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. 2021 Jan 20;46(1):112-122.
doi: 10.1093/jpepsy/jsaa097.

Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use

Kristine Durkin  1 , Desireé N Williford  1 , Nicholas A Turiano  1   2 , Melissa D Blank  1   2 , Paul T Enlow  3 , Pamela J Murray  4 , Christine Banvard-Fox  4 , Christina L Duncan  1   4
Affiliations

Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use

Kristine Durkin et al. J Pediatr Psychol. .

Abstract

Objective: Prior research identified peer use as a salient risk factor of adolescent electronic cigarette (e-cigarette) use, but has not expanded on the mechanisms of this association.

Methods: Participants were 562 adolescents recruited from rural and suburban public high schools and an adolescent medicine clinic in the mid-Atlantic United States. Participants completed a packet of questionnaires that assessed demographics, substance use, expectations about the consequences of e-cigarette use, and perceptions of their own self-efficacy to resist using e-cigarettes. We estimated a series of mediation models using the MODEL INDIRECT command in MPLUS statistical software. In all models, significance of indirect effects from peer e-cigarette use to self-reported e-cigarette use were tested via two variables: (a) expected costs, (b) benefits of e-cigarette use, and (c) the perceived self-efficacy of the individual to refrain from e-cigarette use.

Results: Adolescents with more peers using e-cigarettes were more likely to have ever used an e-cigarette and perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 1). Those with more peers using e-cigarettes were more likely to be currently using e-cigarettes themselves because they perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 2).

Conclusion: Peer use, self-efficacy to resist use, and expectations of cost and benefits of e-cigarette use should be considered as possible targets when devising tailored interventions and policies to prevent or reduce negative health consequences of long-term e-cigarette use.

Keywords: electronic cigarettes; expectations; peer use; self-efficacy.

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Figures

Figure 1.
Figure 1.
Mediation model predicting lifetime and current e-cigarette use. In Model 1, the association between peer e-cigarette use and any self-reported e-cigarette use (lifetime) through perceived benefits of e-cigarette use and self-efficacy was evaluated. Effects are adjusted for age, gender, ever use of cigarettes, and past 30-day use of cigarettes, cigar, and smokeless tobacco products. ***p < .001.
Figure 2.
Figure 2.
Mediation model predicting lifetime and current e-cigarette use. In Model 2, the association between peer e-cigarette use and any self-reported e-cigarette use (current) through perceived benefits of e-cigarette use and self-efficacy was evaluated. Effects are adjusted for age, gender, ever use of cigarettes, and past 30-day use of cigarettes, cigar, and smokeless tobacco products. ***p < .001.
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