Editor’s note: In today’s post, we highlight a few recent dissertations on drug use among college students and its regulation by authorities. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.
E-Cigarette Adoption and Use Intention Among College Students: Determinants and Warning Label Effects
Author: Lee, Hsiao-Yun
Abstract: The electronic nicotine delivery system (also known as the e-cigarette) is a recently-invented battery-operated device that mimics smoking by delivering nicotine without burning tobacco. Without governmental regulation, the e-cigarette has been heavily promoted in the United States (US) and have aroused a vigorous debate over its health effects. Supporters believe that the e-cigarette is a safer alternative for smokers because it does not contain toxicants such as tar and carbon monoxide, while opponents are concerned that e-cigarettes will re-normalize smoking behavior and may serve as a gateway to traditional cigarettes. According to a national report, the percentage of use of non-traditional tobacco products is increasing among college students, implying that more college students are at risk of being addicted to nicotine. Previous studies also show that this age group has the highest rate of ever-use e-cigarettes, indicating an urgent need to investigate college students’ e-cigarette use. Because e-cigarettes are not currently regulated by the US Food and Drug Administration (FDA), manufacturers are not obligated to include warning labels on their packages. Nevertheless, some e-cigarette companies have created their own warning labels without examining their effects. This study consists of two sub-studies. Sub-study 1 investigated college students’ e-cigarette use by examining differences in characteristics at different e-cigarette adoption levels based on the Diffusion of Innovation Theory. Sub-study 2 aimed to investigate the effect of e-cigarette warning labels on college students’ intention to use e-cigarettes by examining two warning labels, one generated by the FDA and one by e-cigarette companies. A total of 1,198 undergraduate college students at a Midwestern university, aged eighteen to twenty-five, were surveyed in September and October 2015. Multinomial logistic regression and Heckman two-step selection procedures were conducted to examine the influence of determinants on levels of e-cigarette adoption and transition. Structural equation modeling analyses were implemented to examine the effect of warning labels on college students’ intention to use e-cigarettes. The findings of this study show that e-cigarette users are more likely to be current substance users and that flavor is a strong factor inducing college students to use e-cigarettes. Rather than seeking to reduce stress, college students use e-cigarettes for positive sensory experiences and care more about their appearance than their health. Regarding warning label effects, the warning label proposed by the FDA was found to reduce college students’ intention to use e-cigarettes via increasing their perceived risk of e-cigarette use. The FDA warning is more effective than the warning label created by e-cigarette companies. The resultant findings not only could be used as references for future e-cigarette regulations and interventions, but also could serve as direct evidence for establishing future mandates, including the regulations of label content and design.