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What May Be Associated with Young Adult E-Cigarette Use? Application of the Integrated Behavior Model and Affect Heuristic to Examine Key Correlates Open Access

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Increasing rates of e-cigarette use among young adults support the critical need for research identifying how attitude, norm, intention, and risk perception may influence e-cigarette use among this age group. Tobacco control approaches shown to prevent cigarette smoking may not work as effectively for the prevention of e-cigarette use. To address this research gap, the present study applied the Integrated Behavior Model (IBM) encompassing the affect heuristic theory to examine individual-level correlates (i.e., attitude, perceived norm, personal agency, intention, and e-cigarette risk perception) of young adults’ e-cigarette use. The 2013-2014 Population Assessment of Tobacco and Health (PATH) Study Wave 1 baseline adult dataset consisted of 9,112 young adults (ages 18-24). A total of 3,887 (42.7%) reported ever having used an e-cigarette even one or two times, and reported now using e-cigarettes every day (n=160, 4.1%), some days (n=947, 24.4%), or not at all/non-users (n=2,780, 71.5%). Findings from structural equation models (SEM) indicated that the affect heuristic theory and constructs adapted from the IBM were associated positively with e-cigarette use among young adults (CFI = 0.935; TLI = 0.925; RMSEA = 0.024, 90% CI: 0.022-0.026). As expected for the IBM, young adults’ positive feelings, perceived benefits, and normative beliefs of e-cigarettes were negatively associated with intention to quit e-cigarettes and, in turn, with a higher likelihood of currently using e-cigarettes. Perceived benefit and positive feelings also were associated inversely with young adults’ risk perceptions and, in turn, a higher likelihood of currently using e-cigarettes. These findings suggest that communication, educational, and policy strategies to prevent e-cigarette use among young adults should highlight the health risk of e-cigarettes in order to address the high perceived benefits and low risk perceptions reported by young adults in this study.

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