of the perceived risk of e-cigarettes, while such exposure via news media was related with a higher level of perceived risk of e-cigarettes. Our findings suggest the need for regulating and counteracting the prevalent e-cigarette information that discounts the relative risks of e-cigarettes as well as the potential of news media as influential sources helping current users scrutinize the risks.
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McKelvey K, Halpern-Felsher B. From tobacco-endgame strategizing to Red Queen's race: The case of non-combustible tobacco products. Addict Behav 2019; 91:1-4. [PMID: 30642577 PMCID: PMC6541479 DOI: 10.1016/j.addbeh.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
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Fakunle DO, Eck R, Milam AJ, Thorpe RJ, Furr-Holden DM. E-Cigarettes in Baltimore Alcohol Outlets: Geographic and Demographic Correlates of Availability. FAMILY & COMMUNITY HEALTH 2019; 41:205-213. [PMID: 30134335 PMCID: PMC6107309 DOI: 10.1097/fch.0000000000000200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is limited research on e-cigarette availability despite increased use. E-cigarette availability within Baltimore alcohol outlets was analyzed for disparities among residential neighborhoods. Data were obtained via field surveys of alcohol outlets, and then spatially merged with sociodemographic data; 18.8% of alcohol outlets had any e-cigarette availability. Regression models showed greater odds ratios for e-cigarette availability when cigarettes, cigars, or hookah paraphernalia were sold, and lower odds ratios when alcohol outlets had an on-site consumption license. Outlets with e-cigarette availability were in predominantly lower-income, nonwhite neighborhoods. It is important to assess exposure of another potentially damaging substance among perpetually disadvantaged populations.
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Affiliation(s)
- David O Fakunle
- School of Community Health & Policy, Morgan State University, Baltimore, Maryland (Dr Fakunle); Departments of Health, Behavior & Society (Drs Eck and Thorpe) and Mental Health (Drs Fakunle and Milam), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and Department of Prevention Science and Public Health, Michigan State University College of Human Medicine, Flint (Dr Furr-Holden)
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McKelvey K, Baiocchi M, Halpern-Felsher B. Adolescents' and Young Adults' Use and Perceptions of Pod-Based Electronic Cigarettes. JAMA Netw Open 2018; 1:e183535. [PMID: 30646249 PMCID: PMC6324423 DOI: 10.1001/jamanetworkopen.2018.3535] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among adolescents and young adults, and the new pod-based e-cigarette devices may put adolescents and young adults at increased risk for polytobacco use and nicotine dependence. OBJECTIVE To build an evidence base for perceptions of risk from and use of pod-based e-cigarettes among adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS In a survey study, a cross-sectional analysis was performed of data collected from April 6 to June 20, 2018, from 445 California adolescents and young adults as part of an ongoing prospective cohort study designed to measure the use and perceptions of tobacco products. EXPOSURES Use of pod-based e-cigarettes, e-cigarettes, and cigarettes. MAIN OUTCOMES AND MEASURES Ever use, past 7-day use, and past 30-day use and co-use of pod-based e-cigarettes, e-cigarettes, and cigarettes; use of flavors and nicotine in pod-based e-cigarettes and e-cigarettes; and associated perceptions of risks, benefits, and nicotine dependence. RESULTS Among 445 adolescents and young adults (280 females, 140 males, 6 transgender individuals, and 19 missing data; mean [SD] age, 19.3 [1.7] years) who completed wave 6 of the ongoing prospective cohort study, ever use information was provided by 437 respondents, of which 68 (15.6%) reported use of pod-based e-cigarettes, 133 (30.4%) reported use of e-cigarettes, and 106 (24.3%) reported use of cigarettes. The mean (SD) number of days that pod-based e-cigarettes were used in the past 7 days was 1.5 (2.4) and in the past 30 days was 6.7 (10.0). The mean (SD) number of days that other e-cigarettes were used in the past 7 days was 0.8 (1.8) and in the past 30 days was 3.2 (7.4). The mean (SD) number of days that cigarettes were used in the past 7 days was 0.7 (1.8) and in the past 30 days was 3.0 (7.6). Among ever users of pod-based e-cigarettes, 18 (26.5%) reported their first e-liquid was flavored menthol or mint and 19 (27.9%) reported fruit (vs 13 [9.8%] and 50 [37.6%] for other e-cigarettes). The mean perceived chance of experiencing social risks and short-term and long-term health risks from the use of either pod-based e-cigarettes or other e-cigarettes was 40% and did not differ statistically by e-cigarette type. Among 34 adolescents and young adults reporting any loss of autonomy from nicotine, there was no difference in mean (SD) Hooked On Nicotine Checklist scores between those using pod-based e-cigarettes (2.59 [3.14]) and other e-cigarettes (2.32 [2.55]). CONCLUSIONS AND RELEVANCE Use by adolescents and young adults of newer types of e-cigarettes such as pod-based systems is increasing rapidly, and adolescents and young adults report corresponding misperceptions and lack of knowledge about these products. Rapid innovation by e-cigarette manufacturers suggests that public health and prevention efforts appear to be needed to include messages targeting components common to all current and emerging e-cigarette products to increase knowledge and decrease misperceptions, with the goal to try to ultimately reduce e-cigarette use among adolescents and young adults.
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Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California
| | - Mike Baiocchi
- Stanford Prevention Research Center, Stanford University, Palo Alto, California
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California
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Trumbo CW. Influence of Risk Perception on Attitudes and Norms Regarding Electronic Cigarettes. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:906-916. [PMID: 29023906 DOI: 10.1111/risa.12918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 08/07/2017] [Accepted: 08/18/2017] [Indexed: 06/07/2023]
Abstract
The use of electronic cigarettes has grown substantially over the last few years. Currently, about 4% of adults use electronic cigarettes, about 16% of high school students report use in the past 30 days, as do approximately 11-25% of college students. A hallmark of the reduction in tobacco use has been the shift in social norms concerning smoking in public. Such norms may also drive views on acceptability of public electronic cigarette use. While normative factors have been given attention, little substantive application of the literature on risk perception has been brought to bear. The overall aim of this study was to place a cognitive-affective measure of risk perception within a model that also includes social cues for e-cigarettes, addictiveness beliefs, and tobacco use to predict perceived social acceptability for public use of e-cigarettes. To do so, a cross-sectional study using an online survey was conducted among a sample of undergraduate students at a Western university (n = 395). A structural equation model showed that the acceptability of public e-cigarette use was influenced by social cues, beliefs about addiction, and cognitive risk perception, even after controlling for nicotine use. What is revealed is that cognitive assessment of e-cigarette risk and perception of addictiveness had a suppressing effect on perceived acceptability of public vaping, while greater exposure to social cues exerted a countervailing effect. This is evidence of the role that risk perception and social norms may play in the increases in electronic cigarette use that have been observed.
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Hammig B, Daniel-Dobbs P, Blunt-Vinti H. Electronic cigarette initiation among minority youth in the United States. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:306-310. [PMID: 27494770 DOI: 10.1080/00952990.2016.1203926] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarette) use among youth is a pressing public health issue, with prevalence of use surpassing that of tobacco cigarettes. While research concerning e-cigarettes has proliferated in recent years, there is a dearth of information regarding those whose first exposure to tobacco products was an e-cigarette. OBJECTIVES To examine factors associated with e-cigarette initiation among minority youth in the United States. METHODS Data on minority students in middle and high schools in the United States derived from the 2014 National Youth Tobacco Survey (NYTS) were sampled (weighted N = 27,294,454). We examined e-cigarette initiation among minority youth using logistic regression models to identify related factors. RESULTS In 2014, 736,158 minority youth were e-cigarette initiators. Odds of e-cigarette initiation was highest among Hispanic youth [adjusted odds ratio (AOR) = 2.70; 95% confidence interval (CI) = 1.60-4.56]. Exposure to e-cigarette advertising (AOR = 1.64; 95% CI = 1.07-2.50), perceptions of little to no harm (AOR = 7.08; 95% CI = 4.03-12.46), and believing e-cigarettes were less addictive than tobacco (AOR = 2.15; 95% CI = 1.52-3.02) were associated with e-cigarette initiation. CONCLUSIONS Odds of initiating e-cigarette use was highest among Hispanic youth. Among minority youth, e-cigarette initiation was associated with perceptions of harm and addiction potential, as well as exposure to e-cigarette advertising. Therefore, prevention efforts targeting minority youth who are at risk of becoming e-cigarette initiators may benefit by incorporating these factors into prevention campaigns.
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Affiliation(s)
- Bart Hammig
- a Community Health Promotion , University of Arkansas , Fayetteville , AR , USA
| | - Page Daniel-Dobbs
- a Community Health Promotion , University of Arkansas , Fayetteville , AR , USA
| | - Heather Blunt-Vinti
- a Community Health Promotion , University of Arkansas , Fayetteville , AR , USA
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Wagoner KG, Cornacchione J, Wiseman KD, Teal R, Moracco KE, Sutfin EL. E-cigarettes, Hookah Pens and Vapes: Adolescent and Young Adult Perceptions of Electronic Nicotine Delivery Systems. Nicotine Tob Res 2016; 18:2006-12. [PMID: 27029821 DOI: 10.1093/ntr/ntw095] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 03/22/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Most studies have assessed use of "e-cigarettes" or "electronic cigarettes," potentially excluding new electronic nicotine delivery systems (ENDS), such as e-hookahs and vape pens. Little is known about how adolescents and young adults perceive ENDS and if their perceptions vary by sub-type. We explored ENDS perceptions among these populations. METHODS Ten focus groups with 77 adolescents and young adults, ages 13-25, were conducted in spring 2014. Participants were users or susceptible nonusers of novel tobacco products. Focus group transcripts were coded for emergent themes. RESULTS Participants reported positive ENDS attributes, including flavor variety; user control of nicotine content; and smoke trick facilitation. Negative attributes included different feel compared to combustible cigarettes, nicotine addiction potential, and no cue to stop use. Participants perceived less harm from ENDS compared to combustible cigarettes, perhaps due to marketing and lack of product regulation, but noted the uncertainty of ingredients in ENDS. Numerous terms were used to describe ENDS, including "e-cigarette," "e-hookah," "hookah pens," "tanks," and "vapes." Although no clear classification system emerged, participants used product characteristics like nicotine content and chargeability to attempt classification. Perceptions differed by product used. E-hookah users were perceived as young and trendy while e-cigarette users were perceived as old and addicted to nicotine. CONCLUSIONS Young adults and adolescents report distinct ENDS sub-types with varying characteristics and social perceptions of users. Although they had more positive than negative perceptions of ENDS, prevention efforts should consider highlighting negative attributes as they may discourage use and product trial among young nonusers. IMPLICATIONS Our study underscores the need for a standardized measurement system for ENDS sub-types and additional research on how ENDS sub-types are perceived among adolescents and young adults. In addition, our findings highlight negative product attributes reported by participants that may be useful in prevention and regulatory efforts to offset favorable marketing messages.
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Affiliation(s)
- Kimberly G Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC;
| | - Jennifer Cornacchione
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Randall Teal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kathryn E Moracco
- Department of Health Behavior, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
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Wackowski OA, Bover Manderski MT, Delnevo CD. Smokers' sources of e-cigarette awareness and risk information. Prev Med Rep 2015; 2:906-910. [PMID: 26576338 PMCID: PMC4643950 DOI: 10.1016/j.pmedr.2015.10.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Few studies have explored sources of e-cigarette awareness and peoples' e-cigarette information needs, interests or behaviors. This study contributes to both domains of e-cigarette research. METHODS Results are based on a 2014 e-cigarette focused survey of 519 current smokers from a nationally representative research panel. RESULTS Smokers most frequently reported seeing e-cigarettes in stores (86.4%) and used in person (83%). Many (73%) had also heard about e-cigarettes from known users, broadcast media ads (68%), other (print, online) advertisements (71.5%), and/or from the news (60.9%); sources of awareness varied by e-cigarette experience. Most smokers (59.9%) believed e-cigarettes are less harmful than regular cigarettes, a belief attributed to "common sense" (76.4%), the news (39.2%) and advertisements (37.2%). However, 79.5% felt e-cigarette safety information was important. Over one-third said they would turn to a doctor first for e-cigarette safety information, though almost a quarter said they would turn to the Internet or product packaging first. Most (59.6%) ranked doctors as the most trustworthy risk source, and 6.8% had asked a health professional about e-cigarettes. CONCLUSIONS Future research should explore the content of e-cigarette information sources, their potential impact, and ways they might be strengthened or changed through regulatory and/or educational efforts.
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Affiliation(s)
- Olivia A Wackowski
- Rutgers School of Public Health, Center for Tobacco Studies, 335 George Street, Suite 2100, New Brunswick, NJ 08901
| | - Michelle T Bover Manderski
- Rutgers School of Public Health, Center for Tobacco Studies, 335 George Street, Suite 2100, New Brunswick, NJ 08901
| | - Cristine D Delnevo
- Rutgers School of Public Health, Center for Tobacco Studies, 335 George Street, Suite 2100, New Brunswick, NJ 08901
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