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Abstract

Vape use among young adults remains a public health concern. Interventions may need to evaluate aspects related to the self to best support individuals. We hypothesized that individuals who vape, compared to those who do not, would report lower self-esteem, higher self-alienation, and increased likelihood to report a concealable stigmatized identity (CSI). This online cross-sectional study recruited undergraduate students (N = 378), and assessed self-esteem, self-alienation, general (non-vape-specific) CSI status, and vape use. Those who vape filled out vape-specific measures and wrote about their vape use which was thematically coded. Contrary to hypotheses, participants who vape reported higher self-esteem, marginally lower self-alienation, and an increased likelihood of a CSI. Thematic coding revealed social reasons as a primary motivation for vape use. These results suggest the role of social connection in engaging in vape use, underscoring the need for interventions that address identity and social belonging.

Keywords

vape e-cigarette self-perception identity social influence

Introduction

Originally intended to be used by individuals to assist in smoking cessation efforts (Rahman et al., 2014), electronic nicotine products (i.e. vapes) have evolved into a significant public health concern for adolescents and young adults (Chadi et al., 2019; Virgili et al., 2022). A common concern noted by those who vape is the potential for nicotine addiction, which can affect various areas of one’s life (Amato et al., 2021). Vape-specific cessation interventions remain scarce and often borrow from traditional tobacco smoking interventions (Berg et al., 2021). While vaping and smoking have similarities, there are noted differences in cessation barriers for vaping that are not present for smoking cigarettes. For example, young adults note perceived social acceptability, discreetness, and lack of consistent information regarding the potential negative effects of vaping as obstacles to quitting (Sanchez et al., 2021). In contrast, those who smoke cigarettes are aware of the negative views and effects of smoking, which is associated with both positive (e.g. reduced smoking) and negative (e.g. shame, defensiveness) consequences that can contribute to one’s smoking cessation experience (Evans-Polce et al., 2015). Related to these negative views of cigarette smoking, many young adults who vape distance themselves from the stigmatized label often associated with tobacco cigarettes, as vaping is seen as more socially acceptable (Sanchez et al., 2021). This social acceptability can be further seen in how social influence plays into vape use, as many young people often report social and peer influence for initiating and continuing to use vape products (Tran et al., 2024). Thus, further understanding vape-specific experiences, such as initiation and continuation of vape use becomes critical in development and refinement of cessation interventions.

Understanding self-perceptions in vaping contexts

In addition to addressing vape-specific facilitators and barriers, it has been proposed that vape cessation interventions also need to address identity considerations to be successful (Berg et al., 2021). The importance of self-perceptions cannot be overstated as self-esteem, self-concept, behaviors, and social conditions are deeply interconnected, with each influencing and limiting the others in significant ways (Swann et al., 2007). For instance, authenticity, the subjective sense of knowing and embracing one’s perceived true self, is linked to many positive outcomes such as a sense of meaning in life (Rivera et al., 2019), overall well-being (Ryan and Ryan, 2019), and increased psychological resilience against adversity and stress (Wickham et al., 2016). Self-alienation, in contrast to authenticity, reflects a sense of disconnection from one's true self and conscious awareness (Wood et al., 2008). Self-alienation has been linked to negative outcomes such as academic amotivation (Kim et al., 2018), decreased life satisfaction (Wood et al., 2008), and decreased well-being (Lutz et al., 2023).

The harmful effects of self-alienation may stem from diminished subjective ownership of one’s experiences (Vess, 2019). Disruptions in self-awareness (e.g. daydreaming) indicate a lack of present moment experiences, which has been linked to greater self-alienation (Vess et al., 2019). Extending connection to the self to addiction literature, prior work has suggested that those who vape may be low in self-awareness when engaging in vape use behavior, making it difficult to quit (Sanchez et al., 2021). Previous work has demonstrated that vape use is associated with lower mindfulness, lower self-compassion, and higher rumination (Evans and Alkan, 2024). This is worrisome, as perceived connection to the self shapes behavior in meaningful ways. For example, feeling authentic while performing a behavior has been associated with increased motivation to continue engaging in the target behavior (Gause et al., 2025), with similar findings extending to continued engagement in addictive behaviors (Lister et al., 2015).

Another powerful self-perception is self-esteem – one’s global evaluation of self-worth (Rosenberg et al., 1995). Greater levels of self-esteem positively predict psychological well-being and felt authenticity (Heppner et al., 2008; Rivera et al., 2019). Conversely, lower self-esteem has been linked to mental illness and substance use disorders (Alavi, 2011; Silverstone and Salsali, 2003), with the anticipation of shame and perceived necessity to conceal one's mental health struggles or addiction further compounding self-esteem issues (Corrigan et al., 2006; Rodrigues et al., 2013).

Beyond self-perceptions, navigating one’s existential being in a complex world requires understanding how social identities – particularly stigmatized ones – shape both self-perceptions and behaviors. Recent research has examined these existential constructs in the context of concealable stigmatized identities (CSIs; Le Forestier et al., 2024; Needy et al., 2025). CSIs are socially devalued but not readily visible identities, such as sexual or gender minority, mental illness, hidden physical illnesses, or a history of trauma (Quinn and Chaudoir, 2009). Findings suggest that individuals with CSIs experience heightened self-alienation (Needy et al., 2025) and lower self-esteem (Le Forestier et al., 2024), both of which contribute to negative health and well-being outcomes. Moreover, research suggests that those with CSIs may face a greater risk of substance misuse (Talley and Littlefield, 2014).

Examining these aspects tied to a person’s sense of self and identity – such as self-alienation, self-esteem, and presence of a CSI – may provide some additional nuance needed to help address addiction-related concerns and treatment. This is especially relevant as vaping complicates the traditional distinction given to cigarette smoking behavior, due to its subtle use and marketing as a smoking alternative.

Study aims

Given (1) the strong empirical support of identity related concerns being directly involved in shaping substance use behavior and (2) the lack of these same identity-related processes examined in the context of vape use, we conducted a cross-sectional online study with currently enrolled college students using two waves of recruitment. Current university students who do and do not vape were recruited. This focus allows us to examine differences between vape use and non-use on existential measures related to the self.

As much research suggests the negative relationship between key variables of interest and shame, worry, and depression, we wanted to control for these variables and examine the relationships between vape use and self-perception concerns. Specifically, we hypothesized that participants who vape would score lower on a self-report measure of self-esteem (H1). We also hypothesized that participants who vape would score higher on measures of self-alienation (H2) and be more likely to self-report having a CSI (H3).

Method

Participants

Undergraduate students from a large public university in the South Central U.S. participated in the study for course credit in their introductory psychology class. Of the 439 participants recruited in both waves, we were left with a final sample size of 378 after removing duplicate responses by participants who went on to complete the study (n = 35), incomplete responses (n = 7), and decline to participate responses (n = 2). Further, participants who self-reported at the end of the study that their data were invalid (n = 15), had survey responses that did not match their pre-screen response of using a vape (n = 1), or experienced difficulties with the study programing (n = 1) also were excluded from the primary analyses (see Table 1 for final sample size demographic information).

Table 1.

Demographic characteristics of study participants (N = 378).

	No, does not vape (n = 307)	Yes, vapes (n = 71)
Variables	M (SD) or N	M (SD) or N
Age	18.85 (1.99)	19.10 (1.19)
Sex
Female	236	55
Male	69	16
Other	1	-
Prefer not to answer or missing	1	-
Ethnicity
Hispanic	86	17
Not Hispanic	220	54
Missing	1	-
Race
White	230	60
Asian	37	7
Indian	15	-
More than one race	3	-
Black or African American	8	-
Other	7	1
American Indian/Alaska Native	3	1
Native Hawaiian or Other Pacific Islander	2	-
Missing	2	2
CSI status^a
Yes	165	52
No	141	19
Missing	1	-
Vape quit intentions
Yes, within the next 30 days	-	25
Yes, within the next 6 months	-	11
Yes, within 1 year	-	17
Yes, within more than 1 year from now	-	12
No	-	4
Missing	-	2

Participants did not significantly differ on demographic variables (age, sex, ethnicity, and race).

CSI: concealable stigmatized identity.

Vape status × CSI status (χ²(1, N = 377) = 8.80, p = 0.003).

Procedure

The study was conducted in two recruitment waves during the middle of both waves’ respective academic semesters. The first wave (October 2023, n = 367) recruited participants via the psychology department’s student research participation website. After providing consent, participants completed randomized measures on state shame, depression, trait worry, self-alienation, concealable stigmatized identity, and self-esteem. They then responded to a vape use item; those who reported vaping completed additional measures on nicotine dependence, quitting intentions, and a vape use writing task. All participants provided demographic information, were debriefed, and earned course credit. Only 60 participants self-reported vaping.

To increase the number of participants who vape, a second recruitment wave (March–April 2024, n = 11) targeted individuals who had previously reported vaping in a department pre-screen. After consenting, they completed randomized measures on state shame, self-alienation, self-esteem, concealable stigmatized identity, trait worry, and depression. Vape use status was reconfirmed using the same measures from wave 1. Participants then provided demographic information, read a debriefing form, and received course credit. Across both waves, 71 participants reported vaping.

The current study received ethical approval from the university’s IRB. This study was not pre-registered; there was no pre-specified sample size as it was part of a larger study not reported here. However, all measures, data, and output files can be found on OSF.¹ Other measures were included but are not reported here.

Measures

Vape-specific measures

The Vape Use Item is a single-question screening tool developed by the research team to assess participants’ current vape use (“Do you engage in using e-cigarettes or vaping devices?”). Participants answered “Yes” or “No”; those who responded “Yes” completed additional vape-related measures, while those who responded “No” did not.

The Penn State Electronic Cigarette Dependence Index (PSECDI; Foulds et al., 2015) is a 10-item self-report measure assessing e-cigarette dependence, covering cravings, withdrawal symptoms, usage frequency, and quitting difficulty. Scores range from 0 to 20, with higher scores indicating greater dependence (0–3 = not dependent, 4–8 = low, 9–12 = medium, 13+ = high). The measure had adequate internal reliability based on the current study’s participant responses (α = 0.79).

The Vape Intention to Quit measure (Cuccia et al., 2021) is a single-item scale assessing vape quit intentions. Responses range from 0 (“No”) to 4 (“Yes, within 30 days”), with higher scores indicating a more immediate intention to quit.

The Vape Use Writing Task is an open-ended question developed to explore participants' personal experiences with vaping, including reasons for starting, thoughts before use, and motivations for continued use. Specifically, we prompted them with the following:

Please take a minute to think about your journey of using e-cigarettes/vapes. Take a few minutes to write about your thoughts and feelings around why you started vaping, what you think of leading up to using your vape, and any thoughts you have around why you continue to use your vape device today.

No further instructions were given, and participants could write as much, or as little, as they desired.

Beck depression inventory

Depression was assessed using the Beck Depression Inventory (Beck et al., 1961). This twenty-item inventory focuses on the behavioral manifestations, or symptoms, of depression. All items were rated on a scale from “0” to “3” with “0” representing no amounts of the symptom presented. One sample item includes the options “I do not feel like a failure,” “I feel I have failed more than the average person,” “As I look back on my life, all I can see is a lot of failures,” and “I feel I am a complete failure as a person.” This measure showed good internal reliability (α = 0.89).

Trait worry

Trait worry was assessed using a brief version of the Penn State Worry Questionnaire (Berle et al., 2011), which is a three-item self-report measure. Participants rated how typical or characteristic each item was for them on a five-point Likert scale (1 = Not at all typical of me, 5 = Very typical of me). Higher scores on this measure indicated greater trait worry. An example item was, “Once I start worrying, I can’t stop.” The measure demonstrated high internal reliability (α = 0.90).

State shame

The State Shame Subscale (Marschall et al., 1994) was a five-item self-report measure asking participants to rate each statement on a five-point Likert scale (1 = Not feeling this way at all, 5 = Feeling this way strongly). Higher scores represented greater levels of state shame. Sample items measuring shame included “I want to sink into the floor and disappear” and “I feel humiliated, disgraced.” The state shame items had high internal reliability (α = 0.88).

Self-alienation

Participants reported self-alienation using an authenticity scale (Wood et al., 2008), rating four items on a seven-point Likert scale (1 = Does not describe me at all, 7 = Describes me very well), with higher values indicating greater self-alienation. Example items included “I feel alienated from myself” and “I feel as if I don’t know myself very well.” The scale showed high internal reliability (α = 0.89).

Self-esteem

To measure self-esteem, participants were asked to rate 10-items (Rosenberg et al., 1995) on a 5-point Likert scale with higher scores representing greater feelings of self-esteem (1 = Strongly disagree, 5 = Strongly agree). Rated items included “I feel that I’m a person of worth,” or reverse coded items such as “I certainly feel useless at times.” This measure reported high internal reliability (α = 0.89).

Concealable stigmatized identity status

Participants were provided with a brief overview of various concealable stigmatized identities (CSIs), including examples such as mental illnesses (e.g. depression), sexual orientation (e.g. asexual, gay), and hidden medical conditions (e.g. diabetes, epilepsy), as adapted from prior research (Quinn and Chaudoir, 2009; see OSF for the full prompt).² After reading the overview, participants were asked to respond to the question: “Do you have a concealable identity similar to those listed above?” by selecting “Yes” or “No.”

Data preparation and analysis overview

Statistical analysis

A two-tailed Pearson correlation was first carried out among the PSECDI, state shame, trait worry, depression, self-alienation, and self-esteem scores. To test our first two hypotheses, we conducted multiple linear regressions, controlling for self-reported shame, worry, and depression. Vape use status was dummy-coded (0 = No, does not vape, 1 = Yes, vapes). The continuous outcome variables of interest were self-alienation and self-esteem. To test our third hypothesis, a logistic regression was carried out. The continuous variables of shame, worry, and depression were entered, followed by the dummy coded vape use status variable (0 = No, does not vape, 1 = Yes, vapes). The outcome variable was CSI status (0 = No, I do not have a CSI, 1 = Yes, I have a CSI). Significance of individual predictors in the regression models were conducted using Type III sum of squares with the significance threshold set to 0.05. All analyses were carried out in SPSS version 29.³

Written vape use experience coding

The research team (KMA and LN) used an inductive approach to identify common themes present in participants’ responses. The research team individually identified common themes, which were then readjusted and consolidated for the final coding process (see Fereday and Muir-Cochrane, 2006). This resulted in four larger themes: (1) reason for starting to vape, (2) thoughts leading up to vape use, (3) reason for continuing to vape, and (4) additional thoughts around their vape use (see Table 2 for full coding definitions and qualitative examples). The reason for starting vape use had five sub-themes: social influence, coping strategy, underestimated addiction possibility, other, and did not mention. The thoughts leading up to vape use had four sub-themes: automatic, reflective, other, and not mentioned. The reason for continuing to vape had six sub-themes: addiction/difficult to quit, social influence, coping strategy, liking buzz/taste/nicotine effect, other, and not mentioned. The additional thoughts around their vape use had three sub-themes: wants to stop, views as a healthy alternative, and not addicted/casual vape use.

Table 2.

Participants written statements about their own vape use experience (N = 60).

Themes	Coding definition	Example	Freq.
Reason for starting
Social influence	Response describes the individual initiating vape use due to social influence (direct, implied, imagined), including but not limited to friends, family members, close others, perceived “cool”-ness, social media, etc.	“I first started vaping because everyone around me was doing it in high school. It was a naive sense of pressure from others.”	34
Coping strategy	Response describes the individual initiating vape use due to wanting or needing a way to address or cope with other inter/intrapersonal states (e.g., anxiety, stress, family-related issues, etc.).	“I think I started to cope with anxiety.”	4
Underestimate addiction possibility	Response describes the individual initiating vape use due to initially thinking they would not become addicted to vape products.	-	0
Other	Response describes the individual initiating vape use due to some other reasons not listed here.	“I started vaping to quit dipping (chewing tobacco) . . .”	2
Multiple themes present	More than one sub-theme present.^a	“I started vaping because my friends were doing it and did not do it regularly, so I thought if I didn't own one I wouldn't be addicted.”	4
Not mentioned	Participant does not describe why they started using	-	16
Automatic	Response describes the individual not thinking of anything specifically leading up to using their vape, such as but not including, not thinking, vape use being habitual, etc.	“I don't crave or anything I just do it, couldn't tell you why.”	6
Reflective	Response describes the individual deliberately thinking or reflecting on thoughts leading up to using their vape, such as but not including, anticipating outcomes associated with vape use, reflecting on thoughts or other internal states, etc.	“Before I hit a vape I think about the buzz it will give me.”	5
Not mentioned	Participant does not describe why they started using.	-	49
Addiction/difficult to quit	Response describes the individual mentioning continuing to use their vape due to being addicted, dependent, habit forming, or otherwise finding it difficult to quit.	“I’d like to stop but it’s such a hard habit to break and I don’t know how to ask my parents for help without them being upset”	11
Social influence	Response describes the individual mentioning continuing to use their vape due to the social aspects (direct, implied, imagined) related to vape use, such as many people they are around still vape, feeling pressured to vape, using it at parties/bars/ “going out,” etc.	“i started because my friends were doing it and thats why i still do it”	14
Coping strategy	Response describes the individual mentioning continuing to use their vape due to wanting or needing a way to cope with other inter/intrapersonal states (e.g., anxiety, stress, family-related issues, etc.).	“I get stressed and then use my vape. I continue to use it for my anxiety or boredom.”	7
Liking buzz, taste, nicotine effect	Response describes the individual mentioning continuing to use their vape due to liking the effect of vaping (i.e., “buzz”), the flavors they use to vape, or any other physical liking component associated with vape use.	“I continued today because I like the buzz it gives me.”	5
Other	Response describes the individual mentioning continuing to use their vape due to other reasons not listed here.	“I continue to use it because I know that I am not addicted to it. if I don't have the free time to relax and do it, then I won't, and I am not bothered or irritable when I can't do it. I know that I can go without it.”	2
Multiple themes present	More than one sub-theme present.^a	“I think I have continued to use it today because I am not naive to the fact that it is addictive. I am addicted to it currently because of how it helps with my diagnosed anxiety. I do plan to quit before I graduate from college.”	8
Not mentioned	Participant does not describe why they continue to use vape.	-	13
Additional thoughts
Wants to stop	Response describes the individual mentioning wanting to stop or quit using vapes.	“I know I have formed an addiction, and I hope to be able to quit within the next year because I do not like something having such an impact on my life.”	13
Views as healthy alt.	Response describes the individual mentioning viewing vape use as a healthier alternative to something else they have or could be doing instead.	-	0
Not addicted/casual vape use	Response describes the individual mentioning they vape but are not addicted, dependent, or otherwise needing to vape in order to satisfy some urge or craving.	“I have not gotten addicted to the point where I need it or even look forward to it either. I believe it's just something I do as a social thing, and not really addiction in that way.”	18
Not mentioned	Participant does not describe any of the above sub-themes.	-	29

Freq.: frequency; Alt.: alternative.

Multiple Themes represents participants that mentioned more than one sub-theme (e.g. addicted to vape and using the vape as a coping mechanism). Raters indicated two or more categories based off the set codebook.

Three of the authors (MGP, SM, and NR) were trained to code the written responses using the finalized list of themes. The two coders with the highest level of agreement are reported (κ = 0.826; other coder pairings ranged from 0.772 to 0.780). A member of the research team (KMA) served as a tiebreaker, resolving any coding disagreements present.

Results

Descriptives

The average age of participants in the final sample was 18.90 (SD = 1.87), and a majority of participants self-reported as female (77.0%), White (76.7%), non-Hispanic (72.5%), and did not engage in vape use (81.2%; see Table 1). A majority of participants who vape reported having a CSI (73.2%), which is notably higher than those who do not vape who also reported a CSI (53.7%). Among participants who reported using a vape, many reported they were seriously planning to quit within the next 30 days (35.2%).

Correlations

In line with previous research, self-esteem was negatively associated with state shame, trait worry, and depression scores (see Table 3). Whereas self-alienation was positively associated with state shame, trait worry, and depression scores. Notably, increasing vape dependence, as captured by the PSECDI, was not significantly associated with any of the self-perception related constructs.

Table 3.

Correlations among variables of interest.

Variables	1.	2.	3.	4.	5.	6.
1. PSECDI^a	-
2. Shame	−0.03	-
3. Worry	−0.11	0.39*	-
4. Depression	0.15	0.71*	0.46*	-
5. Self-Alien.	0.01	0.61*	0.38*	0.63*	-
6. Self-Est.	−0.17	−0.65*	−0.41*	−0.67*	−0.64*	-
M (SD)	6.46 (4.52)	1.64 (0.85)	3.21 ^a(1.05)	9.93 (7.74)	3.12 (1.48)	3.62 (0.76)

PSECDI: Penn. State Electronic Cigarette Dependence Index; Self-Alien.: self-alienation; Self-Est.: self-esteem.

Only participants reporting vape use (n = 71) are reported for correlations among the PSECDI measure.

p < 0.001

Self-esteem and self-alienation outcomes

For ease of presentation, both linear regression results are presented in Table 4. Examining associations between the predictor variables and the outcome of self-esteem scores, the overall regression model was significant, F(4, 371) = 102.62, p < 0.001. When controlling for shame, worry, and depression, vape use was significantly associated with self-esteem (b = 0.15, p = 0.03). Suggesting that, in the presence of the covariates in the model, participants who vape have a higher average self-esteem score compared to those who do not vape. State shame (b = −0.31, p < 0.001), trait worry (b = −0.07, p = 0.03), and depression (b = −0.04, p < 0.001) scores were also significantly associated with self-esteem. While a significant difference between vape status groups emerged, it was not in line with our outlined hypothesis, thus the first hypothesis was not supported.

Table 4.

Linear regression results controlling for shame, worry, and depression.

Variables	R ²	b	T	SE	p	95% CI
Self-esteem as outcome	0.53
State shame		−0.31	−6.86	0.05	<0.001	−0.40, −0.22
Trait worry		−0.07	−2.25	0.03	0.03	−0.12, −0.01
Depression		−0.04	−7.2^a5	0.01	<0.001	−0.05, −0.03
Vape use		0.15	2.20	0.07	0.03	0.02, 0.29
Self-alienation as outcome	0.46
State shame		0.54	5.67	0.10	<0.001	0.35, 0.73
Trait worry		0.12	2.00	0.06	0.046	0.002, 0.24
Depression		0.07	6.73	0.01	<0.001	0.05, 0.10
Vape use^a		−0.28	−1.91	0.15	0.06	−0.57, 0.008

Vape use (0 = no, does not vape; 1 = yes, vapes).

The second linear regression model examined associations between the outcome of self-alienation and the variables of state shame, trait worry, depression scores, and vape use status. The overall regression model was significant, F(4, 373) = 79.80, p < 0.001. When controlling for shame, worry, and depression, vape use was marginally associated with self-alienation (b = −0.28, p = 0.06). Suggesting that, in the presence of the covariates in the model, participants who vape reported a marginally lower average self-alienation score compared to participants who do not vape. State shame (b = 0.54, p < 0.001), trait worry (b = 0.12, p = 0.046), and depression (b = 0.07, p < 0.001) scores were also significantly associated with self-alienation. The results for self-alienation were not in line with the proposed second hypothesis.

Concealable stigmatized identity outcome

When controlling for shame, worry, and depression, participants who vape were significantly more likely to self-report having a CSI (OR = 2.07, p = 0.02) compared to those who do not vape (Table 5). There was also a significant association between depression scores and self-reporting a CSI (OR = 1.07, p = 0.003), such that increasing depression was associated with an increased likelihood of having a CSI. Thus, the third hypothesis was supported.

Table 5.

Logistic regression predicting presence of participant concealable stigmatized identity.

				95% CI
Variables	Odds ratio	SE	p-value	LL	UL
State shame	1.02	0.19	0.90	0.71	1.48
Trait worry	1.01	0.12	0.92	0.80	1.27
Depression	1.07	0.02	0.003	1.02	1.12
Vape use^a	2.07	0.30	0.02	1.15	3.74
Constant	0.60	0.38	0.17	-	-

Vape use (0 = no, does not vape, 1 = yes, vapes).

Vape use experience

Reasons for starting using a vape

Out of the 71 participants that indicated using a vape, only 60 participants responded to the writing prompt. Of the participants with written responses about why they started vaping (44 out of 60 participants), the most common themes identified were social influence (n = 34), using vapes as a coping strategy (n = 4), indicating multiple sub-themes for initiation (n = 4), and other reasons (n = 2).

Thoughts leading up to vape use

A majority of participants did not address what they think of leading up to their vape use (n = 49). Of the 11 participants with a response, over half mentioned the lead up to their vape use as being more automatic or habitual (n = 6), whereas the remaining participants mentioned engaging in more intentional or reflective thoughts prior to their vape use (n = 5).

Reasons for continuing to use a vape

Of the participants with written responses about their reasons for continuing to vape (47 out of 60 participants), a majority of participants mentioned continuing to use a vape due to social influences (n = 14), followed by feeling addicted or finding it difficult to quit (n = 11), indicating multiple sub-themes for their reasons (n = 8), using the vape as a coping mechanism (n = 7), liking the effect of vaping (n = 5), and other reasons (n = 2).

Additional thoughts around vape use

Of the participants with a written response, many provided additional thoughts that went beyond the writing prompt (31 out of 60 participants). Some participants mentioned casual vape use or described not being addicted to vapes (n = 18), followed by wanting to quit at some point in the future (n = 13).

Discussion

Vape products can be a successful tool for helping individuals quit smoking (Ashour, 2023). However, their use among young people continues to remain a concern due to their addictive nature and limited understanding of long-term effects. In this study, we aimed to provide new information regarding how self-perceptions may differ for those who vape compared to those who do not. Although limited to a U.S. college-aged sample, the current study’s results are at odds with some of our initial hypotheses. The third hypothesis was supported, in that those who use vapes were significantly more likely to report having a CSI compared to those who do not vape. However, the remaining hypotheses did not find support, which will be further discussed.

We found that participants who vape, compared to participants who do not vape, reported higher self-esteem and marginally lower self-alienation. These results may be reflective of the common themes noted in the written responses, as many participants mentioned social reasons for starting to vape and continuing to vape. Although coping also came up in participant responses, it should be noted that this was not the most frequently occurring theme. Our findings support prior work suggesting the significant role of peers and social groups underlying vape use (Tran et al., 2024). Given that most of the participants engaging in vape use in the current study did so for social reasons or in social settings, paired with the somewhat low dependence scores reported, it is not surprising that a difference emerged between vape use status counter to our initial hypotheses.

The current study’s results are at odds with previous research that found no differences in self-esteem between high school students who do and do not vape (Jha and Kraguljac, 2021). It may be that the social dynamics surrounding vape use may foster feelings of inclusion within social circles, impacting both self-esteem and self-alienation. According to the Sociometer Hypothesis (Leary et al., 1995), self-esteem functions as a gage of social inclusion, motivating individuals to act in ways that reduce the risk of exclusion. Those who vape may remain engaged in these social circles to maintain their sense of belonging and protect their self-esteem. In the context of self-alienation, relational self theories emphasize the pivotal role others play in shaping our self-concept, both conceptually and motivationally (Andersen et al., 1997; Andersen and Chen, 2002). Our social relationships are essential to understanding who we are, and in a bidirectional relationship, a clear sense of self also enhances the quality of interpersonal relationships (Tenney et al., 2013). Thus, if participants in the current study reported vaping for social reasons, the social nature of using a vape may contribute to their perceptions of themselves via belonging and social relationships.

Lastly, the current study found support that participants who vape were significantly more likely to report having a CSI compared to participants who do not vape. Although the rates of CSIs reported can fluctuate based upon the assessment and sample used, the rates noted in the current study (52 out of 71 for participants who vape) is a much higher rate than has been seen in previous studies (Needy et al., 2025; McNeil, 2000). While this could be a function of participants either viewing their vape use as a CSI, and thus more likely to report this, it could be that those with CSIs (e.g. mental illness, sexual minority, etc.) are potentially using vapes, and the social community around vape use, as a way to mitigate stressors associated with their CSI. This has been previously proposed and has similar support from the study’s qualitative responses (see Talley and Littlefield, 2014).

Clinical significance and future directions

Our findings highlight the need for vape-specific interventions that address key features of a person’s self-concept. Cessation interventions will need to foster more adaptive identities to facilitate long-term behavior change (Berg et al., 2021; Lindgren et al., 2017). Among young people, this is particularly important given that social influences play a key role in vaping, especially within peer groups that reinforce vaping as a source of belonging (Wallace and Roche, 2018).

Embracing self-ambiguity during cessation may help individuals redefine their identity beyond vaping (McConnell and Golova, 2023). Rather than alienating past vape use, promoting self-compassion and integration into a positive self-narrative could enhance long-term success (Snoek, 2023). Research on combustible cigarette use suggests self-concept shifts mediate the relationship between nicotine dependence and abstinence (Falomir-Pichastor et al., 2020), supporting the idea that interventions targeting self-concept in relation to social relationships could be effective. Strategies such as exploring possible selves (Oyserman et al., 2004), self-affirmation (Epton et al., 2015), or self-compassion interventions (Kelly et al., 2010) could encourage self-insight and openness to change for those who use vapes.

Social support is also critical for cessation efforts (Tran et al., 2023). Among marginalized youth, lower social connection is significantly associated with increased vaping for stress management (Donaldson et al., 2022). Addressing vaping as a means of social connection may be relevant for those with marginalized identities who rely on it for connection and support.

Limitations

Our findings are constrained by the WEIRD (Western, Educated, Industrialized, Rich, and Democratic) cultural context and are not generalizable beyond young adults attending college in the United States (Henrich et al., 2010). This limitation raises important questions about how our findings might manifest in populations with different demographic backgrounds and life experiences. Another limitation is the small sample size of participants who vape in the current study. While the research team attempted to increase this with an additional wave of recruitment, it does limit the comparisons that could be made had there been a larger sample. Due to the correlational nature of the current study, the results are limited in determining causality or how patterns in the outcomes may shift across time. Lastly, the results are limited in generalizability due to the low levels of dependence reported for participants who vape in the sample.

Conclusion

The current study provides novel insights into the intersection of vape use and self-perceptions among young adults. While our findings did not support the direction of two of our initial hypotheses, they highlight the role that social influences play in shaping vape use experiences. Indeed, vaping may foster belonging and identity, rather than merely serving as a coping mechanism for distress. Additionally, the strong association between vape use and CSIs underscores the need for further research into the psychosocial factors that drive vaping behavior, particularly among marginalized populations. Given the increasing need for vape-specific interventions, future efforts should consider how self-perceptions and social belonging interact in shaping individuals' vaping behaviors.

Supplemental Material

sj-docx-1-hpq-10.1177_13591053251397696 – Supplemental material for Examining self-perceptions between college students who do and do not vape: an online cross-sectional study

Supplemental material, sj-docx-1-hpq-10.1177_13591053251397696 for Examining self-perceptions between college students who do and do not vape: an online cross-sectional study by Kianna M. Arthur, Lydia Needy, Morgan G. Peace, Summer Moser and Natalie Rodriquez in Journal of Health Psychology

Footnotes

ORCID iDs

Kianna M. Arthur

Lydia Needy

Summer Moser

Ethical considerations

The Institutional Review Board at Texas A&M University approved the study (approval: 2023-0221M; 2024-0416) on September 29, 2023; March 25, 2024.

Consent to participate

Respondents indicated agreement, by selecting “I agree,” on the electronic informed consent form before completing study measures.

Consent for publication

Consent for publication is not applicable. Data reported are deidentified and not linked to individual participants.

Author contributions

KMA and LN designed the survey. LN was responsible for data curation and provided study supervision. KMA and LN drafted and wrote the manuscript with support from MGP, SM, and NR. MGP, SM, and NR provided input on qualitative coding and carried out the thematic coding of study data. All authors reviewed and edited the manuscript. All authors have provided approval for the final version.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data availability statement

All project measures, stimuli, data, and analyses can be found at .

Supplemental material

Supplemental material for this article is available online.

Notes

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