Melissa H. Abadi, Ph.D., mabadi@pire.org
Joel W. Grube, Ph.D., grube@prev.org
Stephen R. Shamblen, Ph.D., sshamblen@PIRE.org
Sharon Lipperman-Kreda, Ph.D., skreda@prev.org
Kirsten Thompson, M.A., kthompson@PIRE.org
Camila Aramburu, M.P.H., caramburu@PIRE.org
Studies show that e-cig and tobacco cigarette susceptibility (intentions and willingness) predict future e-cig and tobacco use. Research suggests that environments favorable to e-cig use may increase susceptibility to future e-cig use and tobacco use among adolescents, but little is known about the predictors of e-cig and tobacco use susceptibility. This study used EMA to investigate daily predictors of e-cig and tobacco cigarette susceptibility over time.
Our sample comprised 50 adolescent vapers (ages 14-17) who completed daily surveys over 14 days (700 observations). Surveys asked about context of vaping, motivations for vaping, exposure to e-cig marketing and others’ e-cig use, and intentions and willingness to use e-cigs and tobacco cigarettes the next day. Adolescents reported intending to vape the next day on 47% of occasions and intending to smoke on 16%. On average, they were “willing” to vape and “somewhat willing” to smoke the next day.
We used multi-level models to examine predictors of susceptibility from risk factors collected the same day. Intentions to vape the next day were predicted by a greater number of total puffs, vaping high nicotine strength (18 mg or greater), vaping with their own device, vaping alone, vaping at home, vaping because it feels good, and greater exposure to adults and peers vaping, e-cig warning messages, and e-cig advertising. Intentions to smoke tobacco the next day were predicted by less exposure to e-cig advertising. Willingness to vape the next day was predicted by a greater number of total puffs, vaping because of appealing flavors, vaping to help quit smoking cigarettes, and exposure to e-cig advertising. Willingness to smoke the next day was predicted by vaping with their own device, vaping because of no odor, and exposure to e-cig advertising. Results provide predictors of e-cig and tobacco use susceptibility that can help inform policy and real-time interventions and ensure effective targeting of adolescents susceptible to e-cig and tobacco use. In addition, results can help clarify how risk factors are differentially associated with intentions and willingness, two common measures of susceptibility.
Funding: This research is supported by the National Institute on Drug Abuse Research (NIDA) and Food and Drug Administration (FDA) Center for Tobacco Products (CTP) grant 1R03DA041899-01A1, as well as grants 25IR-0029 from the California Tobacco-Related Disease Research Program (TRDRP) and P60-AA006282 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The content is solely the responsibility of the authors and does not necessarily represent the official views of FDA, CTP, NIDA, TRDRP, NIAAA, or NIH.
Topic: Public Health
Keywords: Adolescent/Youth; E-cigarette; Tobacco
Statement of Relevance to CTP Regulatory Authorities: Through use of innovative methods and measures, the results of this study inform CTP’s understanding of the attitudes, behaviors, and intentions related to e-cig and tobacco use among adolescents, as well as the influence of exposure to marketing and others’ use.
