Adolescent’s explicit and implicit cigarette cognitions predict experimentation with both cigarettes and e-cigarettes

ABSTRACT

Background: Past year, month, and lifetime adolescent e-cigarette use rates remain persistently high, despite falling cigarette use rates. Previous investigations have noted a strong relationship between an individual’s positive and negative cognitions related to a behavior, and subsequent initiation of that behavior.

Objective: This investigation was conducted to determine the impact positive and negative explicit and implicit cigarette-related cognitions may have on the use of cigarettes and e-cigarettes among at-risk, cigarette-naive adolescents.

Methods: A three-year longitudinal investigation evaluated the relationship between cigarette-related cognitions and subsequent cigarette and e-cigarette use among 586 alternative high school students (female: 50.8%; mean age: 17.4 years; Hispanic/Latino: 75.0%) who had never smoked cigarettes at the baseline assessment. Multilevel logistic regression models were used to generate demographics-adjusted odds ratios (OR) and 95% confidence intervals (95% CI).

Results: Students with higher positive explicit cigarette cognitions at the baseline had greater odds of subsequent cigarette use (OR = 1.72, 95% CI 1.11–2.68). If students also reported an increase over time in positive (OR = 3.45, 95% CI 2.10–5.68) or negative (OR = 1.93, 95% CI 1.03–3.61) explicit cigarette cognitions, the odds of cigarette use increased. The odds of dual use of cigarettes and e-cigarettes were greater among students who had higher negative implicit cigarette cognitions at the baseline (OR = 2.07, 95% CI 1.03–4.17) compared to those with lower levels of negative implicit cognitions.

Conclusion: Prevention programming that focuses on decreasing positive cognitions related to nicotine and tobacco use may have greater overall effect on decreasing use compared to programs that only focus on increasing negative cognitions individuals form surrounding cigarette or e-cigarettes.

KEYWORDS:

• Alternative high school
• adolescent tobacco use
• e-cigarette use
• implicit and explicit cognitions

Acknowledgments

The authors wish to thank Sandy Asad, Sara J Asad, Melissa Garrido, Sarah Z Gonzalez, Hannah Jornacion, and Brenda Lisa Lucero for their tireless efforts recruiting and tracking alternative high school students. Additional thanks to Jerry Grenard for helping to design the study and refine the central concepts.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this publication was supported by the National Institute of Child Health and Human Development and the Food and Drug Administration Center for Tobacco Products (R01HD077560). The content is solely the responsibility of the authors and does not necessarily represent the official views of either institution.