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

Introduction:
This article discusses a study examining the associations between perceptions of costs and benefits of e-cigarette use, peer use, self-efficacy to resist using, and self-reported use of e-cigarettes in a sample of adolescents. The study aimed to understand how peer use influences harm and benefit perceptions and self-efficacy to resist using among adolescents.

Key Points:

* The study used the theory of reasoned action as a framework, which posits that behavioral intention can be understood in terms of social norms, attitudes toward a behavior, and perceived control over the outcome of a behavior.
* The sample included 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.
* The study estimated a series of mediation models using the MODEL INDIRECT command in MPLUS statistical software to test the significance of indirect effects from peer e-cigarette use to self-reported e-cigarette use via expected costs, benefits of e-cigarette use, and self-efficacy to refrain from e-cigarette use.
* 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.
* 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.

Main Message:
The study found that 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 among adolescents. The findings highlight the importance of addressing social norms and perceptions of e-cigarette use in prevention efforts.

Durkin K, Williford DN, Turiano NA, et al. Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use. Journal of pediatric psychology. 2021;46(1):112-122. doi:10.1093/jpepsy/jsaa097