Breadth of Media Scanning Leads to Vaping among Youth and Young Adults: Evidence of Direct and Indirect Pathways from a National Longitudinal Survey

Abstract

Electronic cigarette use among youth and young adults has reached an epidemic proportion of growth. This study examined the direct and indirect effects of the breadth of media scanning about e-cigarette use on subsequent vaping behavior through interpersonal communication and changes in descriptive norm perceptions. We conducted a nationally representative longitudinal phone survey of 13- to 25-year-olds from June 2014 to March 2017, with 11,013 respondents who completed a baseline survey, among which 3,212 completed a follow-up 6 months later. The results from both cross-sectional and lagged analyses provided robust evidence to suggest that passive routine exposure to e-cigarette use content from more media outlets predicted increased likelihood of vaping among youth and young adults. High scanners were about twice as likely to vape as non-scanners (17% versus 9%). Mediation models using bootstrapping procedures found that breadth of scanning predicted higher descriptive norm perceptions which were associated with subsequent vaping; in addition, interpersonal communication mediated the relationship between breadth of scanning and changes in descriptive norm perceptions. These findings highlight the important roles of scanning, norm perceptions and interpersonal discussions in shaping cognition and behavior changes. The results also suggest an overall pro-e-cigarette public communication environment, which warrants further examination.

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Notes

¹ We chose the six-month lag as a tradeoff between allowing enough time for participants’ descriptive norm perceptions and e-cigarette use to change, and following up fast enough to reduce the risk of substantial study drop-out that happens with longer intervals between waves. Given that we are looking at the effects of media scanning, i.e., accumulated incidental exposure to e-cigarette-related content across different media sources, it takes time for such information to be accumulated, to become sufficiently salient and accessible in people’s mental shortcuts (Hornik et al., 2013), and to finally exert influence on their descriptive norm perceptions and tobacco use behaviors (Tankard & Paluck, 2016).

Additional information

Funding

Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50CA179546 to the University of Pennsylvania. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration (FDA).