Sage Journals: Discover world-class research

Abstract

In this article, we explore the context and determinants of pod-mod electronic cigarette (ECIG) use among college students aged 18 to 24 in the United States. We conducted semi-structured interviews with 55 students (M age = 20 years, 56% female, 65% White) on three campuses in the Northwest, Midwest, and Southeast. We performed a thematic analysis. Students described ECIG use by peers, increased ECIG exposure and prevalence in college, and school-related stress as reasons for vaping. Pod-mod features such as convenience, design, easy concealment, and flavors made vaping more appealing. Negative aspects of vaping included addiction, cost, and possible health consequences. Most viewed vaping as a college behavior and intended to quit after graduation. Our results show that the college environment plays a major role in young adult ECIG use. These findings can inform the development of targeted interventions to prevent and control uptake of ECIGs by young adults.

Keywords

electronic cigarettes pod mods university college students young adults qualitative interviews United States

Get full access to this article

View all access options for this article.

References

Ajzen

(1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-t

L. C.

Klatt

Perry

C. L.

Lein

E. B.

Hennrikus

D. J.

Pallonen

U. E.

Bliss

R. L.

Lando

H. A.

Farley

D. M.

Ahluwalia

J. S.

Ehlinger

E. P.

(2008). The RealU online cessation intervention for college smokers: A randomized controlled trial. Preventive Medicine, 47(2), 194–199. https://doi.org/10.1016/j.ypmed.2008.04.011

Bandura

(2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52(1), 1–26. https://doi.org/10.1146/annurev.psych.52.1.1

Barrington-Trimis

J. L.

Gibson

L. A.

Halpern-Felsher

Harrell

M. B.

Kong

Krishnan-Sarin

Leventhal

A. M.

Loukas

McConnell

Weaver

S. R.

(2018). Type of e-cigarette device used among adolescents and young adults: Findings from a pooled analysis of eight studies of 2166 vapers. Nicotine & Tobacco Research, 20(2), 271–274. https://doi.org/10.1093/ntr/ntx069

Breland

Soule

Lopez

Ramoa

El-Hellani

Eissenberg

(2017). Electronic cigarettes: What are they and what do they do? Annals of the New York Academy of Sciences, 1394(1), 5–30. https://doi.org/10.1111/nyas.12977

Buu

Y. H.

Wong

S. W.

Lin

H. C.

(2019). Comparing American college and noncollege young adults on e-cigarette use patterns including polysubstance use and reasons for using e-cigarettes. Journal of American College Health, 68, 610–616. https://doi.org/10.1080/07448481.2019.1583662

Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Chen

J. C.

Green

Fryer

Borzekowski

(2019). Perceptions about e-cigarette flavors: A qualitative investigation of young adult cigarette smokers who use e-cigarettes. Addiction Research & Theory, 27(5), 420–428. https://doi.org/10.1080/16066359.2018.1540693

Cheney

M. K.

Gowin

Clawson

A. H.

(2018). Using the ecological model to understand influences on college student vaping. Journal of American College Health, 66(7), 597–607. https://doi.org/10.1080/07448481.2018.1440578

10.

Choi

Fabian

Mottey

Corbett

Forster

(2012). Young adults’ favorable perceptions of snus, dissolvable tobacco products, and electronic cigarettes: Findings from a focus group study. American Journal of Public Health, 102(11), 2088–2093. https://doi.org/10.2105/AJPH.2011.300525

11.

Clark

V. L. P.

Miller

D. L.

Creswell

J. W.

McVea

McEntarffer

Harter

L. M.

Mickelson

W. T.

(2002). In conversation: High school students talk to students about tobacco use and prevention strategies. Qualitative Health Research, 12(9), 1264–1283. https://doi.org/10.1177/1049732302238249

12.

Coleman

B. N.

Johnson

S. E.

Tessman

G. K.

Tworek

Alexander

Dickinson

D. M.

Rath

Green

K. M.

(2016). “It’s not smoke. It’s not tar. It’s not 4000 chemicals. Case closed”: Exploring attitudes, beliefs, and perceived social norms of e-cigarette use among adult users. Drug and Alcohol Dependence, 159, 80–85. https://doi.org/10.1016/j.drugalcdep.2015.11.028

13.

Cooper

Loukas

Harrell

M. B.

Perry

C. L.

(2017). College students’ perceptions of risk and addictiveness of e-cigarettes and cigarettes. Journal of American College Health, 65(2), 103–111. https://doi.org/10.1080/07448481.2016.1254638

14.

Cullen

K. A.

Gentzke

A. S.

Sawdey

M. D.

Chang

J. T.

Anic

G. M.

Wang

T. W.

Creamer

M. R.

Jamal

Ambrose

B. K.

King

B. A.

(2019). E-cigarette use among youth in the United States, 2019. JAMA, 322(21), 2095–2103. https://doi.org/10.1001/jama.2019.18387

15.

Dai

Leventhal

A. M.

(2019). Prevalence of e-cigarette use among adults in the United States, 2014-2018. JAMA, 322(18), 1824–1827. https://doi.org/10.1001/jama.2019.15331

16.

Davison

W. P.

(1983). The third-person effect in communication. Public Opinion Quarterly, 47(1), 1–15. https://doi.org/10.1086/268763

17.

Fadus

M. C.

Smith

T. T.

Squeglia

L. M.

(2019). The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects. Drug and Alcohol Dependence, 201, 85–93. https://doi.org/10.1016/j.drugalcdep.2019.04.011

18.

Ford

Clifford

Gussy

Gartner

(2013). A systematic review of peer-support programs for smoking cessation in disadvantaged groups. International Journal of Environmental Research and Public Health, 10(11), 5507–5522. https://doi.org/10.3390/ijerph10115507

19.

Getachew

Payne

J. B.

Pillai

Shah

Levine

Berg

C. J.

(2018). Perceptions of alternative tobacco products, anti-tobacco media, and tobacco regulation among young adults: A qualitative study. American Journal of Health Behavior, 42(4), 118–130. https://doi.org/10.5993/AJHB.42.4.11

20.

Gilbert

P. A.

Kava

C. M.

Afifi

(2020). High school students rarely use e-cigarettes alone: A socio-demographic analysis of poly-substance use among adolescents in the USA. Nicotine & Tobacco Research. Advance online publication. https://doi.org/10.1093/ntr/ntaa037

21.

Harrell

P. T.

Brandon

T. H.

England

K. J.

Barnett

T. E.

Brockenberry

L. O.

Simmons

V. N.

Quinn

G. P.

(2019). Vaping expectancies: A qualitative study among young adult nonusers, smokers, vapers, and dual users. Substance Abuse: Research and Treatment, 13, Article 1178221819866210. https://doi.org/10.1177/1178221819866210

22.

Huang

Duan

Kwok

Binns

Vera

L. E.

Kim

Szczypka

Emery

S. L.

(2019). Vaping versus JUULing: How the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market. Tobacco Control, 28(2), 146–151. https://doi.org/10.1136/tobaccocontrol-2018-054382

23.

Keamy-Minor

McQuoid

Ling

P. M.

(2019). Young adult perceptions of JUUL and other pod electronic cigarette devices in California: A qualitative study. BMJ Open, 9(4), Article e026306. https://doi.org/10.1136/bmjopen-2018-026306

24.

King

B. A.

Gammon

D. G.

Marynak

K. L.

Rogers

(2018). Electronic cigarette sales in the United States, 2013-2017. JAMA, 320(13), 1379–1380. https://doi.org/10.1001/jama.2018.10488

25.

Kong

Morean

M. E.

Cavallo

D. A.

Camenga

D. R.

Krishnan-Sarin

(2015). Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine & Tobacco Research, 17(7), 847–854. https://doi.org/10.1093/ntr/ntu257

26.

Lanza

H. I.

Motlagh

Orozco

(2020). E-cigarette use among young adults: A latent class analysis examining co-use and correlates of nicotine vaping. Addictive Behaviors, 110, Article 106528. https://doi.org/10.1016/j.addbeh.2020.106528

27.

Lazard

A. J.

(2020). Social media message designs to educate adolescents about e-cigarettes. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2020.05.030

28.

Leavens

E. L. S.

Stevens

E. M.

Brett

E. I.

Leffingwell

T. R.

Wagener

T. L.

(2019). JUUL in school: JUUL electronic cigarette use patterns, reasons for use, and social normative perceptions among college student ever users. Addictive Behaviors, 99, Article 106047. https://doi.org/10.1016/j.addbeh.2019.106047

29.

Lee

H. Y.

Lin

H. C.

Seo

D. C.

Lohrmann

D. K.

(2017). Determinants associated with e-cigarette adoption and use intention among college students. Addictive Behaviors, 65, 102–110. https://doi.org/10.1016/j.addbeh.2016.10.023

30.

Lincoln

Y. S.

Guba

E. G.

(1985). Naturalistic inquiry. SAGE.

31.

Luzius

Dobbs

P. D.

Jozkowski

K. N.

(2019). College students’ reasons for using different e-cigarette products: A mixed methods analysis. Journal of American College Health, 1–7. https://doi.org/10.1080/07448481.2019.1618313

32.

McDonald

E. A.

Ling

P. M.

(2015). One of several “toys” for smoking: Young adult experiences with electronic cigarettes in New York City. Tobacco Control, 24(6), 588–593. https://doi.org/10.1136/tobaccocontrol-2014-051743

33.

McMillen

R. C.

Gottlieb

M. A.

Shaefer

R. M.

Winickoff

J. P.

Klein

J. D.

(2015). Trends in electronic cigarette use among U.S. adults: Use is increasing in both smokers and nonsmokers. Nicotine & Tobacco Research, 17(10), 1195–1202. https://doi.org/10.1093/ntr/ntu213

34.

Mirbolouk

Charkhchi

Kianoush

Uddin

S. M. I.

Orimoloye

O. A.

Jaber

Bhatnagar

Benjamin

E. J.

Hall

M. E.

DeFilippis

A. P.

Maziak

Nasir

Blaha

M. J.

(2018). Prevalence and distribution of e-cigarette use among U.S. adults: Behavioral risk factor surveillance system, 2016. Annals of Internal Medicine, 169(7), 429–438. https://doi.org/10.7326/M17-3440

35.

Pardun

C. J.

McKeever

Bedingfield

(2017). Smoke gets in their eyes? Third-person effects of electronic cigarette advertising. Journal of Promotion Management, 23(5), 708–726. https://doi.org/10.1080/10496491.2017.1297980

36.

Perkins

H. W.

Craig

D. W.

(2006). A successful social norms campaign to reduce alcohol misuse among college student-athletes. Journal of Studies on Alcohol and Drugs, 67(6), 880–889. https://doi.org/10.15288/jsa.2006.67.880

37.

Pokhrel

Herzog

T. A.

Muranaka

Fagan

(2015). Young adult e-cigarette users’ reasons for liking and not liking e-cigarettes: A qualitative study. Psychology & Health, 30(12), 1450–1469. https://doi.org/10.1080/08870446.2015.1061129

38.

Pokhrel

Herzog

T. A.

Muranaka

Regmi

Fagan

(2015). Contexts of cigarette and e-cigarette use among dual users: A qualitative study. BMC Public Health, 15(1), Article 859. https://doi.org/10.1186/s12889-015-2198-z

39.

QSR International Pty Ltd. (2018). NVivo qualitative data analysis software (Version 12).

40.

Romberg

A. R.

Miller Lo

E. J.

Cuccia

A. F.

Willett

J. G.

Xiao

Hair

E. C.

Vallone

D. M.

Marynak

King

B. A.

(2019). Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018. Drug and Alcohol Dependence, 203, 1–7. https://doi.org/10.1016/j.drugalcdep.2019.05.029

41.

Sharapova

S. R.

Singh

Agaku

I. T.

Kennedy

S. M.

King

B. A.

(2018). Patterns of e-cigarette use frequency-National Adult Tobacco Survey, 2012-2014. American Journal of Preventive Medicine, 54(2), 284–288. https://doi.org/10.1016/j.amepre.2017.09.015

42.

Sutfin

E. L.

McCoy

T. P.

Morrell

H. E.

Hoeppner

B. B.

Wolfson

(2013). Electronic cigarette use by college students. Drug and Alcohol Dependence, 131(3), 214–221. https://doi.org/10.1016/j.drugalcdep.2013.05.001

43.

Talih

Salman

El-Hage

Karam

Karaoghlanian

El-Hellani

Saliba

Shihadeh

(2019). Characteristics and toxicant emissions of JUUL electronic cigarettes. Tobacco Control, 28(6), 678–680. https://doi.org/10.1136/tobaccocontrol-2018-054616

44.

Thomas

D. R.

(2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237–246. https://doi.org/10.1177/1098214005283748

45.

Triandafilidis

Ussher

J. M.

Perz

Huppatz

(2017). An intersectional analysis of women’s experiences of smoking-related stigma. Qualitative Health Research, 27(10), 1445–1460. https://doi.org/10.1177/1049732316672645

46.

U.S. Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

47.

U.S. Department of Health and Human Services. (2018). Surgeon General’s advisory on e-cigarette use among youth. https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf

48.

Vallone

D. M.

Bennett

Xiao

Pitzer

Hair

E. C.

(2019). Prevalence and correlates of JUUL use among a national sample of youth and young adults. Tobacco Control, 28(6), 603–609. https://doi.org/10.1136/tobaccocontrol-2018-054693

49.

Wallace

L. N.

Roche

M. J.

(2018). Vaping in context: Links among e-cigarette use, social status, and peer influence for college students. Journal of Drug Education, 48(1–2), 36–53. https://doi.org/10.1177/0047237918807706

50.

Wong

S. W.

Lin

H. C.

Piper

M. E.

Siddiqui

Buu

(2019). Measuring characteristics of e-cigarette consumption among college students. Journal of American College Health, 67(4), 338–347. https://doi.org/10.1080/07448481.2018.1481075

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB

“Taking Up a New Problem”: Context and Determinants of Pod-Mod Electronic Cigarette Use Among College Students

Abstract

Keywords

Get full access to this article

References

Supplementary Material