E-Cigarette Social Norms and Risk Perceptions Among Susceptible Adolescents in a Country That Bans E-Cigarettes

Background. This study examined how risk perceptions and social norms around e-cigarettes are associated with susceptibility (i.e., openness to using the product in the next 12 months) of e-cigarettes and smoking among adolescents. Methods. We analyzed data from a 2016 representative survey of 8,718...

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Bibliographic Details
Published in:Health education & behavior 2019-04, Vol.46 (2), p.275-285
Main Authors: Lozano, Paula, Arillo-Santillán, Edna, Barrientos-Gutíerrez, Inti, Shigematsu, Luz Myriam Reynales, Thrasher, James F.
Format: Article
Language:English
Subjects:
Acceptability
Adolescent
Adolescents
Advertising
Age Differences
At Risk Persons
Bans
Behavior Standards
Cigarettes
Cross-Sectional Studies
Data processing
Drinking
Educational Attainment
Electronic cigarettes
Electronic Nicotine Delivery Systems
Estimation
Family Influence
Female
Foreign Countries
Friendship
Gender Differences
Humans
Male
Mathematical models
Mexico
Middle School Students
Middle Schools
Norms
Openness
Parent Background
Peer Influence
Perceptions
Regression analysis
Relatives
Risk
Risk perception
Risk-Taking
Smoking
Smoking - psychology
Social Attitudes
Social Influences
Social Norms
Social Norms About Tobacco and Alcohol Use
Students
Surveys and Questionnaires
Susceptibility
Teenagers
Vaping - psychology
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Summary:Background. This study examined how risk perceptions and social norms around e-cigarettes are associated with susceptibility (i.e., openness to using the product in the next 12 months) of e-cigarettes and smoking among adolescents. Methods. We analyzed data from a 2016 representative survey of 8,718 middle school students in Mexico. The study sample was restricted to students who had tried neither e-cigarettes nor cigarettes, (N = 4471). Students reported on the risks of e-cigarettes compared with those of cigarettes, and product-specific norms were measured by assessing current use by family members, at least one close friend, and, for e-cigarettes, by perceived societal acceptability of use (i.e., acceptability among people in general). Adjusted prevalence ratios (APR) were estimated using generalized estimating equation models that regressed e-cigarette societal acceptability on study variables. Adjusted generalized estimating equation models also regressed susceptibility for each product on study variables. Results. Susceptibility to both e-cigarettes and smoking was higher among students who reported that their family and friends used only cigarettes or both products when compared with students whose family and friends did not use either of these products. Friend use of e-cigarettes was associated with e-cigarette susceptibility (APR = 1.33) but not smoking susceptibility. Students who perceived that e-cigarettes were less risky than smoking were more susceptible to e-cigarette use (APR = 1.45). The association between e-cigarette susceptibility and friend or family use was not mediated by societal acceptability. Conclusions. E-cigarette use among family and peers appears associated with susceptibility to use e-cigarettes in a way that is similar to the patterns found for cigarettes. However, the influences appear somewhat specific to the type of product that network members use.
ISSN:1090-1981
1552-6127
1552-6127
DOI:10.1177/1090198118818239