Understanding the Associations Between Adolescents’ Exposure to E-Cigarette Information and Vaping Behavior Through the Theory of Planned Behavior

ABSTRACT

Adolescents have actively looked for and passively scanned information about electronic cigarettes (e-cigarettes) from a variety of media and interpersonal sources. Despite the evidence that exposure to e-cigarette information is associated with youth’s increased vaping intention, there is a paucity of scholarship that differentiates the sources where adolescents obtain e-cigarette information in their investigation, which limits our understanding of the unique association between vaping intention and e-cigarette information acquisition from specific sources. In addition, few studies have systematically examined the mechanism of the aforementioned associations. To fill the gap, an online national survey on a panel of adolescents between 13 to 17 years old was conducted. After controlling for potential confounders, several significant indirect effects were observed. Specifically, adolescents’ vaping intention was negatively associated with e-cigarette information seeking from health professionals but positively with e-cigarette information exposure from family and friends, outdoors advertisements, social media, and other online channels, with the theory of planned behavior (TPB) constructs mediating these relationships. The findings not only contribute to the body of scholarship on TPB but also provide important suggestions for regulating outdoor and online e-cigarette information and designing persuasive interventions and campaigns.

Acknowledgements

The author thanks Ms. Elizabeth Dubson and Ms. Aizi Chang for their great help with literature search and data management respectively.

Disclosure statement

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

Notes

1. The PBC construct was operationalized as participants’ perceived ability to refuse e-cigarettes instead of perceived ability to use e-cigarettes primarily because no measure evaluating adolescent self-efficacy for using e-cigarettes has been validated (Durkin et al., 2021). Therefore, the perceived self-efficacy to resist using e-cigarettes has been widely used in existing literature applying TPB to understand YYAs’ e-cigarette use (e.g., Durkin et al., 2021; Scheinfeld et al., 2019; Weser et al., 2021). Furthermore, compared to the measure of perceived self-efficacy of using e-cigarettes, the measure of perceived self-efficacy to resist using e-cigarettes should be more relevant to this sample and this population (Patrick et al., 2022), where the majority have never vaped.

2. An adequate model fit is demonstrated by a non-significant χ² test and χ² value to degrees of freedom ratio smaller than 3 (Hoelter, 1983). However, since χ²value is almost always statistically significant when the sample size is over 400 (Bentler & Bonett, 1980; Kenny, 2020), the model fit was decided in the current study based on other indices. Specifically, values smaller than .05 for both the standardized root-mean-square residual (SRMR) and root-mean square of approximation (RMSEA) suggest a close model fit while values between .05 and .08 for RMSEA show a reasonable fit (Browne & Cudeck, 1993; Hu & Bentler, 1998). Values greater than .90 for the comparative fit index (CFI) and Tucker – Lewis Index (TLI) indicate a good fit (Hu & Bentler, 1998).

Additional information

Funding

The research reported in this manuscript was supported by the Texas Christian University Research and Creative Activities Fund [60866]