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Purpose: While most U.S. young adults attribute e-cigarette use (vaping) to stress coping, it is relatively unknown how young adults' stress levels influence their e-cigarette health message responses and vaping abstinence intentions., Methods: In an online crowdsourcing study, young adults who currently vape (N = 346, M age  = 25.24) were assessed for their past-30-day stress levels. Then, they saw a message about the health effects of vaping and were asked questions about the messages and their vaping abstinence intentions. We performed multiple regressions to examine the main effects of stress levels on message evaluation (message perceptions, effects perceptions) and intentions to abstain from vaping. We then examined the indirect effects of stress levels on abstinence intentions mediated by each message outcome, respectively. Models controlled for sociodemographic characteristics, mental health status, and past-30-day e-cigarette use and cigarette smoking., Results: Participants with higher stress levels reported more negative message evaluation (ps < 0.05). Additionally, participants with higher stress levels reported lower abstinence intentions via more negative message perceptions (b = -0.02, SE = 0.01, 95 % CI = -0.041, -0.004). Likewise, participants with higher stress levels reported lower abstinence intentions via more negative effects perceptions (b = -0.03, SE = 0.01, 95 % CI = -0.046, -0.008)., Conclusions: Higher stress levels were associated with negative message evaluation among young adults who vape. Additionally, the association of stress levels and abstinence intentions was mediated by negative message evaluation. Public health officials may need to account for stress levels in young adults to increase the effects of e-cigarette health messages on their intentions to abstain from vaping., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: We examined the impact of financial disclosures and warning labels on pro-e-cigarette Instagram posts and their association with attitudes toward the ad and product among youth and young adults., Methods: During March to May 2021, we conducted a factorial experiment using an online convenience sample of youth and young adults (N = 1687, Mage = 21.54). Participants were randomized to one of four conditions: pro-e-cigarette Instagram posts with only a financial disclosure, only a warning label, both a financial disclosure + warning label, or no financial disclosure or warning label. After viewing the posts, participants answered questions regarding their attitude toward the ad and the product. We used one-way ANOVA to estimate the association of condition on outcomes controlling for demographics., Results: Young adults who viewed Instagram posts with only a financial disclosure reported more positive attitudes toward the ad than those who viewed posts with both a financial disclosure + warning label (p < .05). Young adults who viewed posts with only a financial disclosure reported more positive attitudes toward the product than those who viewed posts with only a warning label, both a financial disclosure + warning label, and without either (ps < .05). Differences were not statistically significant for youth. E-cigarette use status was associated with increased positive attitudes toward the ad (p < .001) and product (p < .001) for all participants., Conclusions: Our results can inform policy interventions to mitigate the effects of e-cigarette social media marketing among youth and young adults. Including financial disclosures may not decrease appeal of e-cigarettes compared to posts without either., Implications: Findings from the study suggest that a warning label may be more effective in reducing the effects of pro-e-cigarette social media posts than a financial disclosure among young adults. Public health officials should examine additional strategies beyond financial disclosures and warning labels (eg, social media peer mentoring program) to offset the persuasive effects of pro-e-cigarette social media marketing posts on young people. Additional policy interventional efforts are needed to limit the impact of e-cigarette social media marketing., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The purpose of this study was to identify behavioral and sociodemographic factors associated with intentions to engage with anti-vaping Instagram posts among a young adult population. This study proposes the following research questions: (1) Does e-cigarette use status influence intentions to engage with anti-vaping Instagram posts?, and (2) How are e-cigarette use and social media use associated? We recruited a convenience sample of young adults (N = 459; aged 18-30 years) in July of 2022 into an online experimental study from Prolific. Participants saw five image-based Instagram posts about the health harms of using e-cigarettes. Participants were then asked about their intentions to engage ("Comment on", "Reshare", "DM/Send this to a friend", "Like", and/or "Take a screenshot of") with the posts. We used logistic regression to run adjusted models for each engagement outcome, which included fixed effects for sociodemographics, tobacco use, and social media/internet use. For the sum of the engagement outcome, we used Poisson regression. Total number of social media sites used was associated with intentions to "Like" the posts ( p = 0.025) and the overall engagement score ( p = 0.019), respectively. Daily internet use was associated with intentions to "Comment on" ( p = 0.016) and "Like" ( p = 0.019) the posts. Young adults who reported past 30-day e-cigarette use had higher odds of using Twitter ( p = 0.013) and TikTok ( p < 0.001), and a higher total number of social media sites used ( p = 0.046), compared to young adults who reported never use e-cigarettes. The initial evidence from our exploratory research using a convenience sample suggests that social media campaigns about the harms of e-cigarette use may be an effective way to engage younger audiences, a generation that frequents social media. Efforts to disseminate social media campaigns should consider launching on multiple platforms, such as Twitter and TikTok, and consider e-cigarette use status when posting.

Background: Young adult sexual minoritized women (SMW) are at disproportionate risk for e-cigarette use, which may in part be due to excess minority stress imposed by discrimination exposure. While discrimination exposure is associated with risk for combustible tobacco/nicotine use among SMW, similar associations have yet to be tested with e-cigarettes. Moreover, it is unknown if discrimination-related risk may be mitigated by protective factors such as social support. This study examined concurrent associations of discrimination, perceived stress, and social support with past 30-day e-cigarette use in a sample of young adult SMW during the COVID-19 pandemic. Methods: N  = 501 SMW and nonbinary people assigned female at birth (AFAB) aged 18-30 completed an online survey. A series of logistic regressions examined associations of discrimination, perceived stress, and four forms of social support received during the COVID-19 pandemic with past-30-day e-cigarette use. Results: Among SMW, greater perceived stress (OR = 1.10, p = .03), but not discrimination exposure, was associated with e-cigarette use. Associations of discrimination with e-cigarette use were nonsignificant when most forms of social support (emotional, material/financial, and virtual) were accounted for. Associations of perceived stress with e-cigarette use were strongest among those who needed but did not receive material support. Conclusions: Perceived stress, but not discrimination exposure, was associated with risk for e-cigarette use among young SMW during the COVID-19 pandemic. Effects of nonspecific stress may be compounded by insufficient material/financial support.

Background: The prevalence of e-cigarette use among young people remains high. Young people are susceptible to e-cigarette advertising, although potential heterogeneity in perceptions of e-cigarette ads with respect to age and e-cigarette use history remains unexplored. We aimed to assess differences in perceptions of e-cigarette ads and product use intention, by age and e-cigarette use status. Methods : Participants from an online convenience sample ( N  = 497, M age =31.9) viewed two randomly selected e-cigarette ads and reported their perceptions of the ads and product use intention. We used mixed effects linear regression models to estimate associations between age group (18-20 years, 21-25 years, 26+ years), e-cigarette use status (never, former, and current use), and their interaction effects, on outcomes related to perceptions of ads and use intention. Models controlled for demographics and other tobacco use. Results : Current e-cigarette users (vs. never users) and participants who were 26+ years old (vs. 18-20 years old) had greater liking of the ads, perceived ad relevance, and perceived ad effectiveness. Among current e-cigarette users, participants who were 26+ years old (vs. 18-20 years old) had lower use intention. Conclusion : The effect of e-cigarette ad exposures on perceptions of the ad and use intention is heterogeneous with respect to age group and e-cigarette use history. While ads appealed more to adults who were 26+ years old across e-cigarette use groups, current e-cigarette users who were 18-20 years old demonstrated high use intention following ad exposure, suggesting a need for marketing interventions to mitigate continued e-cigarette use among young people.

Background : In the U.S., 9.3% of young adults currently vape. However, little is known about how vaping identity (i.e., internalizing vaping as an important part of oneself) can influence young adults' e-cigarette perceptions. The purpose of this study was to examine the association between vaping identity and e-cigarette perceptions among young adults. Methods : Young adults who vape (N = 252, Mage = 24.7) were recruited to participate in an online survey assessing a trusted source of health information, e-cigarette harm perceptions, and intentions to abstain from vaping. We estimated associations between vaping identity on outcomes and the interaction of vaping identity and combustible cigarette use on outcomes. Results : Participants with higher vaping identity reported lower trust in government health agencies and a doctor, and higher trust in the tobacco industry and e-cigarette industry (ps < 0.05). Those with higher vaping identity also reported lower e-cigarette harm perceptions and intentions to abstain from vaping (ps < 0.05). Conclusions : Findings show that higher vaping identity is associated with greater trust in the tobacco industry, lower trust in health experts, lower e-cigarette harm perceptions, and lower intentions to abstain from using e-cigarettes. This suggests that efforts to reduce vaping among young adults may need to leverage messages that reduce the credibility of the tobacco industry and prevent nonsmoking young adults from developing a vaping identity.

This study examined the effect of message source credibility on e-cigarette harm perceptions among U.S. young adults. An online experimental study was conducted where young adults (n = 302, Mage = 23.7) were randomized to an e-cigarette public health education message from an expert or a peer young adult. Then, participants answered questions about their perceptions about the message source and e-cigarettes. Results suggest that young adults rated experts as a more credible source (vs. peer) (b = −0.39, SE = 0.15, 95% CI [−0.67, −0.10], p < 0.01). Young adults reported greater perceived credibility of the expert message (vs. peer), which was associated with increased e-cigarette harm perceptions. Increased perceived source credibility mediated the association of increased e-cigarette absolute harm perceptions from viewing an expert message (b = −0.11, SE = 0.04, 95% CI: −0.20, −0.02). Source credibility should be considered when designing e-cigarette education messages for young adults.

E-cigarette (EC) use in young adult sexual-minoritized women (SMW) is disproportionately higher than among heterosexual women and sexual-minoritized men. Public health messaging utilizing social branding, a method used to tailor health messages to one's identity, may help combat this problem. We conducted an online study with SMW ( N = 457) and asked them to complete scales assessing their sexual minoritized identity affirmation and centrality. Participants were randomized to view socially branded messages discouraging EC use across three themes (general wellness, pride, health harms). Results revealed that overall lesbian, bisexual, or queer (LBQ) identity (affirmation and centrality) was significantly positively associated with perceived message effectiveness (PME) ( p < .001). Identity affirmation was significantly associated with PME when controlling for identity centrality ( p = .004). Interaction between identity affirmation and theme was significant ( p = .02), as positive effects of identity affirmation on PME were greater when participants viewed pride-themed messages versus wellness ( p = .03) or harms messages ( p = .01). The findings suggest that socially branded EC prevention messages emphasizing sexual minoritized identity may be more effective for SMW with a strong connection to their LBQ identity. Future research should examine how identity and socially branded messages can impact health behaviors.

AbstractPurpose: The use of e-cigarettes can worsen mental health symptoms in young adults. However, little is known about how young adults’ mental health may relate to their reasons for using e-cigarettes (vaping). We examined the association of mental health and vaping reasons among young adults who currently vape. Methods: Data were analyzed from a sample of young adults who vape (N = 436, Mage=25.19) who participated in an online survey assessing mental health (stress, anxiety, and depression) and vaping reasons (vape for tension reduction or relaxation, user experience, product or substance, or utility). We conducted multiple regressions and ANCOVAs, controlling for age, gender, past 30-day e-cigarette use, and past 30-day cigarette smoking. Results: Experiencing higher levels of stress, anxiety, and depression were associated with vaping for tension reduction or relaxation among young adults who vape (ps < 0.001) and for those who dual use e-cigarettes and cigarettes (ps < 0.01). Experiencing severe anxiety level was associated with vaping for tension reduction or relaxation than among those experiencing minimal, mild or moderate anxiety (ps < 0.05). Conclusions: Findings show that higher stress, anxiety, and depression are associated with greater likelihood of vaping for tension reduction or relaxation. More research should examine the association of stress, anxiety, and depression on vaping in young adults to identify and determine appropriate interventions to help with vaping cessation. [ABSTRACT FROM AUTHOR]