National Youth tobacco surveys (2014-2019) show increasing beliefs in the harm and relative addiction of e-cigarettes but decreasing associations between those beliefs and e-cigarette use.

Introduction:
This text discusses a study that aimed to evaluate the potential efficacy of increasing harm and relative addiction beliefs in discouraging e-cigarette use among adolescents. The study analyzed data from the National Youth Tobacco Survey (NYTS) from 2014-2019 to determine how adolescents' beliefs about e-cigarettes have changed over time and how well these beliefs predict ever use, current use, and susceptibility to use.

Key Points:

* The study found that e-cigarette harm and relative addiction beliefs tended to increase over time.
* In most years, these beliefs were negatively associated with e-cigarette use, including ever use, current use, and susceptibility to use.
* Interactions between these beliefs were also observed in some years such that harm belief better predicted use when e-cigarettes were also perceived as more addictive.
* however, the predictive validity of these beliefs for e-cigarette use decreased over time.
* The study also found that many adolescents have low perceived harm and addictiveness of e-cigarettes.
* Both health harm and relative addiction messages independently discourage e-cigarette use and vaping.
* a synergistic relationship between different elements of risk appraisals on intentions and behavior was observed.

Main Message:
The study suggests that while beliefs about e-cigarette harm and relative addiction have increased over time and predict use of, and susceptibility to, e-cigarettes among US adolescents, the predictive validity of these beliefs has decreased over time. This highlights the need for future research to explore the reasons for the decreased predictive validity of health beliefs in e-cigarette use and identify constructs that predict adolescent e-cigarette use over and above general harm and relative addiction beliefs. Public health campaigns seeking to discourage e-cigarette use should consider targeting these constructs to effectively inform adolescent e-cigarette prevention messages and campaigns.

Ma h, Gaudiello E, Sheeran P, Sanzo N, Sutfin EL, Noar SM. National Youth tobacco surveys (2014-2019) show increasing beliefs in the harm and relative addiction of e-cigarettes but decreasing associations between those beliefs and e-cigarette use. addictive behaviors. 2023;144:107713. doi:10.1016/j.addbeh.2023.107713